Aggressive Corticotroph Tumors and Carcinomas

Overview

Journal J Neuroendocrinol

Specialty Endocrinology

Date 2022 Aug 18

PMID 35979732

Authors

Helene Lasolle

Alexandre Vasiljevic

Emmanuel Jouanneau

Mirela Diana Ilie

Gerald Raverot

Affiliations

Soon will be listed here.

Abstract

Pituitary tumors are generally benign, although in rare cases aggressive pituitary tumors (APTs) and carcinomas present important diagnostic and therapeutic challenges and are associated with a high mortality rate. Almost half of these APTs and carcinomas are corticotroph tumors, suggesting a specific prognosis. Clinical, pathological and molecular prognostic markers are limited and do not allow early management of these tumors. Temozolomide remains the first-line treatment once a diagnosis of aggressive pituitary tumor or carcinoma has been made. Novel alternative treatments exist, including immune checkpoint inhibitors, which can be used in the case of temozolomide treatment failure. The aim of this review is to present the clinical, pathological and molecular characteristics of aggressive corticotroph tumors and carcinomas, and to describe the results obtained with currently available treatments.

Citing Articles

Longitudinal multiomics analysis of aggressive pituitary neuroendocrine tumors: comparing primary and recurrent tumors from the same patient, reveals genomic stability and heterogeneous transcriptomic profiles with alterations in metabolic pathways.

Taniguchi-Ponciano K, Hinojosa-Alvarez S, Hernandez-Perez J, Chavez-Santoscoy R, Remba-Shapiro I, Guinto G Acta Neuropathol Commun. 2024; 12(1):142.

PMID: 39217365 PMC: 11365143. DOI: 10.1186/s40478-024-01796-x.

An individualized approach to the management of Cushing disease.

Fleseriu M, Varlamov E, Hinojosa-Amaya J, Langlois F, Melmed S Nat Rev Endocrinol. 2023; 19(10):581-599.

PMID: 37537306 DOI: 10.1038/s41574-023-00868-7.

Refractory corticotroph adenomas.

Sumal A, Zhang D, Heaney A Pituitary. 2023; 26(3):269-272.

PMID: 36917358 PMC: 10333410. DOI: 10.1007/s11102-023-01308-5.

Distinguishing Cushing's disease from the ectopic ACTH syndrome: Needles in a haystack or hiding in plain sight?.

Hayes A, Grossman A J Neuroendocrinol. 2022; 34(8):e13137.

PMID: 35980277 PMC: 9542389. DOI: 10.1111/jne.13137.

Long-term effects of glucocorticoid excess on the brain.

Dekkers A, Amaya J, van der Meulen M, Biermasz N, Meijer O, Pereira A J Neuroendocrinol. 2022; 34(8):e13142.

PMID: 35980208 PMC: 9541651. DOI: 10.1111/jne.13142.

References

Fountas A, Lavrentaki A, Subramanian A, Toulis K, Nirantharakumar K, Karavitaki N . Recurrence in silent corticotroph adenomas after primary treatment: A systematic review and meta-analysis. J Clin Endocrinol Metab. 2018; . DOI: 10.1210/jc.2018-01956. View

Tatsi C, Pankratz N, Lane J, Faucz F, Hernandez-Ramirez L, Keil M . Large Genomic Aberrations in Corticotropinomas Are Associated With Greater Aggressiveness. J Clin Endocrinol Metab. 2019; 104(5):1792-1801. PMC: 6452317. DOI: 10.1210/jc.2018-02164. View

Mete O, Lopes M . Overview of the 2017 WHO Classification of Pituitary Tumors. Endocr Pathol. 2017; 28(3):228-243. DOI: 10.1007/s12022-017-9498-z. View

Lelotte J, Mourin A, Fomekong E, Michotte A, Raftopoulos C, Maiter D . Both invasiveness and proliferation criteria predict recurrence of non-functioning pituitary macroadenomas after surgery: a retrospective analysis of a monocentric cohort of 120 patients. Eur J Endocrinol. 2017; 178(3):237-246. DOI: 10.1530/EJE-17-0965. View

Castellnou S, Vasiljevic A, Lapras V, Raverot V, Alix E, Borson-Chazot F . SST5 expression and USP8 mutation in functioning and silent corticotroph pituitary tumors. Endocr Connect. 2020; . PMC: 7077525. DOI: 10.1530/EC-20-0035. View

Luo M, Tan Y, Chen W, Hu B, Wang Z, Zhu D . Clinical Efficacy of Temozolomide and Its Predictors in Aggressive Pituitary Tumors and Pituitary Carcinomas: A Systematic Review and Meta-Analysis. Front Neurol. 2021; 12:700007. PMC: 8250148. DOI: 10.3389/fneur.2021.700007. View

Lasolle H, Elsensohn M, Wierinckx A, Alix E, Bonnefille C, Vasiljevic A . Chromosomal instability in the prediction of pituitary neuroendocrine tumors prognosis. Acta Neuropathol Commun. 2020; 8(1):190. PMC: 7653703. DOI: 10.1186/s40478-020-01067-5. View

Roussel-Gervais A, Couture C, Langlais D, Takayasu S, Balsalobre A, Rueda B . The Cables1 Gene in Glucocorticoid Regulation of Pituitary Corticotrope Growth and Cushing Disease. J Clin Endocrinol Metab. 2015; 101(2):513-22. DOI: 10.1210/jc.2015-3324. View

Ieva A, Davidson J, Syro L, Rotondo F, Montoya J, Horvath E . Crooke's cell tumors of the pituitary. Neurosurgery. 2015; 76(5):616-22. DOI: 10.1227/NEU.0000000000000657. View

10.

Lin A, Jonsson P, Tabar V, Yang T, Cuaron J, Beal K . Marked Response of a Hypermutated ACTH-Secreting Pituitary Carcinoma to Ipilimumab and Nivolumab. J Clin Endocrinol Metab. 2018; 103(10):3925-3930. PMC: 6456994. DOI: 10.1210/jc.2018-01347. View

11.

Bengtsson D, Schroder H, Berinder K, Maiter D, Hoybye C, Ragnarsson O . Tumoral MGMT content predicts survival in patients with aggressive pituitary tumors and pituitary carcinomas given treatment with temozolomide. Endocrine. 2018; 62(3):737-739. DOI: 10.1007/s12020-018-1751-9. View

12.

Losa M, Albano L, Bailo M, Barzaghi L, Mortini P . Role of radiosurgery in the treatment of Cushing's disease. J Neuroendocrinol. 2022; 34(8):e13134. DOI: 10.1111/jne.13134. View

13.

Sol B, de Filette J, Awada G, Raeymaeckers S, Aspeslagh S, Andreescu C . Immune checkpoint inhibitor therapy for ACTH-secreting pituitary carcinoma: a new emerging treatment?. Eur J Endocrinol. 2020; 184(1):K1-K5. PMC: 7707801. DOI: 10.1530/EJE-20-0151. View

14.

Assie G, Bahurel H, Coste J, Silvera S, Kujas M, Dugue M . Corticotroph tumor progression after adrenalectomy in Cushing's Disease: A reappraisal of Nelson's Syndrome. J Clin Endocrinol Metab. 2006; 92(1):172-9. DOI: 10.1210/jc.2006-1328. View

15.

Hamblin R, Coulden A, Fountas A, Karavitaki N . The diagnosis and management of Cushing's syndrome in pregnancy. J Neuroendocrinol. 2022; 34(8):e13118. PMC: 9541401. DOI: 10.1111/jne.13118. View

16.

Salehidoost R, Korbonits M . Glucose and lipid metabolism abnormalities in Cushing's syndrome. J Neuroendocrinol. 2022; 34(8):e13143. DOI: 10.1111/jne.13143. View

17.

Ben-Shlomo A, Cooper O . Silent corticotroph adenomas. Pituitary. 2018; 21(2):183-193. DOI: 10.1007/s11102-018-0864-8. View

18.

Reincke M, Albani A, Assie G, Bancos I, Brue T, Buchfelder M . Corticotroph tumor progression after bilateral adrenalectomy (Nelson's syndrome): systematic review and expert consensus recommendations. Eur J Endocrinol. 2021; 184(3):P1-P16. PMC: 8060870. DOI: 10.1530/EJE-20-1088. View

19.

Ilie M, Lasolle H, Raverot G . Emerging and Novel Treatments for Pituitary Tumors. J Clin Med. 2019; 8(8). PMC: 6723109. DOI: 10.3390/jcm8081107. View

20.

Guaraldi F, Zoli M, Righi A, Gibertoni D, Picciola V, Faustini-Fustini M . A practical algorithm to predict postsurgical recurrence and progression of pituitary neuroendocrine tumours (PitNET)s. Clin Endocrinol (Oxf). 2020; 93(1):36-43. DOI: 10.1111/cen.14197. View