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Related Experiment Videos

Aggressive pituitary tumors

L S Blevins1, D K Verity, G Allen

  • 1Department of Neurosurgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.

Oncology (Williston Park, N.Y.)
|October 21, 1998
PubMed
Summary
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Most pituitary tumors are benign, but many invade surrounding tissues. While rare, pituitary carcinomas are aggressive, and predicting invasion remains challenging using current diagnostic methods.

Area of Science:

  • Endocrinology
  • Neurosurgery
  • Pathology

Background:

  • Pituitary tumors are typically benign adenomas.
  • A significant proportion of these adenomas exhibit invasive behavior, extending beyond the pituitary gland.
  • Pituitary carcinomas are rare, accounting for approximately 0.13% of all pituitary tumors.

Purpose of the Study:

  • To review criteria for determining pituitary tumor invasiveness.
  • To explore markers associated with aggressive tumor behavior.
  • To discuss the clinical significance of invasion, particularly in macroadenomas.

Main Methods:

  • Review of existing literature and diagnostic criteria for pituitary tumor invasion.
  • Analysis of histopathological findings, including microscopic and gross invasion.

Related Experiment Videos

  • Correlation of invasion with proliferation markers (PCNA, Ki-67, MIB-1) and molecular markers (p53, EGFR, PKC).
  • Radiological assessment using MRI and CT scans.

    • Main Results:

    • Microscopic dural invasion is detected in 85% of cases via intraoperative biopsies.
    • Gross invasion and radiological evidence (MRI, CT) are less frequent but may predict surgical outcomes.
    • Higher proliferation rates (PCNA, Ki-67, MIB-1) are associated with invasive adenomas.
    • Expression of p53, increased epidermal growth factor receptors, and protein kinase C activity correlate with invasion.
    • Macroadenomas, excluding gonadotroph subtypes, show a >50% incidence of gross invasion.

    Conclusions:

    • Invasiveness in pituitary tumors can be assessed through various methods, including biopsy, imaging, and molecular markers.
    • Macroadenomas frequently exhibit gross invasion, indicating a higher risk of aggressive behavior.
    • Currently, predicting clinically significant invasiveness and long-term aggressiveness of pituitary adenomas remains an unmet clinical need.