Advances in pituitary tumor therapy:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1999
|
| Schriftenreihe: | Endocrinology and metabolism clinics of North America
28,1 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | NT: Advances in the management of pituitary tumors |
| Beschreibung: | XII, 246 S. Ill., graph. Darst. |
Internformat
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| 245 | 1 | 0 | |a Advances in pituitary tumor therapy |c Mark E. Molitch guest ed. |
| 246 | 1 | 3 | |a Advances in the management of pituitary tumors |
| 264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 1999 | |
| 300 | |a XII, 246 S. |b Ill., graph. Darst. | ||
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| 650 | 7 | |a Hypofyse |2 gtt | |
| 650 | 4 | |a Hypophyse - Tumeurs - Traitement | |
| 650 | 2 | |a Tumeurs de l'hypophyse - Thérapeutique | |
| 650 | 7 | |a Tumoren |2 gtt | |
| 650 | 4 | |a Acromegaly |x Chemotherapy | |
| 650 | 4 | |a Acromegaly |x drug therapy | |
| 650 | 4 | |a Cushing Syndrome |x diagnosis | |
| 650 | 4 | |a Cushing Syndrome |x drug therapy | |
| 650 | 4 | |a Cushing's syndrome |x Chemotherapy | |
| 650 | 4 | |a Cushing's syndrome |x Diagnosis | |
| 650 | 4 | |a Pituitary Neoplasms |x therapy | |
| 650 | 4 | |a Pituitary gland |x Tumors |x Chemotherapy | |
| 650 | 4 | |a Prolactinoma |x Chemotherapy | |
| 650 | 4 | |a Prolactinoma |x drug therapy | |
| 650 | 4 | |a Radioimmunoguided Surgery (Trademark) | |
| 650 | 4 | |a Radiosurgery | |
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Datensatz im Suchindex
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| adam_text | ADVANCES IN I lTUITARY TUMOR IHhKAW
CONTENTS
Preface xi
Mark E. Molitch
Pathogenesis of Pituitary Tumors 1
Shlomo Melmed
This article focuses on the molecular events associated with
pituitary tumorigenesis. An accurate description of the molecu¬
lar pathogenesis of pituitary adenomas will have an important
impact on clinical practice: identification of specific molecular
markers of tumor invasiveness and recurrence will allow ear¬
lier therapeutic intervention and selection of appropriate fol¬
low up protocols; family screening may become practically fea¬
sible; and potent subcellular therapies may be developed for
patients with nonfunctioning tumors, in whom nonsurgical
therapies are ineffective, and for those with resistant hormone
secreting tumors.
The Pathology of Pituitary Tumors 13
Sylvia L. Asa
The pathologist plays an important role in the distinction of
pituitary adenomas from other tumors and tumor like lesions of
the sellar region, and in the accurate morphologic characterization
of pitutiary adenomas. A clinicopathologic classification of pitu¬
itary adenomas is based on cell differentiation correlated with
clinical evidence of hormone secretion; this classification empha¬
sizes clinically relevant features that can offer guidance for patient
management. The application of a rational approach to the immu
nohistochemical analysis of these lesions can be used to evaluate
pathogenetic and prognostic markers and to predict responses to
specific therapeutic modalities.
Current Approaches to Imaging of the Sellar Region
and Pituitary 45
Michelle J. Naidich and Eric J. Russell
Recent advances in MR imaging have enabled the radiologist to
view the pituitary gland in its normal and diseased states to a
greater extent than ever before. The techniques for obtaining
quality images of the sellar region and the normal appearance of
the pituitary gland are discussed. This article also discusses the
imaging of several pituitary disease processes, with emphasis on
pitutiary adenomas and recent advances in diagnosis and follow
up. Current controversies also are addressed.
Differential Diagnosis of Sellar Masses 81
Pamela U. Freda and Kalmon D. Post
The differential diagnosis of nonpituitary sellar masses is broad;
differentiating among potential etiologies may not always be
straightforward because many of these lesions, tumorous and
nontumorous, may mimic the clinical, endocrinologic, and radio
logic presentations of pituitary adenomas. This article provides
an overview of the clinical and radiographic characteristics of
both pituitary tumors and the nonpituitary lesions found in the
sellar/parasellar region and discusses, in detail, the specific non¬
pituitary origins of the sellar masses.
Pituitary Surgery 119
Edward R. Laws, Jr and Kamal Thapar
Pituitary surgery remains the procedure of choice for dealing
with a majority of clinically encountered pituitary adenomas. This
article discusses the indications for surgical management of the
various types of pituitary tumors, emphasizing the use of the
transsphenoidal approach, which is suitable for more than 90%
of pituitary tumors. The results for each type of hypersecreting
tumor are given, with remission rates ranging from 60% to 90%,
depending on the size and stage of the tumor, and the type of
endocrinopathy involved. For clinically nonfunctioning tumors,
most of which present with headache and visual loss, improve¬
ment or maintenance of vision occurs in 87% of patients. Compli¬
cations of pituitary surgery are relatively rare, with a mortality
rate less than 1% and a morbidity rate less than 3% for most
lesions currently encountered. Modern techniques and improve¬
ments, both in endocrine diagnosis and surgical management,
should lead to even more effective therapy in the future.
Role of Gamma Knife Therapy in the Management of
Pituitary Tumors 133
Ivor M. D. Jackson and Georg Noren
Stereotactic radiosurgery with the Gamma Knife Unit allows de¬
livery of focused radiation to a pituitary tumor in a single session,
with little radiation exposure to the surrounding, normal central
nervous system (CNS). The major role for Gamma Knife surgery
is for the treatment of failed pituitary surgery, although it can be
used as a primary therapy for cases unsuitable, or unwilling, to
undergo a transsphenoidal procedure. It may produce effects on
secretory pituitary adenomas faster than fractionated radiother¬
apy, without the potential risk of developing secondary extrapitu
itary CNS tumors and the neuropsychiatric complications associ¬
ated with the conventional form of radiation delivery.
Medical Treatment of Prolactinomas 143
Mark E. Molitch
Prolactinomas are a common cause of reproductive and sexual
dysfunction. Once other causes of hyperprolactinemia have been
excluded with a careful history, physical examination, routine
chemistries, and a TSH, MR imaging or computerized tomogra¬
phy will delineate the size and extent of the tumor. Medical
therapy is the initial treatment of choice. When infertility is the
primary indication for treatment, bromocriptine use has an exten¬
sive safety experience and is preferred. For other indications,
however, cabergoline appears to be more efficacious and better
tolerated. Transsphenoidal surgery remains an option, especially
for patients with microadenomas, when medical therapy is inef¬
fective.
Medical Therapy for Acromegaly 171
Connie B. Newman
Medical therapy for acromegaly is generally prescribed for pa¬
tients who are poor surgical candidates or have failed surgery or
for those who refuse surgery. The most effective medications are
somatostatin analogues, which include octreotide (administered
subcutaneously three times a day) and the longer acting com¬
pounds SR lanreotide (administered intramuscularly every 10 to
14 days) and octreotide LAR (administered once every 28 days).
Somatostatin analogues reduce GH levels in most patients and
restore IGF I levels to normal in 60% to 68% of patients but
reduce tumor size in only 40% of cases. Dopamine agonists, such
as bromocriptine, pergolide, quinagolide, and cabergoline may
also be used to treat acromegaly, particularly in patients who
refuse injections and have modest elevations of GH. However,
dopamine agonist compounds are less successful than octreotide
in reducing GH and restoring IGF I levels to normal. The use of
somatostatin analogues as primary therapy of acromegaly is still
controversial.
Newer Diagnostic Techniques and Problems in
Cushing s Disease 191
James W. Findling and Hershel Raff
The diagnosis and differential diagnosis of endogenous Cushing s
syndrome are among the most challenging problems in clinical
endocrinology. Traditional approaches have failed to provide ade¬
quate sensitivity, specificity, and accuracy for the diagnosis of
Cushing s disease. This article contrasts newer diagnostic tech¬
niques with traditional approaches. New problems in the evalua¬
tion and management of patients with suspected Cushing s dis¬
ease also are reviewed.
Medical Therapy for Cushing s Disease 211
Nicoletta Sonino and Marco Boscaro
In the medical treatment of Cushing s disease, the choice of ther¬
apy may vary considerably, from applying a palliative and tempo¬
rary measure to a definitive therapy, or to some intermediate
measure in the management of difficult cases. The complexity of
choices is a reflection of the way in which pharmacologic com¬
pounds are classified, the complexity of Cushing s disease itself,
and the implications involved in the association between the
forms of Cushing s disease and the effects of pharmacologic ma¬
nipulation. These concepts are outlined in this article, together
with practical notes on current medical treatment.
Medical Therapy for Gonadotroph and
Thyrotroph Tumors 223
Mansur E. Shomali and Laurence Katznelson
Gonadotroph adenomas, a common type of pituitary tumor, are
not associated with syndromes of hormonal hypersecretion and
thus present as pituitary macroadenomas with mass effects, or as
incidentally discovered pituitary masses. When indicated, pri¬
mary therapy is neurosurgery, but there may be a limited role for
medical therapy in patients with residual disease. Thyrotroph
adenomas are rare neoplasms that present with hyperthyroidism
and local mass effects. Medical therapy may be effective in con¬
trolling tumor growth and in achieving euthyroidism, when sur¬
gery or radiation, or both, do not control the tumor.
Index 241
Subscription Information Inside back cover
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| spelling | Advances in pituitary tumor therapy Mark E. Molitch guest ed. Advances in the management of pituitary tumors Philadelphia [u.a.] Saunders 1999 XII, 246 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Endocrinology and metabolism clinics of North America 28,1 NT: Advances in the management of pituitary tumors Hypofyse gtt Hypophyse - Tumeurs - Traitement Tumeurs de l'hypophyse - Thérapeutique Tumoren gtt Acromegaly Chemotherapy Acromegaly drug therapy Cushing Syndrome diagnosis Cushing Syndrome drug therapy Cushing's syndrome Chemotherapy Cushing's syndrome Diagnosis Pituitary Neoplasms therapy Pituitary gland Tumors Chemotherapy Prolactinoma Chemotherapy Prolactinoma drug therapy Radioimmunoguided Surgery (Trademark) Radiosurgery Therapie (DE-588)4059798-2 gnd rswk-swf Hypophysentumor (DE-588)4161132-9 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Hypophysentumor (DE-588)4161132-9 s Therapie (DE-588)4059798-2 s DE-604 Molitch, Mark E. Sonstige oth Endocrinology and metabolism clinics of North America 28,1 (DE-604)BV000625447 28,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008507931&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Advances in pituitary tumor therapy Endocrinology and metabolism clinics of North America Hypofyse gtt Hypophyse - Tumeurs - Traitement Tumeurs de l'hypophyse - Thérapeutique Tumoren gtt Acromegaly Chemotherapy Acromegaly drug therapy Cushing Syndrome diagnosis Cushing Syndrome drug therapy Cushing's syndrome Chemotherapy Cushing's syndrome Diagnosis Pituitary Neoplasms therapy Pituitary gland Tumors Chemotherapy Prolactinoma Chemotherapy Prolactinoma drug therapy Radioimmunoguided Surgery (Trademark) Radiosurgery Therapie (DE-588)4059798-2 gnd Hypophysentumor (DE-588)4161132-9 gnd |
| subject_GND | (DE-588)4059798-2 (DE-588)4161132-9 (DE-588)4143413-4 |
| title | Advances in pituitary tumor therapy |
| title_alt | Advances in the management of pituitary tumors |
| title_auth | Advances in pituitary tumor therapy |
| title_exact_search | Advances in pituitary tumor therapy |
| title_full | Advances in pituitary tumor therapy Mark E. Molitch guest ed. |
| title_fullStr | Advances in pituitary tumor therapy Mark E. Molitch guest ed. |
| title_full_unstemmed | Advances in pituitary tumor therapy Mark E. Molitch guest ed. |
| title_short | Advances in pituitary tumor therapy |
| title_sort | advances in pituitary tumor therapy |
| topic | Hypofyse gtt Hypophyse - Tumeurs - Traitement Tumeurs de l'hypophyse - Thérapeutique Tumoren gtt Acromegaly Chemotherapy Acromegaly drug therapy Cushing Syndrome diagnosis Cushing Syndrome drug therapy Cushing's syndrome Chemotherapy Cushing's syndrome Diagnosis Pituitary Neoplasms therapy Pituitary gland Tumors Chemotherapy Prolactinoma Chemotherapy Prolactinoma drug therapy Radioimmunoguided Surgery (Trademark) Radiosurgery Therapie (DE-588)4059798-2 gnd Hypophysentumor (DE-588)4161132-9 gnd |
| topic_facet | Hypofyse Hypophyse - Tumeurs - Traitement Tumeurs de l'hypophyse - Thérapeutique Tumoren Acromegaly Chemotherapy Acromegaly drug therapy Cushing Syndrome diagnosis Cushing Syndrome drug therapy Cushing's syndrome Chemotherapy Cushing's syndrome Diagnosis Pituitary Neoplasms therapy Pituitary gland Tumors Chemotherapy Prolactinoma Chemotherapy Prolactinoma drug therapy Radioimmunoguided Surgery (Trademark) Radiosurgery Therapie Hypophysentumor Aufsatzsammlung |
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