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Pituitary
Published in: Pituitary 1/2017

01-02-2017

Management of aggressive growth hormone secreting pituitary adenomas

Authors: Daniel A. Donoho, Namrata Bose, Gabriel Zada, John D. Carmichael

Published in: Pituitary | Issue 1/2017

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Abstract

Aggressive GH-secreting pituitary adenomas (GHPAs) represent an important clinical problem in patients with acromegaly. Surgical therapy, although often the mainstay of treatment for GHPAs, is less effective in aggressive GHPAs due to their invasive and destructive growth patterns, and their proclivity for infrasellar invasion. Medical therapies for GHPAs, including somatostatin analogues and GH receptor antagonists, are becoming increasingly important adjuncts to surgical intervention. Stereotactic radiosurgery serves as an important fallback therapy for tumors that cannot be cured with surgery and medications. Data suggests that patients with aggressive and refractory GHPAs are best treated at dedicated tertiary pituitary centers with multidisciplinary teams of neuroendocrinologists, neurosurgeons, radiation oncologists and other specialists who routinely provide advanced care to GHPA patients. Future research will help clarify the defining features of “aggressive” and “atypical” PAs, likely based on tumor behavior, preoperative imaging characteristics, histopathological characteristics, and molecular markers.
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Metadata
Title
Management of aggressive growth hormone secreting pituitary adenomas
Authors
Daniel A. Donoho
Namrata Bose
Gabriel Zada
John D. Carmichael
Publication date
01-02-2017
Publisher
Springer US
Published in
Pituitary / Issue 1/2017
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-016-0781-7

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