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Pituitary adenomas in patients with multiple endocrine neoplasia type 1: a single-center experience in China

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Abstract

Purpose

To explore the clinical characteristics of pituitary adenomas in patients with MEN1 and to summarize treatment strategies for MEN1 in a Chinese population.

Methods

We retrospectively analyzed 54 MEN1 patients with pituitary adenomas diagnosed at Peking Union Medical College Hospital from March 2003 to January 2017. Clinical data, laboratory testing results, treatments of involved glands and treatment responses were collected and analyzed.

Results

The mean age at pituitary adenoma diagnosis was 53.9 ± 17.8. The patients initially consulted the Endocrinology, General Surgery and Neurosurgery departments, in descending frequency. The nonfunctioning adenoma, prolactinoma, GH-secreting adenoma, cosecreting adenoma, and ACTH-secreting adenoma subtypes accounted for 48.1%, 27.8%, 9.3%, 9.3% and 5.6% of the cases, respectively. The remission rate for prolactinomas was 46.2% (6/13) treated with bromocriptine. And the remission rates were 87.5% (7/8) and 100% (3/3) for GH-secreting adenomas and ACTH-secreting adenomas respectively achieved by transsphenoidal surgery. Nineteen (35.2%) patients with asymptomatic nonfunctioning pituitary adenomas showed no progression after a 35-month follow-up with close observation. Regarding treatment priority, patients with thymic carcinoid tumors received first-line surgery, 54% of the patients with enteropancreatic tumors had these tumors treated first, and 26% of all patients had their pituitary adenomas treated first. In acromegalic patients, pituitary lesions tended to be treated first (75%, p = 0.002). PHPT and adrenocortical adenomas can be managed with elective surgery.

Conclusions

The treatment of MEN1 requires cooperation between multidisciplinary teams. Individualized treatment according to the severity of glandular involvement is needed. GH-secreting and ACTH-secreting pituitary adenomas require active treatment, while nonfunctioning pituitary adenomas can be observed closely.

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Acknowledgements

This study did not receive any specific grant from any funding agency in the public, commercial or non-for-profit sector.

Author information

Author notes

  1. Yanyan Wu and Lu Gao contributed equally to this paper.

Authors and Affiliations

  1. Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China

    Yanyan Wu, Lu Gao, Xiaopeng Guo, Zihao Wang, Wei Lian, Kan Deng & Bing Xing

  2. China Pituitary Disease Registry Center, Chinese Pituitary Adenoma Specialist Council, Beijing, 100730, China

    Yanyan Wu, Lu Gao, Xiaopeng Guo, Zihao Wang, Wei Lian, Kan Deng & Bing Xing

  3. Key Laboratory of Endocrinology of National Health and Family Planning Commission, Beijing, 100730, China

    Yanyan Wu, Lu Gao, Xiaopeng Guo, Zihao Wang, Wei Lian, Kan Deng & Bing Xing

  4. Department of Endocrinology, Peking Union Medical College Hospital, Beijing, 100730, China

    Lin Lu & Huijuan Zhu

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  1. Yanyan Wu
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  2. Lu Gao
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  3. Xiaopeng Guo
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  4. Zihao Wang
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  7. Lin Lu
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  8. Bing Xing
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Corresponding authors

Correspondence to Bing Xing or Huijuan Zhu.

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The authors declare no conflicts of interest.

Ethical approval

This study was performed in accordance with the ethical standards of the Institutional Ethics Committee of Peking Union Medical College Hospital at the Chinese Academy of Medical Sciences & Peking Union Medical College and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Written or verbal informed consent was obtained from all individual participants included in the study.

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Wu, Y., Gao, L., Guo, X. et al. Pituitary adenomas in patients with multiple endocrine neoplasia type 1: a single-center experience in China. Pituitary 22, 113–123 (2019). https://doi.org/10.1007/s11102-019-00939-x

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  • DOI: https://doi.org/10.1007/s11102-019-00939-x

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