Posterior pituitary tumours: patient outcomes and determinants of disease recurrence or persistence.
Posterior pituitary tumours: patient outcomes and determinants of disease recurrence or persistence.
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DOI：
10.1530/ec-20-0621
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发表时间：
2021-04
影响因子：
2.9
通讯作者：
Dutta P
中科院分区：
文献类型：
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作者：
Das L;Vaiphei K;Rai A;Ahuja CK;Singh P;Mohapatra I;Chhabra R;Bhansali A;Radotra BD;Grossman AB;Korbonits M;Dutta P
根据2017年世卫组织分类，垂体后叶肿瘤（PPTs）是一种罕见的肿瘤，具有甲状腺转录因子-1 （TTF-1）表达统一的四种公认亚型。虽然传统上定义为低级别肿瘤，但相当大比例的肿瘤在手术后复发/持续存在。我们从过去10年（2010-2019年）1760例垂体肿瘤手术患者中选择了PPTs患者。分析了3例确诊病例（2例垂体瘤和1例梭形细胞癌，SCO）的临床、放射学、激素、组织病理学和长期预后。在文献回顾之后，我们分析了所有已发表的TTF-1阳性垂体瘤和SCOs病例的数据，以确定这些肿瘤复发/持续的预测因素。患者表现为压迫性特征或性腺功能减退。2例有鞍上肿块。1例为单纯鞍上肿块，术前影像学怀疑为垂体瘤。2例经蝶窦手术，1例经颅神经导航手术。组织病理学证实梭形细胞呈层状排列，Ki67指数低。免疫组化显示TTF-1、S-100阳性，EMA、vimentin、GFAP可变阳性。重新评估显示2例患者复发/持续。对复发/持续性垂体瘤（n = 17）和SCO （n = 9）病例的文献回顾显示，临床线索（垂体瘤为头痛，SCO为男性）、基线肿瘤大小（≥20.5 mm，敏感性超过80%）和较长的随访时间是复发/持续性的决定因素。ppt是罕见的鞍状肿块，典型的TTF-1阳性。手术后复发/持续性疾病取决于基线时较大的肿瘤大小和随访时间。这需要对这些患者进行密集和长期的监测。
Posterior pituitary tumours (PPTs) are rare neoplasms with the four recognised subtypes unified by thyroid transcription factor -1 (TTF-1) expression, according to the 2017 WHO classification. Though traditionally defined as low-grade neoplasms, a substantial proportion of them show recurrence/persistence following surgery. We selected patients with PPTs in our cohort of 1760 patients operated for pituitary tumours over the past 10 years (2010–2019). The clinical, radiological, hormonal, histopathological profiles and long-term outcomes of the three cases identified (two pituicytomas and one spindle cell oncocytoma, SCO) were analysed. Following a literature review, data of all published cases with documented TTF-1 positive pituicytomas and SCOs were analysed to determine the predictors of recurrence/persistence in these tumours. Patients presented with compressive features or hypogonadism. Two had sellar-suprasellar masses. One had a purely suprasellar mass with a pre-operative radiological suspicion of pituicytoma. Two were operated by transsphenoidal surgery and one transcranially guided by neuronavigation. Histopathology confirmed spindle cells in a storiform arrangement and low Ki67 index. Immunohistochemistry showed positive TTF-1, S-100 expression and variable positivity for EMA, vimentin and GFAP. Re-evaluation showed recurrence/persistence in two patients. A literature review of recurrent/persistent pituicytoma (n = 17) and SCO (n = 9) cases revealed clinical clues (headache for pituicytomas, male gender for SCO), baseline tumour size (≥20.5 mm with sensitivity exceeding 80%) and longer follow-up duration as determinants of recurrence/persistence. PPTs are rare sellar masses with quintessential TTF-1 positivity. Recurrent/persistent disease following surgery is determined by greater tumour size at baseline and duration of follow-up. This warrants intensive and long-term surveillance in these patients.
影响因子：
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作者：
Brandão RA;Braga MH;de Souza AA;Reis BL;Faraj de Lima FB
通讯作者：
Faraj de Lima FB