BACKGROUND Although conservative treatment is typically recommended for pregnant patients with pituitary adenoma(PA),surgical treatment is occasionally necessary for those with acute symptoms.Currently,surgical interv...BACKGROUND Although conservative treatment is typically recommended for pregnant patients with pituitary adenoma(PA),surgical treatment is occasionally necessary for those with acute symptoms.Currently,surgical interventions utilized among these patients is poorly studied.AIM To evaluate the surgical indications,timing,perioperative precautions and postoperative complications of PAs during pregnancy and to provide comprehensive guidance.METHODS Six patients with PAs who underwent surgical treatment during pregnancy at Peking Union Medical College Hospital between January 1990 and June 2021 were recruited for this study.Another 35 pregnant patients who were profiled in the literature were included in our analysis.RESULTS The 41 enrolled patients had acute symptoms including visual field defects,severe headaches or vision loss that required emergency pituitary surgeries.PA apoplexies were found in 23 patients.The majority of patients(55.9%)underwent surgery in the second trimester of pregnancy.A multidisciplinary team was involved in patient care from the preoperative period through the postpartum period.With the exception of 1 patient who underwent an induced abortion and 1 fetus that died due to a nuchal cord,39 patients delivered successfully.Among them,37 fetuses were healthy until the most recent follow-up.CONCLUSION PA surgery during pregnancy is effective and safe during the second and third trimesters.Pregnant patients requiring emergency PA surgery require multidisciplinary evaluation and healthcare management.展开更多
To the Editor:Pituitary gonadotroph adenoma is a type of non-functioning pituitary adenoma of which approximately 35%ecrete biologically active luteinizing hormone(LH)or follicle-stimulating hormone(FSH),and these ade...To the Editor:Pituitary gonadotroph adenoma is a type of non-functioning pituitary adenoma of which approximately 35%ecrete biologically active luteinizing hormone(LH)or follicle-stimulating hormone(FSH),and these adenomas are named functioning gonadotroph adenoma(FGA).We present three cases of FSH-secreting adenomas who were admitted to our hospital between 2014 and 2016.Case 1:A 37-year-old woman was admitted due to menstrual irregularity and galactorrhea for 2 years.The laboratory tests showed a significantly elevated estradiol 2(E2)level,and multiple cyst fusions could be observed by transvaginal ultrasonography.The pituitary magnetic resonance imaging(MRI)revealed an upper-right wing distension and detected a mass with a size of approximately 7.5 mm×10.7 mm in the saddle area,and a pituitarymacroadenoma was considered.The patient underwent a transsphenoidal microsurgical resection of the pituitary adenoma.The pathologic examination showed a positive result for FSH,LH,and SF-1,and a negative result for growth hormone,insulin-like growth factor 1,TPIT,and PIT1.展开更多
Recently,bispecific T-cell engagers(BiTEs)and chimeric antigen receptor-modified T cells(CAR-Ts)have been shown to have high therapeutic efficacy in hematological tumors.CD87 is highly expressed in solid tumors with a...Recently,bispecific T-cell engagers(BiTEs)and chimeric antigen receptor-modified T cells(CAR-Ts)have been shown to have high therapeutic efficacy in hematological tumors.CD87 is highly expressed in solid tumors with an oncogenic function.To assess their cytotoxic effects on invasive nonfunctioning pituitary adenomas(iNFPAs),we first examined CD87 expression and its effects on the metabolism of iNFPA cells.We generated CD87-specific BiTE and CAR/IL-12 T cells,and their cytotoxic effects on iNFPAs cells and in mouse models were determined.CD87 had high expression in i NFPA tissue and cell samples but was undetected in noncancerous brain samples.CD87×CD3 BiTE and CD87 CAR/IL-12 T-cells showed antigenic specificity and exerted satisfactory cytotoxic effects,decreasing tumor cell proliferation in vitro and reducing existing tumors in experimental mice.Overall,the above findings suggest that CD87 is a promising target for the immunotherapeutic management of iNFPAs using anti-CD87 BiTE and CD87-specific CAR/IL-12 T cells.展开更多
To the Editor:Pituitary disease is a group of pituitary gland disorders, including pituitary adenoma and other lesions,in the sellar region.[1] Typical endocrine symptoms and mass effects are likely to have harmful re...To the Editor:Pituitary disease is a group of pituitary gland disorders, including pituitary adenoma and other lesions,in the sellar region.[1] Typical endocrine symptoms and mass effects are likely to have harmful results on patients,families,and society.Pituitary databases of various sizes and focuses have been established in the USA and Europe.[2-4]展开更多
To the Editor： A 35-year-old Chinese woman was admitted to our hospital complaining of a 1-year history of bilateral temporal chronic intermittent moderate headache which used to be alleviated by ibuprofen tablets or...To the Editor： A 35-year-old Chinese woman was admitted to our hospital complaining of a 1-year history of bilateral temporal chronic intermittent moderate headache which used to be alleviated by ibuprofen tablets or rest and had increased in intensity in the past 1 month. The patient also presented with the slow development of visual deficit. In January 2012, the patient presented with polyuria and polydipsia suggestive of central diabetes insipidus. Endocrine studies showed no clinically significant results.展开更多
To the Editor:Cortisol is closely related to hemostasis.[1]In patients with hyperadrenalism,that is,Cushing syndrome(CS),a reduction in the activated partial thromboplastin time(APTT),an increased level of coagulation...To the Editor:Cortisol is closely related to hemostasis.[1]In patients with hyperadrenalism,that is,Cushing syndrome(CS),a reduction in the activated partial thromboplastin time(APTT),an increased level of coagulation factors,and an increased risk of thrombosis have been repeatedly reported.[1,2]However,no studies reported the hemostatic status of patients with hypoadrenalism which is commonly seen in patients with pituitary diseases.展开更多
文摘BACKGROUND Although conservative treatment is typically recommended for pregnant patients with pituitary adenoma(PA),surgical treatment is occasionally necessary for those with acute symptoms.Currently,surgical interventions utilized among these patients is poorly studied.AIM To evaluate the surgical indications,timing,perioperative precautions and postoperative complications of PAs during pregnancy and to provide comprehensive guidance.METHODS Six patients with PAs who underwent surgical treatment during pregnancy at Peking Union Medical College Hospital between January 1990 and June 2021 were recruited for this study.Another 35 pregnant patients who were profiled in the literature were included in our analysis.RESULTS The 41 enrolled patients had acute symptoms including visual field defects,severe headaches or vision loss that required emergency pituitary surgeries.PA apoplexies were found in 23 patients.The majority of patients(55.9%)underwent surgery in the second trimester of pregnancy.A multidisciplinary team was involved in patient care from the preoperative period through the postpartum period.With the exception of 1 patient who underwent an induced abortion and 1 fetus that died due to a nuchal cord,39 patients delivered successfully.Among them,37 fetuses were healthy until the most recent follow-up.CONCLUSION PA surgery during pregnancy is effective and safe during the second and third trimesters.Pregnant patients requiring emergency PA surgery require multidisciplinary evaluation and healthcare management.
文摘To the Editor:Pituitary gonadotroph adenoma is a type of non-functioning pituitary adenoma of which approximately 35%ecrete biologically active luteinizing hormone(LH)or follicle-stimulating hormone(FSH),and these adenomas are named functioning gonadotroph adenoma(FGA).We present three cases of FSH-secreting adenomas who were admitted to our hospital between 2014 and 2016.Case 1:A 37-year-old woman was admitted due to menstrual irregularity and galactorrhea for 2 years.The laboratory tests showed a significantly elevated estradiol 2(E2)level,and multiple cyst fusions could be observed by transvaginal ultrasonography.The pituitary magnetic resonance imaging(MRI)revealed an upper-right wing distension and detected a mass with a size of approximately 7.5 mm×10.7 mm in the saddle area,and a pituitarymacroadenoma was considered.The patient underwent a transsphenoidal microsurgical resection of the pituitary adenoma.The pathologic examination showed a positive result for FSH,LH,and SF-1,and a negative result for growth hormone,insulin-like growth factor 1,TPIT,and PIT1.
基金supported by the National Key Research and Development Program of China(2021YFE0114300)the National Key Basic Research Program of China(973 Program)(2014CB541603)+1 种基金the National High Technology Research and Development Program of China(863 Program)(2013AA020106)the National Natural Science Foundation of China(82171475,82170799)。
文摘Recently,bispecific T-cell engagers(BiTEs)and chimeric antigen receptor-modified T cells(CAR-Ts)have been shown to have high therapeutic efficacy in hematological tumors.CD87 is highly expressed in solid tumors with an oncogenic function.To assess their cytotoxic effects on invasive nonfunctioning pituitary adenomas(iNFPAs),we first examined CD87 expression and its effects on the metabolism of iNFPA cells.We generated CD87-specific BiTE and CAR/IL-12 T cells,and their cytotoxic effects on iNFPAs cells and in mouse models were determined.CD87 had high expression in i NFPA tissue and cell samples but was undetected in noncancerous brain samples.CD87×CD3 BiTE and CD87 CAR/IL-12 T-cells showed antigenic specificity and exerted satisfactory cytotoxic effects,decreasing tumor cell proliferation in vitro and reducing existing tumors in experimental mice.Overall,the above findings suggest that CD87 is a promising target for the immunotherapeutic management of iNFPAs using anti-CD87 BiTE and CD87-specific CAR/IL-12 T cells.
基金a grant from the Beijing Municipal Natural Science Foundation (No.7182137).
文摘To the Editor:Pituitary disease is a group of pituitary gland disorders, including pituitary adenoma and other lesions,in the sellar region.[1] Typical endocrine symptoms and mass effects are likely to have harmful results on patients,families,and society.Pituitary databases of various sizes and focuses have been established in the USA and Europe.[2-4]
文摘To the Editor： A 35-year-old Chinese woman was admitted to our hospital complaining of a 1-year history of bilateral temporal chronic intermittent moderate headache which used to be alleviated by ibuprofen tablets or rest and had increased in intensity in the past 1 month. The patient also presented with the slow development of visual deficit. In January 2012, the patient presented with polyuria and polydipsia suggestive of central diabetes insipidus. Endocrine studies showed no clinically significant results.
基金This work was supported by grants from the National Key R&D Program of China(No.2018YFA0108600)the Beijing Natural Science Foundation(No.7182134)+2 种基金the CAMS Initiative for Innovative Medicine(CAMS-I2M)(No.2016-I2M-1-017)the CAMS Young Talents Award Project(No.2018RC320003)the Beijing Nova Program(No.Z181100006218003).
文摘To the Editor:Cortisol is closely related to hemostasis.[1]In patients with hyperadrenalism,that is,Cushing syndrome(CS),a reduction in the activated partial thromboplastin time(APTT),an increased level of coagulation factors,and an increased risk of thrombosis have been repeatedly reported.[1,2]However,no studies reported the hemostatic status of patients with hypoadrenalism which is commonly seen in patients with pituitary diseases.
