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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Clinically silent somatotroph adenomas are common
European Journal of Endocrinology, Volume 165, No. 1, Year 2011
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Description
Objective: Somatotroph adenomas are typically recognized when they secrete GH excessively and cause acromegaly. Both 'silent' somatotroph adenomas (immunohistochemical evidence of GH excess without biochemical or clinical evidence) and 'clinically silent' somatotroph adenomas (immunohistochemical and biochemical evidence but no clinical evidence) have occasionally been reported. The relative frequency of each presentation is unknown. The goal of this study was, therefore, to determine the frequency of clinically silent somatotroph adenomas, a group that is potentially recognizable in vivo. Design: We retrospectively identified 100 consecutive patients who had surgically excised and histologically confirmed pituitary adenomas. Methods: Each pituitary adenoma was classified immunohistochemically by pituitary cell type. Somatotroph adenomas were further classified as 'classic' (obvious clinical features of acromegaly and elevated serum IGF1), 'subtle' (subtle clinical features of acromegaly and elevated IGF1), 'clinically silent' (no clinical features of acromegaly but elevated IGF1), and 'silent' (no clinical features of acromegaly and normal IGF1). Results: Of the 100 consecutive pituitary adenomas, 29% were gonadotroph/glycoprotein, 24% somatotroph, 18% null cell, 15% corticotroph, 6% lactotroph, 2% thyrotroph, and 6% not classifiable. Of the 24 patients with somatotroph adenomas, classic accounted for 45.8%, subtle 16.7%, clinically silent 33.3%, and silent 4.2%. Conclusions: Clinically silent somatotroph adenomas are more common than previously appreciated, representing one-third of all somatotroph adenomas. IGF1 should be measured in all patients with a sellar mass, because identification of a mass as a somatotroph adenoma expands the therapeutic options and provides a tumor marker to monitor treatment. © 2011 European Society of Endocrinology.
Authors & Co-Authors
Wade, Alisha N.
United States, Philadelphia
University of Pennsylvania Perelman School of Medicine
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
Baccon, Jennifer
United States, Philadelphia
University of Pennsylvania Perelman School of Medicine
United States, Hershey
Penn State Health Milton S. Hershey Medical Center
Grady, M. Sean
United States, Philadelphia
University of Pennsylvania Perelman School of Medicine
Judy, Kevin D.
United States, Philadelphia
University of Pennsylvania Perelman School of Medicine
O'Rourke, Donald M.
United States, Philadelphia
University of Pennsylvania Perelman School of Medicine
Snyder, Peter J.
United States, Philadelphia
University of Pennsylvania Perelman School of Medicine
Statistics
Citations: 58
Authors: 6
Affiliations: 3
Identifiers
Doi:
10.1530/EJE-11-0216
ISSN:
08044643
e-ISSN:
1479683X
Research Areas
Cancer