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Annales D'endocrinologie Jul 2015Non-functioning pituitary adenoma may be totally asymptomatic and discovered "incidentally" during radiological examination for some other indication, or else induce... (Review)
Review
Non-functioning pituitary adenoma may be totally asymptomatic and discovered "incidentally" during radiological examination for some other indication, or else induce tumoral signs with compression of the optic chiasm and pituitary dysfunction. Non-functioning adenomas are mainly gonadotroph, but may also be "silent". Treatment strategy depends on initial clinical, biological, ophthalmological and radiological findings. The present French Society of Endocrinology Consensus work-group sought to update the pitfalls associated with hormone assay and outline a hormonal exploration strategy for diagnosis and follow-up, without overlooking the particularities of silent adenoma. We also drew up basic rules for initial exploration and radiological follow-up of both operated and non-operated pituitary adenomas.
Topics: Adenoma; Consensus; Gonadotropins; Humans; Pituitary Hormones; Pituitary Neoplasms; Radiography
PubMed: 26122495
DOI: 10.1016/j.ando.2015.04.005 -
The Korean Journal of Gastroenterology... Apr 2021Superficial nonampullary duodenal epithelial tumors are considered rare but have been increasingly recognized in recent years. Accordingly, the importance of endoscopic... (Review)
Review
Superficial nonampullary duodenal epithelial tumors are considered rare but have been increasingly recognized in recent years. Accordingly, the importance of endoscopic treatment for the lesions are also increasing. An endoscopic resection can be considered for duodenal adenoma and mucosal cancer. The choice of resection method should be made based on the size of the lesion, endoscopic findings, pathologic diagnosis, and risk of procedure-related complication. For small adenomas <10 mm in size, endoscopic mucosal resection (EMR), cold snare polypectomy, and underwater EMR can be considered. An or piecemeal resection using EMR or underwater EMR can be selected for 10-20 mm sized adenomas. For lesions ≥20 mm in size or suspicious for mucosal cancer, an endoscopic submucosal dissection followed by closure of the mucosal defect conducted by an experienced endoscopist is appropriate.
Topics: Adenoma; Colonic Polyps; Colonoscopy; Duodenal Neoplasms; Endoscopic Mucosal Resection; Humans; Retrospective Studies; Treatment Outcome
PubMed: 33896904
DOI: 10.4166/kjg.2021.039 -
Frontiers in Endocrinology 2020Pituitary adenomas (PAs) can be classified as non-secreting adenomas, somatotroph adenomas, corticotroph adenomas, lactotroph adenomas, and thyrotroph adenomas.... (Review)
Review
Pituitary adenomas (PAs) can be classified as non-secreting adenomas, somatotroph adenomas, corticotroph adenomas, lactotroph adenomas, and thyrotroph adenomas. Substantial advances have been made in our knowledge of the pathobiology of PAs. To obtain a comprehensive understanding of the molecular biological characteristics of different types of PAs, we reviewed the important advances that have been made involving genetic and epigenetic variation, comprising genetic mutations, chromosome number variations, DNA methylation, microRNA regulation, and transcription factor regulation. Classical tumor predisposition syndromes include multiple endocrine neoplasia type 1 (MEN1) and type 4 (MEN4) syndromes, Carney complex, and X-LAG syndromes. PAs have also been described in association with succinate dehydrogenase-related familial PA, neurofibromatosis type 1, and von Hippel-Lindau, DICER1, and Lynch syndromes. Patients with aryl hydrocarbon receptor-interacting protein () mutations often present with pituitary gigantism, either in familial or sporadic adenomas. In contrast, guanine nucleotide-binding protein G(s) subunit alpha () and G protein-coupled receptor 101 () mutations can lead to excess growth hormone. Moreover, the deubiquitinase gene , , and mutations are associated with adrenocorticotropic hormone production. In this review, we describe the genetic and epigenetic landscape of PAs and summarize novel insights into the regulation of pituitary tumorigenesis.
Topics: Adenoma; Epigenesis, Genetic; Gene Expression Regulation; Genetic Markers; Genetic Predisposition to Disease; Humans; Mutation; Pituitary Neoplasms
PubMed: 33574795
DOI: 10.3389/fendo.2020.596554 -
Journal of Internal Medicine Dec 2016The recently available genomic sequencing techniques have led to breakthroughs in understanding of the underlying genetic mechanisms in adrenocortical tumours.... (Review)
Review
The recently available genomic sequencing techniques have led to breakthroughs in understanding of the underlying genetic mechanisms in adrenocortical tumours. Disease-causing mutations have been described for aldosterone-producing adenomas, cortisol-producing adenomas and adrenocortical carcinomas. Further, knowledge gained from transcriptome analyses and methylation arrays has provided new insights into the development of these tumours. Elucidation of the genomic landscape of adrenocortical tumours and improved techniques may in the future be useful for early diagnosis through the detection of mutated DNA in the circulation. Moreover, compounds that bind specifically to altered proteins may be used as screening targets or therapeutic agents. Regulation of cortisol release by interaction with an altered subunit in adenylate cyclase may be more complex, but may provide a new option for regulating steroid release. Information about derangements in adrenocortical carcinoma is already helpful for determining patient prognosis. With further knowledge, we may be able to identify novel biomarkers that effectively and noninvasively help in differentiating between benign and malignant disease. It is clear that the next few years will provide much novel information that hopefully will aid in the treatment of patients with adrenocortical tumours.
Topics: Adenoma; Adrenal Cortex Neoplasms; Carcinoma; DNA Mutational Analysis; Genomics; Glucocorticoids; Humans; Hyperaldosteronism
PubMed: 27864864
DOI: 10.1111/joim.12452 -
Arquivos Brasileiros de Cirurgia... 2013Benign liver tumors, due to its relative easeness its imaging identification, have their incidence increasing in population in recent years, becoming frequent in the... (Review)
Review
BACKGROUND
Benign liver tumors, due to its relative easeness its imaging identification, have their incidence increasing in population in recent years, becoming frequent in the clinical picture and often a challenge for clinicians and surgeons. Doctors began to face dilemmas related to diagnosis in asymptomatic patients with liver nodules.
AIM
Update the knowledge of hepatic adenomas due to the crescent diagnosis seen in the recent years.
METHODS
Was performed a literature review consulting Medline/PubMed, SciELO, Embase, Lilacs database with the following descriptors: hepatic adenoma, surgery, medical treatment, diagnosis, pathophysiology and molecular biology.
CONCLUSION
The diagnosis of incidental asymptomatic lesions is a major dilemma in clinical practice because it brings intense distress for patients and their families, and often become a challenge for the physician or surgeon. Injury is of particular interest because it can provide both benign evolution or potentially lethal complications. Recently, its resection is no more mandatory; currently, more individualized treatment are required, aiming less morbidity. In light of new advances in molecular biology, the physician who diagnoses the lesion must identify the potential unfavorable evolution, and recognize cases who need more aggressive medical management.
Topics: Adenoma; Humans; Liver Neoplasms
PubMed: 24190381
DOI: 10.1590/s0102-67202013000300012 -
Archives of Pathology & Laboratory... Mar 2007Serrated adenomas can be morphologically subdivided into traditional and sessile types. They are thought to have a comparable rate of cancer progression like... (Review)
Review
CONTEXT
Serrated adenomas can be morphologically subdivided into traditional and sessile types. They are thought to have a comparable rate of cancer progression like conventional adenomas, but they potentially have a faster rate of growth through methylation pathway(s). They share similar morphologic features with both the conventional adenoma and the hyperplastic polyp in a fashion that is different from a mixed adenoma and a hyperplastic polyp.
OBJECTIVE
To describe the histopathologic features of traditional serrated adenoma and sessile serrated adenoma and their comparison with traditional adenomas and hyperplastic polyp.
DATA SOURCES
Relevant articles in peer-review journals and the authors' working experience as practicing surgical pathologists with a specific interest in gastrointestinal pathology.
CONCLUSIONS
Both types of serrated adenomas, traditional serrated adenoma and sessile serrated adenoma, are morphologically distinct, clinically important entities, and they can be diagnosed accurately in routine practice.
Topics: Adenoma; Adenomatous Polyps; Colonic Polyps; Colorectal Neoplasms; Diagnosis, Differential; Humans; Hyperplasia
PubMed: 17516746
DOI: 10.5858/2007-131-440-HOSAIV -
Archives of Pathology & Laboratory... Dec 2008Hepatic adenomatosis was first described in 1985 by Flejou et al as multiple adenomas, arbitrarily more than 10, in an otherwise normal liver parenchyma. Several authors... (Review)
Review
Hepatic adenomatosis was first described in 1985 by Flejou et al as multiple adenomas, arbitrarily more than 10, in an otherwise normal liver parenchyma. Several authors have suggested that it is a distinct entity from hepatic adenoma, which is predominantly seen in young women taking oral contraceptives. Although considered a benign disease, it can be associated with potentially fatal complications such as malignant transformation and intraperitoneal hemorrhage due to rupture. Although its etiology and natural history have not been fully elucidated, germline mutation of hepatocyte nuclear factor 1alpha, which is associated with maturity-onset diabetes of the young type 3, has recently been implicated in a subset of cases. Currently, there is no consensus on patient management. However, surgical removal of large lesions may significantly improve symptoms and reduce the risk of complications. Genetic counseling may now play an important role in case management.
Topics: Adenoma; Diagnosis, Differential; Germ-Line Mutation; Hepatocyte Nuclear Factor 1-alpha; Humans; Liver Neoplasms; Prognosis
PubMed: 19061298
DOI: 10.5858/132.12.1951 -
The Korean Journal of Gastroenterology... Sep 2017Gastric adenoma (dysplasia) is a precancerous lesion. Therefore, managements of gastric adenomas are important for preventing the development of gastric cancers and for... (Review)
Review
Gastric adenoma (dysplasia) is a precancerous lesion. Therefore, managements of gastric adenomas are important for preventing the development of gastric cancers and for detecting gastric cancers at earlier stages. The Vienna classification divides gastric adenomas into two categories: high-grade dysplasia and low-grade dysplasia. Generally, endoscopic resection is performed for adenoma with high-grade dysplasia due to the coexistence of carcinoma and the potential of progression to carcinomas. However, the treatments of adenoma with low-grade dysplasia remain controversial. Currently two treatment strategies for the low-grade type have been suggested; First is the 'wait and see' strategy; Second is endoscopic treatment (e.g., endoscopic mucosal resection, endoscopic submucosal dissection, or argon plasma coagulation). In this review, we discuss the current optimal strategies for endoscopic management of gastric adenoma.
Topics: Adenoma; Argon Plasma Coagulation; Endoscopic Mucosal Resection; Humans; Precancerous Conditions; Remission Induction; Stomach
PubMed: 28934826
DOI: 10.4166/kjg.2017.70.3.115 -
Medicina (Kaunas, Lithuania) Aug 2019Colorectal cancer (CRC) is one of the most common causes of cancer mortality in the world. The incidence is related to increases with age and western dietary habits.... (Review)
Review
Colorectal cancer (CRC) is one of the most common causes of cancer mortality in the world. The incidence is related to increases with age and western dietary habits. Early detection through screening by colonoscopy has been proven to effectively reduce disease-related mortality. Currently, it is generally accepted that most colorectal cancers originate from adenomas. This is known as the "adenoma-carcinoma sequence", and several studies have shown that early detection and removal of adenomas can effectively prevent the development of colorectal cancer. The other two pathways for CRC development are the Lynch syndrome pathway and the sessile serrated pathway. The adenoma detection rate is an established indicator of a colonoscopy's quality. A 1% increase in the adenoma detection rate has been associated with a 3% decrease in interval CRC incidence. However, several factors may affect the adenoma detection rate during a colonoscopy, and techniques to address these factors have been thoroughly discussed in the literature. Interestingly, despite the use of these techniques in colonoscopy training programs and the introduction of quality measures in colonoscopy, the adenoma detection rate varies widely. Considering these limitations, initiatives that use deep learning, particularly convolutional neural networks (CNNs), to detect cancerous lesions and colonic polyps have been introduced. The CNN architecture seems to offer several advantages in this field, including polyp classification, detection, and segmentation, polyp tracking, and an increase in the rate of accurate diagnosis. Given the challenges in the detection of colon cancer affecting the ascending (proximal) colon, which is more common in women aged over 65 years old and is responsible for the higher mortality of these patients, one of the questions that remains to be answered is whether CNNs can help to maximize the CRC detection rate in proximal versus distal colon in relation to a gender distribution. This review discusses the current challenges facing CRC screening and training programs, quality measures in colonoscopy, and the role of CNNs in increasing the detection rate of colonic polyps and early cancerous lesions.
Topics: Adenoma; Adenomatous Polyps; Colonoscopy; Colorectal Neoplasms; Deep Learning; Early Detection of Cancer; Humans; Neural Networks, Computer
PubMed: 31409050
DOI: 10.3390/medicina55080473 -
JPMA. the Journal of the Pakistan... Jan 2022Non-functioning pituitary adenomas account for 30% of anterior pituitary tumours. Based on their inability to secrete hormones, these are often diagnosed incidentally or... (Review)
Review
Non-functioning pituitary adenomas account for 30% of anterior pituitary tumours. Based on their inability to secrete hormones, these are often diagnosed incidentally or due to pressure symptoms. Understanding the pathogenesis of these adenomas can provide insight into factors leading to its progression and serving as biomarkers for early recognition. A literature search was performed in the current narrative review for articles published in PubMed for the last 10 years till January 2020 on micro-ribonucleic acid involved in the pathogenesis of non-functioning pituitary adenomas. Of the 478 articles found, 21(4.4%) were filtered. In total, 106 micro-ribonucleic acids were identified, 25(23.5%) of which appeared in more than one study. Among them, 7(28%)were up-regulated, 11(44%) down-regulated, and 7(28%) were either up- or down-regulated. Micro- ribonucleic acids allow the screening, diagnosis and treatment of diseases in a relatively easy and inexpensive manner. This can revolutionise tumour management in the years ahead, especially in resource-constrained low- and middle-income countries.
Topics: Adenoma; Humans; MicroRNAs; Pituitary Neoplasms
PubMed: 35099451
DOI: 10.47391/JPMA.3149