- Title
- Recurrences of Pituitary Adenomas or Second De Novo Tumors: Comparisons with First Tumors
- Creator
- Saeger, Wolfgang; Müller, Maximilian; Buslei, Rolf; Flitsch, Jörg; Fahlbusch, Rudolf; Buchfelder, Michael; Knappe, Ulrich J.; Crock, Patricia A.; Lüdecke, Dieter K.
- Relation
- World Neurosurgery Vol. 119, Issue November 2018, p. e118-e124
- Publisher Link
- http://dx.doi.org/10.1016/j.wneu.2018.07.056
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2018
- Description
- Background: Recurrences of pituitary adenomas are not so rare. Methods: In the German Registry of Pituitary Tumors, more than 12,000 surgical specimens were collected between 1967 and 2012, of which 312 patients with altogether 334 recurrences (n = 646 specimens) were included in our study. Results: The histopathology of 162 recurrent adenomas could be compared with the original tumor and 37 second recurrences could be compared with the first recurrence. Comparing the proliferation index (Ki-67) of the original and the first recurrent tumor (n = 162), we found an unchanged index in 43 cases (26%), whereas in 69 cases (43%) the index increased and in 50 cases (31%) it decreased. Comparing the first with the second recurrence (n = 37), we found an unchanged index in 8 cases (22%), an increased index in 15 cases (40%), and a decreased index in 14 cases (38%). The third recurrence showed an unchanged index in 1 case (20%), an increased index in 2 cases (40%), and a decreased index in 2 cases (40%). p53 was unchanged in recurrences in 44% of cases, increased in 33%, and decreased in 22%. In 4 cases, adenomas developed into adenomas with strongly increased proliferation (formerly atypical adenomas, now aggressive adenomas) for the first recurrence, and 9 recurrences became aggressive adenomas. A change of tumor type without change of the common transcription factor occurred in 82 cases. Conclusions: A second independent de novo adenoma was present in 10 cases, probably due to changes of transcription factors.
- Subject
- adenoma; de novo tumor; pituitary; recurrence
- Identifier
- http://hdl.handle.net/1959.13/1440963
- Identifier
- uon:41275
- Identifier
- ISSN:1878-8750
- Language
- eng
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