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Corticotroph Tumour Type Influences Clinical Behaviour in Patients With
Nonfunctioning Pituitary Neuroendocrine Tumours
#MMPMID41351299
Al-Shamkhi N
; Edén Engström B
; Gudjonsson O
; Wikström J
; Casar-Borota O
; Rask E
Endocrinol Diabetes Metab
2026[Jan]; 9
(1
): e70143
PMID41351299
show ga
INTRODUCTION: This study aims to describe whether the clinical behaviour of
nonfunctioning pituitary neuroendocrine tumours/nonfunctioning pituitary adenomas
(NF-PitNETs/NFPAs) is affected by pituitary cell lineage differentiation,
focusing on patients with silent corticotroph tumours (SCTs) and silent
gonadotroph tumours (SGTs). METHODS: Patients (N?=?101) who underwent primary
surgery for NF-PitNETs/NFPAs from August 2014 to March 2020 at Uppsala University
Hospital were included. Data on sex, age, MRI, pituitary function and
immunohistochemical analysis of anterior pituitary hormone and transcription
factor expression, were explored. RESULTS: Seventy-three patients had SGTs, and
18 had SCTs. Binary logistic regression revealed that having SCT versus SGT (OR
6.41 (CI: 1.20-34.42), p?=?0.03), being older at the time of surgery (OR 1.07
(CI: 1.02-1.12), p?=?0.01), and having a larger preoperative tumour volume (OR
1.17 (CI: 1.04-1.32), p?=?0.01) were associated with an increased likelihood of
postoperative pituitary failure. Patients with preoperative pituitary failure
were older at the time of surgery (p?=?0.01) and more often had preoperative
elevation of prolactin levels (p?=?0.01) than patients without preoperative
pituitary failure. SCT patients were younger at the time of surgery than SGT
patients (p?=?0.003), but no significant difference in preoperative tumour volume
was detected. CONCLUSION: The results indicate that cell lineage differentiation
in NF-PitNETs/NFPAs influences clinical behaviour. Patients with SCTs were
younger at the time of surgery, and harbouring a SCT was associated with an
increased likelihood of having postoperative pituitary failure. These findings
emphasise the importance of routine immunohistochemical analyses of anterior
pituitary hormone and transcription factor expression to identify silent
corticotroph tumours.
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