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Management of Pituitary Tumors: Current and Future Treatment Options—2nd Edition
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Management of Pituitary Tumors: Current and Future Treatment Options—2nd Edition

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 2295

Special Issue Editor

Prof. Dr. Amit Akirov

E-Mail Website
Guest Editor
1. Institute of Endocrinology, Beilinson Campus, Rabin Medical Center, Petach-Tikva, Israel
2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Interests: pituitary; acromegaly; cushing; prolactinoma; pituitary adenoma
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is our pleasure to invite you to contribute to the Special Issue entitled “Management of Pituitary Tumors: Current and Future Treatment Options—2nd Edition”. This is a new Special Issue proceeding from the five papers we published in the first edition. For more details, please visit: https://www.mdpi.com/journal/jcm/special_issues/pituitary_tumors.

Pituitary disorders may be associated with significant morbidity and may require the use of multiple treatment modalities. As in other disciplines of medicine, the field of pituitary disorders has undergone rapid advances, which have transformed our understanding of the important principles underlying normal and abnormal pituitary function as well as our approach to the management of pituitary disorders.

This Special Issue will focus on current and future medical treatment options for patients with various pituitary disorders, including functional and non-functional pituitary adenomas. Experts in the field of medical treatment of pitutiary disorders will provide updates on the management and outcomes of the available, new, and emerging therapies.

Prof. Dr. Amit Akirov
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pituitary
  • cushing syndrome
  • acromegaly
  • prolactinoma
  • non-functioning pituitary adenoma
  • hypopituitarism
  • hypophysitis

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Related Special Issue

Published Papers (4 papers)

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Research

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13 pages, 833 KiB  
Article
Prediction of Pituitary Adenoma’s Volumetric Response to Gamma Knife Radiosurgery Using Machine Learning-Supported MRI Radiomics
by Herwin Speckter, Marko Radulovic, Erwin Lazo, Giancarlo Hernandez, Jose Bido, Diones Rivera, Luis Suazo, Santiago Valenzuela, Peter Stoeter and Velicko Vranes
J. Clin. Med. 2025, 14(9), 2896; https://doi.org/10.3390/jcm14092896 - 23 Apr 2025
Viewed by 592
Abstract
Background/Objectives: Gamma knife radiosurgery (GKRS) is widely performed as an adjuvant management of patients with residual or recurrent pituitary adenoma (PA). However, the variability in the tumor volume response to GKRS emphasizes the need for reliable predictors of treatment outcomes. The application of [...] Read more.
Background/Objectives: Gamma knife radiosurgery (GKRS) is widely performed as an adjuvant management of patients with residual or recurrent pituitary adenoma (PA). However, the variability in the tumor volume response to GKRS emphasizes the need for reliable predictors of treatment outcomes. The application of radiomics, an analytical approach for quantitative imaging, remains unexplored in predicting treatment responses for PAs. This study aimed to pioneer the use of radiomic MRI analysis to predict the volumetric response of PA to GKRS. Methods: This retrospective observational cohort study involved 81 patients who underwent GKRS for PA. Pre-treatment 3-Tesla MRI scans were used to extract radiomic features capturing the intensity, shape, and texture of the tumors. Radiomic signatures were generated using the least absolute shrinkage and selection operator (LASSO) for feature selection, in conjunction with several classifiers: random forest, naïve Bayes, kNN, logistic regression, neural network, and SVM. Results: The models demonstrated predictive performance in the test folds, with AUC values ranging from 0.759 to 0.928 and R2 values between 0.272 and 0.665. Single-sequence T1w, dual-sequence T1w + CE-T1w, and multi-modality including clinicopathological (CP) parameters (CP + T1w + CE-T1w) achieved rather similar prognostic performance in the test folds, with respective AUCs of 0.928, 0.899, and 0.909. All these radiomics models significantly outperformed a benchmark model involving only CP features (AUC = 0.846). Conclusions: This study represents a radiomic analysis focused on predicting the volume response of PAs to GKRS to facilitate treatment individualization. The developed MRI-based radiomics models exhibited superior classification performance compared with the benchmark model composed solely of standard clinicopathological parameters. Full article
(This article belongs to the Special Issue Management of Pituitary Tumors: Current and Future Treatment Options—2nd Edition)
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14 pages, 679 KiB  
Article
Real-World Experience with Pasireotide-LAR in Cushing’s Disease: Single-Center 12-Month Observational Study
by Lukasz Dzialach, Wioleta Respondek and Przemyslaw Witek
J. Clin. Med. 2025, 14(8), 2794; https://doi.org/10.3390/jcm14082794 - 18 Apr 2025
Cited by 1 | Viewed by 699
Abstract
Background/Objectives: Pasireotide-LAR represents a novel therapeutic option for patients with Cushing’s disease (CD). Its efficacy and safety were assessed in clinical trials; however, the real-world evidence is still scarce. Methods: The study aimed to evaluate the impact of 12-month pasireotide-LAR therapy [...] Read more.
Background/Objectives: Pasireotide-LAR represents a novel therapeutic option for patients with Cushing’s disease (CD). Its efficacy and safety were assessed in clinical trials; however, the real-world evidence is still scarce. Methods: The study aimed to evaluate the impact of 12-month pasireotide-LAR therapy on disease control, glucose metabolism, lipid profiles, and adverse effects in a real-life setting. We retrospectively studied prospectively collected data of patients with persistent or recurrent CD administered with pasireotide-LAR in a single pituitary center. Results: Mean urinary free cortisol (mUFC) showed a sustained decrease from baseline, with the most pronounced decrease in the first 3 months of therapy (p = 0.007). The analysis of mean late-night salivary cortisol showed fluctuations over time, with the largest mean reduction in mLNSC at 3 months. During the therapy, an improvement in blood pressure control was observed, with a significant decrease in systolic blood pressure during the first 6 months of treatment (p = 0.005). Hyperglycemia was the most common adverse effect. Fasting plasma glucose and glycated hemoglobin (HbA1c) showed a gradual increase during pasireotide-LAR treatment, with the HbA1c significantly increasing at the last follow-up (p = 0.04). Conclusions: Pasireotide-LAR is an effective alternative treatment in selected patients with CD. Pasireotide-LAR is overall safe and well tolerated, with hyperglycemia being the most common but manageable adverse event. Full article
(This article belongs to the Special Issue Management of Pituitary Tumors: Current and Future Treatment Options—2nd Edition)
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Review

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13 pages, 282 KiB  
Review
Management of Recurrent and Aggressive Non-Functioning Pituitary Adenomas
by Nicole A. Hefner and Odelia Cooper
J. Clin. Med. 2025, 14(15), 5203; https://doi.org/10.3390/jcm14155203 - 23 Jul 2025
Viewed by 151
Abstract
When non-functioning pituitary adenomas (NFPAs) behave aggressively or recur after first-line surgical treatment, it can be challenging to decide whether and how to escalate therapy. Up to 47% of patients with residual tumor after transsphenoidal surgery will show disease recurrence or progression and [...] Read more.
When non-functioning pituitary adenomas (NFPAs) behave aggressively or recur after first-line surgical treatment, it can be challenging to decide whether and how to escalate therapy. Up to 47% of patients with residual tumor after transsphenoidal surgery will show disease recurrence or progression and may require an intervention. Repeat surgical resection can be attempted in select cases if the tumor is accessible; for the remainder of patients, non-surgical treatment options may need to be considered. Radiotherapy can control tumor growth in 75% of NFPAs, but confers increased risk of hypopituitarism and other disorders. Currently, there are no medical therapies approved for patients with recurrent or aggressive NFPA. However, several have been investigated, including temozolomide, somatostatin receptor ligands, dopamine agonists, immune checkpoint inhibitors, vascular endothelial growth factor inhibitors, and peptide receptor radionuclide therapy. We present a review of the available evidence to provide guidance for pituitary endocrinologists and neuro-oncologists when treating patients with recurrent or aggressive NFPA. Full article
(This article belongs to the Special Issue Management of Pituitary Tumors: Current and Future Treatment Options—2nd Edition)
13 pages, 2660 KiB  
Review
Pituitary Apoplexy in a Non-Functioning PitNET After Cabergoline Use: Case Report and Review of the Literature
by Federica De Luca, Margherita Paccagnella, Anna Pizzo, Giulia Zuolo, Veronica Calabrò and Stella Bernardi
J. Clin. Med. 2025, 14(14), 5089; https://doi.org/10.3390/jcm14145089 - 17 Jul 2025
Viewed by 170
Abstract
Background/Objectives: Pituitary apoplexy (PA) is a rare medical emergency characterized by the sudden onset of symptoms resulting from hemorrhage and/or infarction within the pituitary gland. Precipitating factors include the use of dopamine agonists (DAs), whose main indication is the treatment of prolactin [...] Read more.
Background/Objectives: Pituitary apoplexy (PA) is a rare medical emergency characterized by the sudden onset of symptoms resulting from hemorrhage and/or infarction within the pituitary gland. Precipitating factors include the use of dopamine agonists (DAs), whose main indication is the treatment of prolactin (PRL)-secreting pituitary neuroendocrine tumors (PitNETs), but which can also be considered in non-functioning PitNETs. Here we report a case of PA in a patient taking cabergoline for a non-functioning PitNET, followed by a review of the literature focusing on the cases of PA associated with the use of DAs. Methods: A review of the literature was performed, searching Pubmed for other clinical cases of PA associated with the use of DAs, from inception to March 2025. Results: We found 43 cases of PA associated with the use of DAs. All the patients had secreting tumors: 86% were classified as PRL-secreting PitNETs, 7% were classified as GH-secreting PitNETs, and 4.6% included a mixed PRL/GH-secreting PitNET and a TSH-secreting PitNET. By contrast, here we present a case of PA in a non-functioning PitNET during cabergoline therapy. Our patient was managed conservatively and endocrine function recovered spontaneously. In our case, cabergoline might have promoted PA, which is consistent with the reported efficacy of cabergoline in inducing tumor shrinkage of non-functioning PitNETs that express dopamine 2 receptors, including silent PIT1 and SF1 or NULL tumors. Conclusions: Our case confirms cabergoline efficacy in non-functioning PitNETs and sheds light on a possible complication of its use. Patients, particularly those with large tumors, should be closely monitored for this occurrence. Full article
(This article belongs to the Special Issue Management of Pituitary Tumors: Current and Future Treatment Options—2nd Edition)
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