Cargando…

GCT-75. ISOLATED PITUITARY STALK THICKENING

OBJECTIVES: Only few studies have examined the predictive factors and outcome of isolated pituitary stalk thickening (PST) in children. We aim to describe our institutional cohort to determine predictors of future malignancy. METHODS: A search of the radiology, endocrinology and neuro-oncology datab...

Descripción completa

Detalles Bibliográficos
Autores principales: Bennett, Julie, Nobre, Liana, Bouffet, Eric, Abla, Oussama, Wasserman, Jonathan, Ertl-Wagner, Birgit, Bartels, Ute
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7715351/
http://dx.doi.org/10.1093/neuonc/noaa222.291
_version_ 1783618935495589888
author Bennett, Julie
Nobre, Liana
Bouffet, Eric
Abla, Oussama
Wasserman, Jonathan
Ertl-Wagner, Birgit
Bartels, Ute
author_facet Bennett, Julie
Nobre, Liana
Bouffet, Eric
Abla, Oussama
Wasserman, Jonathan
Ertl-Wagner, Birgit
Bartels, Ute
author_sort Bennett, Julie
collection PubMed
description OBJECTIVES: Only few studies have examined the predictive factors and outcome of isolated pituitary stalk thickening (PST) in children. We aim to describe our institutional cohort to determine predictors of future malignancy. METHODS: A search of the radiology, endocrinology and neuro-oncology databases was performed to identify patients with isolated PST diagnosed between January 2000 and June 2019. Clinical data was collected. A detailed radiology review of baseline and follow up magnetic resonance imaging (MRI) was undertaken in a blinded fashion by two examiners. RESULTS: Forty-four patients were identified, with 37 meeting criteria for isolated PST and adequate imaging. Median age of baseline MRI was 9.9 years (range 0.9–17.5). Twenty-three were female (62%). Median follow up time was 5 (0.31–18.6) years. Indication for MRI was symptoms of diabetes insipidus (DI) in 28 patients with the remainder having other concerns for endocrine disturbance (7), headache (1) or visual impairment (1). Thirty-five subjects had pituitary dysfunction (95%), including 30 with diabetes insipidus (81%). Nine patients developed a malignancy (24%), with germinoma (5), Langerhans cell histiocytosis (3) and lymphoma (1) at a median of 0.36 years, 0.63 years and 1.1 years respectively. Elevated white blood cell count (>5 x 10(6)/L) in initial cerebrospinal fluid analysis was predictive of future diagnosis of germinoma or lymphoma (p=0.027). CONCLUSION: In this cohort 24% of children with PST were eventually diagnosed with a neoplasia after a median of 0.63 years. Pleocytosis in initial CSF samples was predictive for future development of germinoma or lymphoma.
format Online
Article
Text
id pubmed-7715351
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-77153512020-12-09 GCT-75. ISOLATED PITUITARY STALK THICKENING Bennett, Julie Nobre, Liana Bouffet, Eric Abla, Oussama Wasserman, Jonathan Ertl-Wagner, Birgit Bartels, Ute Neuro Oncol Germ Cell Tumors OBJECTIVES: Only few studies have examined the predictive factors and outcome of isolated pituitary stalk thickening (PST) in children. We aim to describe our institutional cohort to determine predictors of future malignancy. METHODS: A search of the radiology, endocrinology and neuro-oncology databases was performed to identify patients with isolated PST diagnosed between January 2000 and June 2019. Clinical data was collected. A detailed radiology review of baseline and follow up magnetic resonance imaging (MRI) was undertaken in a blinded fashion by two examiners. RESULTS: Forty-four patients were identified, with 37 meeting criteria for isolated PST and adequate imaging. Median age of baseline MRI was 9.9 years (range 0.9–17.5). Twenty-three were female (62%). Median follow up time was 5 (0.31–18.6) years. Indication for MRI was symptoms of diabetes insipidus (DI) in 28 patients with the remainder having other concerns for endocrine disturbance (7), headache (1) or visual impairment (1). Thirty-five subjects had pituitary dysfunction (95%), including 30 with diabetes insipidus (81%). Nine patients developed a malignancy (24%), with germinoma (5), Langerhans cell histiocytosis (3) and lymphoma (1) at a median of 0.36 years, 0.63 years and 1.1 years respectively. Elevated white blood cell count (>5 x 10(6)/L) in initial cerebrospinal fluid analysis was predictive of future diagnosis of germinoma or lymphoma (p=0.027). CONCLUSION: In this cohort 24% of children with PST were eventually diagnosed with a neoplasia after a median of 0.63 years. Pleocytosis in initial CSF samples was predictive for future development of germinoma or lymphoma. Oxford University Press 2020-12-04 /pmc/articles/PMC7715351/ http://dx.doi.org/10.1093/neuonc/noaa222.291 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Germ Cell Tumors
Bennett, Julie
Nobre, Liana
Bouffet, Eric
Abla, Oussama
Wasserman, Jonathan
Ertl-Wagner, Birgit
Bartels, Ute
GCT-75. ISOLATED PITUITARY STALK THICKENING
title GCT-75. ISOLATED PITUITARY STALK THICKENING
title_full GCT-75. ISOLATED PITUITARY STALK THICKENING
title_fullStr GCT-75. ISOLATED PITUITARY STALK THICKENING
title_full_unstemmed GCT-75. ISOLATED PITUITARY STALK THICKENING
title_short GCT-75. ISOLATED PITUITARY STALK THICKENING
title_sort gct-75. isolated pituitary stalk thickening
topic Germ Cell Tumors
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7715351/
http://dx.doi.org/10.1093/neuonc/noaa222.291
work_keys_str_mv AT bennettjulie gct75isolatedpituitarystalkthickening
AT nobreliana gct75isolatedpituitarystalkthickening
AT bouffeteric gct75isolatedpituitarystalkthickening
AT ablaoussama gct75isolatedpituitarystalkthickening
AT wassermanjonathan gct75isolatedpituitarystalkthickening
AT ertlwagnerbirgit gct75isolatedpituitarystalkthickening
AT bartelsute gct75isolatedpituitarystalkthickening