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Clinical Significance of Radical Surgery in the Treatment of Silent Corticotroph Adenoma
DC Field | Value | Language |
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dc.contributor.author | 구철룡 | - |
dc.contributor.author | 김세훈 | - |
dc.contributor.author | 김의현 | - |
dc.contributor.author | 문주형 | - |
dc.contributor.author | 이은직 | - |
dc.contributor.author | 김준형 | - |
dc.date.accessioned | 2019-12-18T00:36:24Z | - |
dc.date.available | 2019-12-18T00:36:24Z | - |
dc.date.issued | 2019 | - |
dc.identifier.issn | 2005-3711 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/173133 | - |
dc.description.abstract | OBJECTIVE: Silent corticotroph adenomas (SCA) are endocrine-inactive pituitary adenomas with positive immunohistochemistry staining for adrenocorticotropic hormone (ACTH). We investigated whether SCA-associated clinical profiles were more aggressive than hormonally negative adenomas (HNA). METHODS: Among 627 patients with pathologically proven endocrine-inactive pituitary adenomas between 2004 and 2013, positive immunohistochemistry revealed 55 SCAs and 411 HNAs. Surgical outcomes and radiological and endocrinological characteristics were compared. RESULTS: Strong female predominance was observed in the SCA group (p<0.001). Cavernous sinus invasion was identified in 22 (40%) SCA patients and 72 (17.6%) HNA patients (p<0.001). There were no differences in ACTH or cortisol levels between the two groups. The incidence of preoperative hypopituitarism and postoperative hormonal outcome did not differ between two groups. Total resection was achieved in 35 patients (63.7%) with SCA and 332 patients (80.8%) with HNA (p=0.007). When tumors were completely removed, recurrence rates were not statistically different between two groups (p=0.60). When complete resection was not achieved, tumors regrew from these remnants in seven patients (35.0%) with SCA and 12 patients (15.2%) with HNA (p=0.05). CONCLUSION: Total surgical resection for SCA is often challenging as these tumors frequently invade a cavernous sinus. Early remnant tumor intervention is justified, because untreated residual pituitary tumors regrow when patients were followed up for a long time. Prophylactic radiotherapy is not warranted for completely resected SCAs as tumor recurrence is uncommon. | - |
dc.description.statementOfResponsibility | open | - |
dc.format | application/pdf | - |
dc.language | English | - |
dc.publisher | Korean Neurosurgical Society | - |
dc.relation.isPartOf | JOURNAL OF KOREAN NEUROSURGICAL SOCIETY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.title | Clinical Significance of Radical Surgery in the Treatment of Silent Corticotroph Adenoma | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Junhyung Kim | - |
dc.contributor.googleauthor | Seon Jin Yoon | - |
dc.contributor.googleauthor | Ju Hyung Moon | - |
dc.contributor.googleauthor | Cheol Ryong Ku | - |
dc.contributor.googleauthor | Se Hoon Kim | - |
dc.contributor.googleauthor | Eun Jig Lee | - |
dc.contributor.googleauthor | Sun Ho Kim | - |
dc.contributor.googleauthor | Eui Hyun Kim | - |
dc.identifier.doi | 10.3340/jkns.2018.0027 | - |
dc.contributor.localId | A00201 | - |
dc.contributor.localId | A00610 | - |
dc.contributor.localId | A00837 | - |
dc.contributor.localId | A01383 | - |
dc.contributor.localId | A03050 | - |
dc.relation.journalcode | J01520 | - |
dc.identifier.eissn | 1598-7876 | - |
dc.identifier.pmid | 30630298 | - |
dc.subject.keyword | Adrenocorticotropic hormone | - |
dc.subject.keyword | Corticotrophs | - |
dc.subject.keyword | Pituitary neoplasms | - |
dc.contributor.alternativeName | Ku, Cheol Ryong | - |
dc.contributor.affiliatedAuthor | 구철룡 | - |
dc.contributor.affiliatedAuthor | 김세훈 | - |
dc.contributor.affiliatedAuthor | 김의현 | - |
dc.contributor.affiliatedAuthor | 문주형 | - |
dc.contributor.affiliatedAuthor | 이은직 | - |
dc.citation.volume | 62 | - |
dc.citation.number | 1 | - |
dc.citation.startPage | 114 | - |
dc.citation.endPage | 122 | - |
dc.identifier.bibliographicCitation | JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, Vol.62(1) : 114-122, 2019 | - |
dc.identifier.rimsid | 62640 | - |
dc.type.rims | ART | - |
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