Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0598934 (tumor growth)
 58,965 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Therapy with 910 MeV alpha particles provides a treatment with no mortality and an extremely low morbidity and has been highly successful in the control of pituitary hormone hypersecretion and tumor growth. It is possible to deliver radiation doses to the pituitary gland that are sufficiently high to inhibit or destroy the tumor cells that cause abnormal secretory activity without damaging the surrounding structures. The data demonstrate the effectiveness of this form of treatment in acromegaly, non-functioning pituitary tumors, prolactin secreting adenomas, Cushing's disease and Nelson's syndrome.
 ...
PMID:Heavy particle therapy: pituitary tumors. 22 2

Nelson's syndrome is generally regarded as an unusual sequela of primary bilateral adrenalectomy when performed for Cushing's disease. It is classically defined by cutaneous hyperpigmentation, considerably elevated adrenocorticotropic hormone (ACTH) levels, and an enlarged sella turcica. In this report, we present three cases initially treated by transsphenoidal sellar exploration for Cushing's disease. In two of these cases, remission of hypercortisolism did not occur after the initial pituitary exploration. A microadenomectomy was performed in one case and, in the other, no microadenoma was found. In both, Nelson's syndrome occurred after adrenalectomy. A second transsphenoidal operation and radiotherapy were required to control tumor growth. In another case, transsphenoidal adenomectomy of an ACTH-secreting tumor initially led to a remission of hypercortisolism for 4 years, but recurrent Cushing's disease necessitated adrenalectomy, and again Nelson's syndrome occurred. The documentation of a pre-existing ACTH-secreting basophilic pituitary microadenoma before adrenalectomy, as seen in two of our cases, has not been previously reported, and these observations of "non-classical" courses have major implications for the pathophysiology of Nelson's syndrome.
 ...
PMID:Observations on the pathophysiology of Nelson's syndrome: a report of three cases. 217 67

The paper is devoted to the use of a new method of nuclear magnetic resonance tomography (MR tomography) in the diagnosis of diseases of the adrenal glands developing with the syndrome of total and partial hypercorticism. A MR tomograph with resistive magnet (0.234 T) was employed. Altogether 25 patients were examined (21 with Itsenko-Cushing disease of various degrees of severity, 2 patients with Itsenko-Cushing syndrome and 2 patients with aldosteronoma). MR tomography was shown to possess a high informative value permitting the assessment of a type of adrenal changes without irradiation of a patient. In combination with routine methods of examination (hormonal investigation, retropneumoperitoneum, x-ray computerized tomography) MR tomography makes it possible to improve considerably the diagnosis of Itsenko-Cushing disease and to specify tumor sizes and tumor growth type.
 ...
PMID:[Magnetic resonance tomography of the adrenals in the diagnosis of total and partial hypercorticism]. 255 15

The paper is concerned with the use of a new tomographic method based on the principle of nuclear magnetic resonance (NMR-tomography) in the diagnosis of adenohypophyseal diseases. A NMR-tomograph with a resistive magnet (0.234 T) was employed. Altogether 15 patients with the most common types of hypothalamo-hypophyseal diseases including Itsenko-Cushing disease (6) of various degrees of severity, hyperprolactinemic hypogonadism (8), and one patient with acromegaly were investigated. NMR-tomography was shown to possess a high informative value permitting assessment of the presence of adenohypophyseal pathology without irradiation of a patient. NMR-tomography combined with routine methods of examination of patients with hypothalamohypophyseal pathology (roentgenography, computerized tomography, hormonal investigation) made it possible to improve considerably early diagnosis of pituitary adenomas and to specify the volume and type of tumor growth.
 ...
PMID:[The use of nuclear magnetic resonance in the diagnosis of hypophyseal adenomas (preliminary report)]. 260 49

Pituitary adenomas may produce local endocrine and neurological effects, as well as systemic metabolic complications due to hormonal hypersecretion. Medical therapy with pharmacological agents has been developed and is based on the neurotransmitter regulation of normal pituitary hormonal secretion. 189 patients with secretory pituitary adenomas underwent medical therapy for the hypersecretory state. 156 of these were prolactin-secreting adenomas, 16 of which were in males. The response of bromocriptine was almost universal with lowering of serum prolactin and reversal of the clinical symptoms, as well as tumor shrinkage of most large adenomas with suprasellar extension. 23 patients with acromegaly were treated with bromocriptine, with 11 noting clinical improvement, and decreased tumor size in two. Five patients with Cushing's disease were treated with cyproheptadine, with only one showing a biochemical and clinical improvement. Two patients with Nelson's syndrome each had progressive tumor growth stabilized with cyproheptadine and bromocriptine in one, and sodium valproate in the other. There appears to be a role for medical therapy in the majority of prolactin-secreting pituitary tumors, some growth hormone secreting pituitary tumors, and selected adrenocorticotropin secreting-pituitary tumors.
 ...
PMID:The medical treatment of the hypersecreting pituitary gland. 299 35

The immunohistological detection of a proliferation-associated nuclear antigen by the monoclonal antibody Ki-67 allows the determination of the growth fraction in human cell populations. In this study, biopsy specimens of 31 pituitary adenomas representing all major endocrine types were examined. All adenomas contained proliferating cells and the percentage of nuclei that were immunoreactive to Ki-67 ranged from 0.1% to 3.7%. Low values (0.1% to 1.0%) were present in 11 endocrine-inactive adenomas and higher values (1.1% to 1.5%) were found in six acromegalic patients. The percentages of Ki-67-positive cells in 12 prolactinomas and two adenomas from patients with Cushing's disease covered the entire range (0.1% to 3.7%). Preoperative bromocriptine treatment of prolactinomas did not influence Ki-67 expression. Invasive adenomas, as determined by preoperative computerized tomography, surgical observation, and histological examination of the sella dura demonstrated significantly higher Ki-67 values (average 1.15%) than noninvasive adenomas (average 0.60%). Determination of the incidence of proliferating cells by Ki-67 immunoreactivity represents a new tool for intraoperative quantitative assessment of tumor growth characteristics and may aid in the planning of adjuvant therapy and estimation of prognosis.
 ...
PMID:Growth rate of human pituitary adenomas. 368 19

To determine the endocrine, ophthalmologic, and tumor growth control responses after stereotactic radiosurgery using the gamma unit, we reviewed our experience in 35 patients with pituitary adenomas. Twenty-four females and 11 males (mean age 47 years, range 9-81 years) had radiosurgery with average follow-up of 26 months (range 6-60 months). Most patients were refractory to surgical removal. Fifteen patients had Cushing's disease. Prior transsphenoidal resection was performed in 14 patients (6 had two prior operations), fractionated radiotherapy in 3, and adrenalectomy in 2. In 11 evaluable patients, the hormone response was normalized in 8, decreased in 2 and increased in 1. Five patients remained on cortisol suppression. Of 12 patients with imaging follow-up, 4 had decreased tumor size, 6 had no change, and 2 had an increase; these 2 patients underwent subsequent surgery. Ten patients had acromegaly, and 6 had undergone prior surgery. Of 8 evaluable patients, growth hormone secretion has normalized in 3, decreased in 3, and increased in 2. Six tumors decreased in size, and 2 were unchanged. One patient had repeat resection 21 months after radiosurgery and one patient underwent repeat radiosurgery. Ten patients had non-secreting adenomas; all 10 had prior operations (1-4 operations, 6 underwent frontal craniotomy) and 5 had undergone fractionated radiotherapy. Eight patients had panhypopituitarism prior to radiosurgery. Four tumors decreased in size and 6 were without change.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Stereotactic radiosurgery for pituitary adenomas: imaging, visual and endocrine results. 771 32

Immunohistochemical expression of the three major isozymes of protein kinase C--Types I, II, and III--was studied in 32 cases of human pituitary adenomas, and the results were compared in detail with their clinical data. Immunoreactivity for the Type I and Type II isozymes was negative in tumor cells of all pituitary adenomas. Moderate to strong cytoplasmic immunoreactivity for the Type III isozyme was constantly seen in acromegaly, Cushing's disease, and nonfunctioning adenomas, which indicated overexpression of the isozyme, since only slight cytoplasmic immunoreactivity was observed in the normal human anterior pituitary cells. Among 13 prolactinomas, 5 cases showed positive immunoreactivity for Type III in all tumor cells, whereas 8 cases showed negative immunoreactivity for the isozyme in all or more than 85% of tumor cells. The sizes of the tumors in this protein kinase C Type III negative group of prolactinomas tended to be smaller than those of the Type III positive prolactinomas. Also, the negative immunoreactivity for Type III was predominantly observed in those cases where prolactinomas were relatively well controlled by continuous oral dosage of dopamine agonists before operation. These results suggest that protein kinase C Type III is closely involved in human pituitary adenomas. The exceptional negativity for the isozyme in prolactinomas may be relevant to the suppression of tumor growth by dopamine agonists.
 ...
PMID:Immunohistochemical expression of protein kinase C type III in human pituitary adenomas. 809 3

The development of efficacious surgical and medical therapies for pituitary adenomas as well as the improvement of hormone therapy for ovulation induction has made pregnancy possible for women harboring pituitary tumors. However, gestational risks due to the possibility of tumor growth during pregnancy, mainly in women with macroadenomas, raise a concern. Bromocriptine has a well-established role for prolactinoma treatment before and during pregnancy, even when a symptomatic tumor increase occurs. It can also be used in acromegaly, despite its poorer results. Somatostatin analogs have been used in acromegaly even during pregnancy with uneventful outcomes, but their safety in pregnancy is not well established, yet. The largest experience with medical treatment for Cushing's disease during pregnancy involves metyrapone, a steroidogenesis inhibitor, without descriptions of congenital abnormalities. Concerning clinically non-functioning pituitary tumors, ovulation induction or even in vitro fertilization are frequently needed. The purpose of this review is to provide an update on therapeutic strategies to restore fertility as well as gestational and post-gestational management of patients with pituitary adenomas, focusing mainly on the role of medical treatment for different tumor types.
 ...
PMID:Medical management of pituitary adenomas: the special case of management of the pregnant woman. 1267 7

Medical therapy with a dopamine agonist is the most effective for treatment of a prolactin-producing adenoma and is considered as primary treatment. Surgery and pituitary radiation are reserved for patients who either do not tolerate or do not respond to a dopamine agonist drug. A somatostatin analogue is effective medical therapy for patients with acromegaly, and this is usually administered if there is persistent GH hypersecretion after surgical resection. Medical treatment for patients with Cushing's disease is directed at the adrenal glands to reduce cortisol hypersecretion. Unfortunately, there is no effective medical therapy to reduce pituitary corticotropin production. Medical therapy for a gonadotrope adenoma with a dopamine agonist or somatostatin analogue has limited utility but is employed in patients who are unable to undergo surgery and may delay or prevent additional tumor growth. Many patients with a pituitary adenoma can be successfully treated with one treatment, either a dopamine agonist for a prolactinoma or surgery for other types of tumors. A substantial number of patients require multimodality therapy, however, including medical therapy, surgery, and pituitary radiation. Because the biologic behavior of pituitary adenomas varies considerably, a patient with a pituitary adenoma requires lifelong regular monitoring for hormone hypersecretion, tumor recurrence, and development of new pituitary hormone deficiency. A coordinated plan of care among endocrinologists, neurosurgeons, neuroophthalmologists, and radiation therapists is necessary to provide optimal care for these patients.
 ...
PMID:Medical treatment of functional pituitary tumors. 1269 Sep 80


1 2 3 4 Next >>