Pituitary carcinoma: Difference between revisions
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==Risk Factors== | ==Risk Factors== | ||
*Common known risk factors in the development of pituitary carcinoma are : | *Common known risk factors in the development of pituitary carcinoma are<ref name="urlPituitary Gland Tumor: Risk Factors | Cancer.Net">{{cite web |url=https://www.cancer.net/cancer-types/pituitary-gland-tumor/risk-factors |title=Pituitary Gland Tumor: Risk Factors | Cancer.Net |format= |work= |accessdate=}}</ref> : | ||
# '''Multiple endocrine neoplasia type 1 (MEN1).''' | # '''Multiple endocrine neoplasia type 1 (MEN1).''' | ||
Revision as of 19:05, 27 September 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]
Overview
Historical Perspective
- pituitary carcinoma was first discovered by Pierre Marie, a French neurologist (Salpetriere Hospital, Paris) in 1886 following his studying in2 patients with clinical findings of what he termed acromegaly and postulated that the pituitary gland was involved in the pathogenesis.[1]
- The history of pituitary tumor biology is rich. A recent DNA examination from the teeth of an Irish patient with gigantism (7 ft, 7 in in height), who lived from 1761 to 1783 and was housed at the Hunterian Museum in London, revealed the same mutation in the AIP gene (c.910 C- T mutation) present in 4 families with pituitary tumors from Northern Ireland. This patient shared common haplotypes with the recent families studied.[1]
Classification
- Pituitary carcinoma may be classified according to the type of cells involved into following subtypes:[2][3]
- Corticotroph carcinoma
- Prolactin-secreting carcinomas
- Gonadotroph carcinomas
- Growth hormone–secreting carcinoma
Pathophysiology
- Several possible causes have been proposed for pathogenesis of Pituitary carcinoma.[4]The pathogenesis of pituitary carcinoma is characterized by :
- consequence of pervious irradiation in a treatment of a pituitary carcinoma
- microscopic tumor seeding from a pervious Pituitary surgery
- malignant progression of a Pituitary carcinoma
- denovo carcinoma
- The [gene name] gene/Mutation in [gene name] has been associated with the development of [disease name], involving the [molecular pathway] pathway.
- On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of pituitary carcinoma
- On microscopic histopathological analysis, hypochromatasia, [feature2], and [feature3] are characteristic findings of pituitary carcinoma[5]
Associated Conditions
Differentiating pituitary carcinoma from other Diseases
- pituitary carcinoma must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
- [Differential dx1]
- [Differential dx2]
- [Differential dx3]
Epidemiology and Demographics
- The prevalence of pituitary carcinoma is very rare as it accounts for 0.1-0.2% of all pituitary tumors and approximately 4616 individuals worldwide and 207 in US.[5][6]
- In [year], the incidence of pituitary carcinoma was estimated to be [number or range] cases per 100,000 individuals in [location].
Age
- Patients of all age groups may develop pituitary carcinoma.
- Pituitary carcinoma is more commonly observed among those in third or fifth decade of life.[7]
Gender
- Pituitary carcinoma affects men and women equally.[5]
Race
- There is no racial predilection for pituitary carcinoma
- pituitary carcinoma usually affects individuals of the [race 1] race.
- [Race 2] individuals are less likely to develop pituitary carcinoma
Risk Factors
- Common known risk factors in the development of pituitary carcinoma are[8] :
- Multiple endocrine neoplasia type 1 (MEN1).
- Families with MEN1 have an increased risk of pituitary gland tumors.
- Carney complex. Like MEN1, the Carney complex is a rare genetic condition that can increase the risk of a pituitary gland tumor.
- Familial acromegaly. Acromegaly is a condition in adults that is caused by too much growth hormone. Familial acromegaly can occur as part of MEN1, described above, or alone within a family.
Natural History, Complications and Prognosis
- The majority of patients with pituitary carcinoma remain asymptomatic or latent from a few months to 18 years depending upon the subtype.[5]
- If left untreated, [#%] of patients with pituitary carcinoma may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
- Common complications of pituitary carcinoma include [complication 1], [complication 2], and [complication 3].
- Prognosis is generally [excellent/good/poor], and the [1/5/10year mortality/survival rate] of patients with pituitary carcinoma is approximately [#%].
Diagnosis
Diagnostic Criteria
- The diagnosis of pituitary carcinoma is made when at least [number] of the following [number] diagnostic criteria are met:
- [criterion 1]
- [criterion 2]
Symptoms
- Pituitary carcinoma is usually manifested as:[9]
Physical Examination
- Patients with pituitary carcinoma usually appear [general appearance].
- Physical examination may be remarkable for:
- [finding 1]
Laboratory Findings
- There are no specific laboratory findings associated with pituitary carcinoma
- A [positive/negative] [test name] is diagnostic of pituitary carcinoma
- An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of pituitary carcinoma
- Other laboratory findings consistent with the diagnosis of pituitary carcinoma include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
Imaging Findings
- There are no [imaging study] findings associated with pituitary carcinoma
- [Imaging study 1] is the imaging modality of choice for pituitary carcinoma
- On [imaging study 1], pituitary carcinoma is characterized by [finding 1], [finding 2], and [finding 3].
- [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
- pituitary carcinoma may also be diagnosed using [diagnostic study name].
- Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
Treatment
Medical Therapy
- There is no treatment for [disease name]; the mainstay of therapy is supportive care.
- The mainstay of therapy for pituitary carcinoma is [medical therapy 1] and [medical therapy 2].
- [Medical therapy 1] acts by [mechanism of action 1].
- Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
Surgery
- Surgery is the mainstay of therapy for pituitary carcinoma
- [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of pituitary carcinoma
- [Surgical procedure] can only be performed for patients with [disease stage] pituitary carcinoma
Prevention
- There are no primary preventive measures available for pituitary carcinoma
References
- ↑ 1.0 1.1 "Pituitary Tumors: Background, Pathophysiology, Epidemiology".
- ↑ Ragel BT, Couldwell WT (April 2004). "Pituitary carcinoma: a review of the literature". Neurosurg Focus. 16 (4): E7. PMID 15191336.
- ↑ Scheithauer BW, Kovacs KT, Laws ER, Randall RV (December 1986). "Pathology of invasive pituitary tumors with special reference to functional classification". J. Neurosurg. 65 (6): 733–44. doi:10.3171/jns.1986.65.6.0733. PMID 3095506.
- ↑ "Pituitary carcinoma: a review of the literature in: Neurosurgical Focus Volume 16 Issue 4 (2004)".
- ↑ 5.0 5.1 5.2 5.3 5.4 Pernicone PJ, Scheithauer BW, Sebo TJ, Kovacs KT, Horvath E, Young WF, Lloyd RV, Davis DH, Guthrie BL, Schoene WC (February 1997). "Pituitary carcinoma: a clinicopathologic study of 15 cases". Cancer. 79 (4): 804–12. PMID 9024719.
- ↑ Daly AF, Tichomirowa MA, Beckers A (October 2009). "The epidemiology and genetics of pituitary adenomas". Best Pract. Res. Clin. Endocrinol. Metab. 23 (5): 543–54. doi:10.1016/j.beem.2009.05.008. PMID 19945022.
- ↑ Kontogeorgos G (October 2005). "Classification and pathology of pituitary tumors". Endocrine. 28 (1): 27–35. doi:10.1385/ENDO:28:1:027. PMID 16311407.
- ↑ "Pituitary Gland Tumor: Risk Factors | Cancer.Net".
- ↑ Scheithauer BW, Jaap AJ, Horvath E, Kovacs K, Lloyd RV, Meyer FB, Laws ER, Young WF (September 2000). "Clinically silent corticotroph tumors of the pituitary gland". Neurosurgery. 47 (3): 723–9, discussion 729–30. doi:10.1097/00006123-200009000-00039. PMID 10981760.