Clinical profile of silent growth hormone pituitary adenomas; higher recurrence rate compared to silent gonadotroph pituitary tumors, a large single center experience

Fabienne Langlois, Dawn Shao Ting Lim, Elena Varlamov, Christine (Chris) Yedinak, Justin Cetas, Shirley McCartney, Aclan Dogan, Maria Fleseriu

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: Study and comparison of characteristics of silent growth hormone adenomas (SGHA), silent corticotroph adenomas (SCA), and silent gonadotroph adenomas (SGA) in a single institution cohort of surgically treated pituitary adenomas. Methods: Retrospective analysis of SGHA surgically resected over 10 years: SGHA was defined as no clinical or biochemical evidence of acromegaly and positive GH immunostaining. Results: Of 814 pituitary surgeries; 2.1% (n = 17) were SGHA, 4.5% (n = 37) SCA, and 18.9% (n = 70/371; 2011–2016) SGA. Mean age at SGHA diagnosis was 43 years, with a large female predominance (82%). Mean tumor size and cavernous/sphenoid sinus invasiveness for SGHA, SCA, and SGA were 1.5 ± 1.0 cm and 25%, 2.5 ± 1.2 cm and 43%, 2.9 ± 2.0 cm and 41%, respectively (tumor size p = 0.009, SGHA vs. SGA, and invasion p; not-significant). During mean follow-up of 3.9 years, two patients (11%) developed elevated insulin-like growth factor-1 and five patients (29%) required a second surgery for tumor recurrence. Rate of surgical reintervention was similar to SCA (31%), but higher than SGA (10%) (p = 0.035, SGHA vs. SGA), and 18% underwent radiation therapy, similar to SCA (19%, p; not-significant) but higher than SGA (2.9%, p = 0.018). Conclusion: This is the largest single center study characterizing SGHA behavior with SGA and SCA control groups in a cohort of surgically resected pituitary adenomas. SGHA present mostly in young females, and should be closely followed due to their higher likelihood of recurrence and potential of progression to clinical acromegaly. We propose that a complete hormonal staining panel be routinely performed for all pituitary adenomas.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalEndocrine
DOIs
StateAccepted/In press - Oct 17 2017

Fingerprint

Gonadotrophs
Pituitary Neoplasms
Adenoma
Growth Hormone
Recurrence
ACTH-Secreting Pituitary Adenoma
Acromegaly
Sphenoid Sinus
Neoplasms
Cavernous Sinus

Keywords

  • Acromegaly
  • Non-functioning
  • Silent corticotroph
  • Silent gonadotroph
  • Silent pituitary adenomas
  • Silent somatotroph adenomas

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

@article{78f8c37dae104f4fa983878924cc8f4e,
title = "Clinical profile of silent growth hormone pituitary adenomas; higher recurrence rate compared to silent gonadotroph pituitary tumors, a large single center experience",
abstract = "Purpose: Study and comparison of characteristics of silent growth hormone adenomas (SGHA), silent corticotroph adenomas (SCA), and silent gonadotroph adenomas (SGA) in a single institution cohort of surgically treated pituitary adenomas. Methods: Retrospective analysis of SGHA surgically resected over 10 years: SGHA was defined as no clinical or biochemical evidence of acromegaly and positive GH immunostaining. Results: Of 814 pituitary surgeries; 2.1{\%} (n = 17) were SGHA, 4.5{\%} (n = 37) SCA, and 18.9{\%} (n = 70/371; 2011–2016) SGA. Mean age at SGHA diagnosis was 43 years, with a large female predominance (82{\%}). Mean tumor size and cavernous/sphenoid sinus invasiveness for SGHA, SCA, and SGA were 1.5 ± 1.0 cm and 25{\%}, 2.5 ± 1.2 cm and 43{\%}, 2.9 ± 2.0 cm and 41{\%}, respectively (tumor size p = 0.009, SGHA vs. SGA, and invasion p; not-significant). During mean follow-up of 3.9 years, two patients (11{\%}) developed elevated insulin-like growth factor-1 and five patients (29{\%}) required a second surgery for tumor recurrence. Rate of surgical reintervention was similar to SCA (31{\%}), but higher than SGA (10{\%}) (p = 0.035, SGHA vs. SGA), and 18{\%} underwent radiation therapy, similar to SCA (19{\%}, p; not-significant) but higher than SGA (2.9{\%}, p = 0.018). Conclusion: This is the largest single center study characterizing SGHA behavior with SGA and SCA control groups in a cohort of surgically resected pituitary adenomas. SGHA present mostly in young females, and should be closely followed due to their higher likelihood of recurrence and potential of progression to clinical acromegaly. We propose that a complete hormonal staining panel be routinely performed for all pituitary adenomas.",
keywords = "Acromegaly, Non-functioning, Silent corticotroph, Silent gonadotroph, Silent pituitary adenomas, Silent somatotroph adenomas",
author = "Fabienne Langlois and Lim, {Dawn Shao Ting} and Elena Varlamov and Yedinak, {Christine (Chris)} and Justin Cetas and Shirley McCartney and Aclan Dogan and Maria Fleseriu",
year = "2017",
month = "10",
day = "17",
doi = "10.1007/s12020-017-1447-6",
language = "English (US)",
pages = "1--7",
journal = "Endocrine",
issn = "1355-008X",
publisher = "Humana Press",

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T1 - Clinical profile of silent growth hormone pituitary adenomas; higher recurrence rate compared to silent gonadotroph pituitary tumors, a large single center experience

AU - Langlois, Fabienne

AU - Lim, Dawn Shao Ting

AU - Varlamov, Elena

AU - Yedinak, Christine (Chris)

AU - Cetas, Justin

AU - McCartney, Shirley

AU - Dogan, Aclan

AU - Fleseriu, Maria

PY - 2017/10/17

Y1 - 2017/10/17

N2 - Purpose: Study and comparison of characteristics of silent growth hormone adenomas (SGHA), silent corticotroph adenomas (SCA), and silent gonadotroph adenomas (SGA) in a single institution cohort of surgically treated pituitary adenomas. Methods: Retrospective analysis of SGHA surgically resected over 10 years: SGHA was defined as no clinical or biochemical evidence of acromegaly and positive GH immunostaining. Results: Of 814 pituitary surgeries; 2.1% (n = 17) were SGHA, 4.5% (n = 37) SCA, and 18.9% (n = 70/371; 2011–2016) SGA. Mean age at SGHA diagnosis was 43 years, with a large female predominance (82%). Mean tumor size and cavernous/sphenoid sinus invasiveness for SGHA, SCA, and SGA were 1.5 ± 1.0 cm and 25%, 2.5 ± 1.2 cm and 43%, 2.9 ± 2.0 cm and 41%, respectively (tumor size p = 0.009, SGHA vs. SGA, and invasion p; not-significant). During mean follow-up of 3.9 years, two patients (11%) developed elevated insulin-like growth factor-1 and five patients (29%) required a second surgery for tumor recurrence. Rate of surgical reintervention was similar to SCA (31%), but higher than SGA (10%) (p = 0.035, SGHA vs. SGA), and 18% underwent radiation therapy, similar to SCA (19%, p; not-significant) but higher than SGA (2.9%, p = 0.018). Conclusion: This is the largest single center study characterizing SGHA behavior with SGA and SCA control groups in a cohort of surgically resected pituitary adenomas. SGHA present mostly in young females, and should be closely followed due to their higher likelihood of recurrence and potential of progression to clinical acromegaly. We propose that a complete hormonal staining panel be routinely performed for all pituitary adenomas.

AB - Purpose: Study and comparison of characteristics of silent growth hormone adenomas (SGHA), silent corticotroph adenomas (SCA), and silent gonadotroph adenomas (SGA) in a single institution cohort of surgically treated pituitary adenomas. Methods: Retrospective analysis of SGHA surgically resected over 10 years: SGHA was defined as no clinical or biochemical evidence of acromegaly and positive GH immunostaining. Results: Of 814 pituitary surgeries; 2.1% (n = 17) were SGHA, 4.5% (n = 37) SCA, and 18.9% (n = 70/371; 2011–2016) SGA. Mean age at SGHA diagnosis was 43 years, with a large female predominance (82%). Mean tumor size and cavernous/sphenoid sinus invasiveness for SGHA, SCA, and SGA were 1.5 ± 1.0 cm and 25%, 2.5 ± 1.2 cm and 43%, 2.9 ± 2.0 cm and 41%, respectively (tumor size p = 0.009, SGHA vs. SGA, and invasion p; not-significant). During mean follow-up of 3.9 years, two patients (11%) developed elevated insulin-like growth factor-1 and five patients (29%) required a second surgery for tumor recurrence. Rate of surgical reintervention was similar to SCA (31%), but higher than SGA (10%) (p = 0.035, SGHA vs. SGA), and 18% underwent radiation therapy, similar to SCA (19%, p; not-significant) but higher than SGA (2.9%, p = 0.018). Conclusion: This is the largest single center study characterizing SGHA behavior with SGA and SCA control groups in a cohort of surgically resected pituitary adenomas. SGHA present mostly in young females, and should be closely followed due to their higher likelihood of recurrence and potential of progression to clinical acromegaly. We propose that a complete hormonal staining panel be routinely performed for all pituitary adenomas.

KW - Acromegaly

KW - Non-functioning

KW - Silent corticotroph

KW - Silent gonadotroph

KW - Silent pituitary adenomas

KW - Silent somatotroph adenomas

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