High-Grade Progression and Metastasis of Pituitary Neuroendocrine Neoplasms
Author Information
Author(s): Terry Merryl, Nguyen Minh P., Tang Vivian, Guney Ekin, Bharani Krishna L., Dahiya Sonika, Choutka Ondrej, Borys Ewa, Reis Gerald, Blevins Lewis, Aghi Manish K., Kunwar Sandeep, DeGroot John, Raleigh David R., Pekmezci Melike, Bollen Andrew W., Cha Soonmee, Joseph Nancy M.
Primary Institution: University of California San Francisco
Hypothesis
Can histopathologic and molecular features predict the aggressiveness of pituitary neuroendocrine neoplasms?
Conclusion
Metastatic PitNET is not the only high-grade form of pituitary NEN, and certain histopathologic and molecular features may indicate biological aggressiveness.
Supporting Evidence
- 62% of patients died of disease, indicating high mortality associated with aggressive PitNETs.
- The median Ki-67 labeling index was 25%, suggesting a high proliferation rate in these tumors.
- Histopathologic features included loss of p16 in 3 cases and strong p53 immunopositivity in 3 specimens.
- Seven patients developed metastatic disease, highlighting the aggressive nature of certain PitNETs.
- Four patients had a history of previously diagnosed PitNETs, indicating recurrence risk.
- Immunohistochemical loss of neuroendocrine markers was noted in high-grade tumors.
- Next-generation sequencing revealed TERT alterations in 3 of 4 tumors tested.
Takeaway
Some pituitary tumors can be very aggressive and spread, even if they aren't metastatic. Doctors are trying to find ways to tell which ones might be dangerous.
Methodology
The study reviewed clinical, radiologic, histopathologic, immunohistochemical, and molecular features of 21 specimens from 13 patients with aggressive PitNETs.
Limitations
The study is based on a relatively small sample size, which may limit the generalizability of the findings.
Participant Demographics
10 male and 3 female patients with a median age of 55 years.
Digital Object Identifier (DOI)
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