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Abramson Cancer CenterNCI CANCERLIT® Search: Pituitary Tumor - October 2002
National Cancer Institute®
Last Modified: October 1, 2002
- Coexistence of pyoderma gangrenosum and Cushing's disease: a paradoxical association?
- Long-term survival with ACTH-secreting carcinoma of the pituitary: a case report and review of the literature.
- The association of oral contraception with kidney cancer, colon cancer, gallbladder cancer (including extrahepatic bile duct cancer) and
- Blunted prolactin response to hypoglycemia in patients with hypothalamic-pituitary disease and in subjects receiving estrogen.
- [Oral contraceptives and prolactin-producing hypophyseal tumors]
- Oral contraceptive history as a risk indicator in patients with pituitary tumors with hyperprolactinemia: a case comparison study of
- Oral contraceptives and prolactinomas: a case-control study.
- Prolactin-secreting pituitary adenoma: occurrence following prenatal exposure to diethylstilbestrol.
- Prolactin response to dopamine synthesis inhibition using monoiodotyrosine in subjects on oral contraceptives and patients with
- Oral contraceptive steroids do not promote the development or growth of prolactinomas.
- Vasospasm following transsphenoidal tumor removal associated with the arterial changes of oral contraception.
- Oral contraceptive exposure of amenorrheic women with and without prolactinomas.
- The utility of external beam radiation and intracystic 32P radiation in the treatment of craniopharyngiomas.
- AgNOR values are not helpful in the differential diagnosis of pituitary adenomas.
- Intraoperative bilateral cavernous sinus sampling for ACTH measurements during transsphenoidal pituitary surgery in patients with Cushing's
- Coexistence of a cerebellopontine epidermoid cyst with a pituitary adenoma.
- The use of dextroamphetamine to treat obesity and hyperphagia in children treated for craniopharyngioma.
- Are nonfunctioning pituitary adenomas extending into the cavernous sinus aggressive and/or invasive?
- [The endonasal approach to pituitary adenomas: experience in 105 procedures]
- [Ectopic prolactinoma of the sphenoidal sinus: case report]
- Prop-1 gene expression in human pituitary tumors.
- Fluctuating confusional state due to massive macro-prolactinoma resulting in obstructive hydrocephalus.
- Frameless stereotaxy as an alternative to fluoroscopy for transsphenoidal surgery: use of the InstaTrak-3000 and a novel headset.
- Results of stereotactic radiosurgery in patients with hormone-producing pituitary adenomas: factors associated with endocrine normalization.
- Characterization and localization of an immunoreactive growth hormone-releasing hormone precursor form in normal and tumoral human
- Screening for macroprolactinaemia and pituitary imaging studies.
- The treatment of a thyrotropin-secreting pituitary macroadenoma with octreotide in twin pregnancy.
- Pituicytomas, a mis-diagnosed benign tumor of the neurohypophysis: report of three cases.
- Impaired estrogen-induced negative feedback on gonadotropin secretion in patients with gonadotropin-secreting and nonfunctioning pituitary
- Pituitary tumours and acromegaly (Pierre Marie's disease).
- Distribution and regulation of proconvertases PC1 and PC2 in human pituitary adenomas.
- Image-guided transorbital roof craniotomy via a suprabrow approach: a surgical series of 72 patients.
- Image-guided transorbital roof craniotomy via a suprabrow approach: a surgical series of 72 patients.
- CCK processing by pituitary GH3 cells, human teratocarcinoma cells NT2 and hNT differentiated human neuronal cells evidence for a
- Expression patterns of messenger ribonucleic acids encoding prohormone convertases (PC2 and PC3) in human pituitary adenomas.
- Expression of the prohormone convertase PC2 correlates with the presence of corticotropin-like intermediate lobe peptide in human
- Analysis of the chromogranin A post-translational cleavage product pancreastatin and the prohormone convertases PC2 and PC3 in normal and
- Localization of prohormone convertases 1/3 and 2 in the human pituitary gland and pituitary adenomas: analysis by immunohistochemistry,
- Chemotherapy with Adriamycin (doxorubicin) and CCNU (lomustine) in four children with recurrent craniopharyngioma.
- Clinical and biochemical characteristics of growth hormone-secreting pituitary tumors.
- Preliminary study on the relationship between cAMP level and gsp expression in cultured human pituitary somatotrophinomas.
- Minimally invasive endoscope-assisted endonasal trans-sphenoidal microsurgery for pituitary tumors: experience with 215 cases comparing
- [Effect of somatocrinin 1-40 (hpGRF-40) on human prolactinoma]
- [Release of thyrotropin releasing hormone (TRH) from human prolactin-secreting pituitary adenoma cells. Modulation by dopamine]
- [In vitro secretion of somatostatin (SRIH) by human adenomatous somatotropic cells. Relation with somatotropic hormone (GH) release and
- [Presence and characterization of somatostatin precursor in human growth hormone secreting pituitary gland tumor]
- [Diagnostic difficulties in scanty symptomatic pituitary tumor]
- External beam irradiation of craniopharyngiomas: long-term analysis of tumor control and morbidity.
- The novel use of very high doses of cabergoline and a combination of testosterone and an aromatase inhibitor in the treatment of a giant
- Primary medical therapy for acromegaly: an open, prospective, multicenter study of the effects of subcutaneous and intramuscular
Table of Contents
1
UI - 10809875
AU - De Silva B; Doherty VR
TI -
Coexistence of pyoderma gangrenosum and Cushing's disease: a paradoxical
association?
SO - Br J Dermatol 2000 May;142(5):1051-2
2
UI - 12107205
AU - Landman RE; Horwith M; Peterson RE; Khandji AG; Wardlaw SL
TI -
Long-term survival with ACTH-secreting carcinoma of the pituitary: a
case report and review of the literature.
SO - J Clin Endocrinol Metab 2002 Jul;87(7):3084-9
AD - Department of Medicine, Columbia University College of Physicians and
Surgeons, 630 West 168th Street, New York, NY 10032, USA.
A 48-yr-old woman was evaluated 21 yr after receiving treatment for an
ACTH-secreting metastatic pituitary carcinoma. She had been diagnosed
with Cushing's disease 35 yr earlier at the age of 14 yr and had
undergone bilateral adrenalectomy. Six years later she developed
Nelson's syndrome, which was treated with resection of a pituitary
adenoma followed by radiotherapy to the sella turcica. Eight years later
she was found to have craniospinal metastases with three remote
intracerebral lesions. Two of these lesions were surgically resected and
stained positive for ACTH by immunofluorescence. She subsequently
received whole-brain radiotherapy and is doing well 21 yr later with no
lesions seen on magnetic resonance imaging and no evidence of recurrent
metastatic disease. We present this case in detail along with a
literature review of ACTH-secreting pituitary carcinoma.
3
UI - 1868737
AU - Milne R; Vessey M
TI -
The association of oral contraception with kidney cancer, colon cancer,
gallbladder cancer (including extrahepatic bile duct cancer) and
pituitary tumours.
SO - Contraception 1991 Jun;43(6):667-93
AD - Department of Public Health and Primary Care, Radcliffe Infirmary,
Oxford, England.
This paper reviews the evidence for a relationship between oral
contraceptive use and certain neoplasms: cancers of the kidney, colon
and gallbladder (including the extrahepatic bile ducts) and tumours
(benign or malignant) of the pituitary. Special reference is made to
controlled epidemiological studies, both case-control and cohort. There
is no convincing evidence that oral contraceptive use is causally
related, either negatively or positively, to any of the tumours studied.
4
UI - 6768957
AU - May P; Proper S; Ourednik J; Schneider G; Ertel N
TI -
Blunted prolactin response to hypoglycemia in patients with
hypothalamic-pituitary disease and in subjects receiving estrogen.
SO - Metabolism 1980 Apr;29(4):340-5
The prolactin response to hypoglycemia was evaluated in 22 control
subjects and 8 patients with hypothalamic-pituitary disease but normal
basal serum prolactin levels. Eighteen of the 22 control subjects
demonstrated at least a twofold prolactin rise in response to
hypoglycemia. In contrast to the control subjects, none of the 8
patients demonstrated a prolactin response to hypoglycemia. This blunted
prolactin response to hypoglycemia was the only endocrine abnormality in
3 of these 8 patients. In an attempt to better determine the sensitivity
of the prolactin response to hypoglycemia as an index of early pituitary
disease, the effect of a short course of estrogen on the prolactin
response to hypoglycemia was examined. Estrogen was selected because of
its known acute stimulatory effect on pituitary mitosis and chronic
effects that lead to pituitary tumor formation in rodents. Accordingly,
diethylstilbestrol (DES) 5 mg t.i.d. was administered orally to 6 normal
men for 3 days, a period known to stimulate pituitary mitotic activity
in rodents. Diethylstilbestrol treatment caused significant elevation of
the baseline prolactin (8 +/- 2 versus 18 +/- 3 ng/ml, p less than
0.05); however, the prolactin response to hypoglycemia was blunted (8
+/- 2--30 +/- 10 ng/ml, p less than 0.05, before DES; 18 +/- 3--20 +/- 5
ng/ml after DES, p greater than 0.05). This estrogen-induced blunted
prolactin response to hypoglycemia resembled the blunted prolactin
response to hypoglycemia found in patients with hypothalamic-pituitary
disease.
5
UI - 7374834
AU - Lamberts SW
TI -
[Oral contraceptives and prolactin-producing hypophyseal tumors]
SO - Ned Tijdschr Geneeskd 1980 Jan 26;124(4):111-3
6
UI - 7193811
AU - Teperman L; Futterweit W; Zappulla R; Malis LI
TI -
Oral contraceptive history as a risk indicator in patients with
pituitary tumors with hyperprolactinemia: a case comparison study of
twenty patients.
SO - Neurosurgery 1980 Dec;7(6):571-3
This report presents a retrospective case comparison study of 20
hyperprolactinemic patients with pituitary adenomas treated at the Mount
Sinai Hospital (1976-1079). An association between oral contraceptive
(OC) use and 20 subjects with pituitary tumors was substantiated using
discordant paired analysis. The comparison group consisted of
appendectomy patients admitted during the same time period and matched
for sex and age. The estimated relative risk was 4.0 (P less than
0.025). This study suggests that there is a significant association
between OC use and pituitary tumors associated with hyperprolactinemia.
7
UI - 7081323
AU - Maheux R; Jenicek M; Cleroux R; Beauregard H; De Muylder X; Gratton NM;
TI -
Van Campenhout J
Oral contraceptives and prolactinomas: a case-control study.
SO - Am J Obstet Gynecol 1982 May 15;143(2):134-8
The increase in the number of newly diagnosed cases of prolactinomas
seems to coincide with the use of oral contraceptives during the past
two decades. The following retrospective case-control study was
undertaken in an attempt to disprove a null hypothesis of relationship
between oral contraceptive use and prolactinomas. Each of 70 patients
operated upon for removal of a prolactinoma was closely matched for age,
gravidity, and year of final diagnosis with one patient in each of three
control groups. The control groups selected were constituted,
respectively, of patients with secondary amenorrhea and normal prolactin
levels, patients with normal ovulatory cycles consulting for
infertility, and subjects without medical or gynecologic problems. No
statistically significative differences were found in the exposure rates
to oral contraceptives among four groups. This study thus failed to
reveal a significant association between prolactinomas and oral
contraceptives but, given the sample size, a relative risk lower than
3.32 cannot be demonstrated or disproved.
8
UI - 7168914
AU - Cunningham JR; Gidwani GP; Gupta MS; Duchesneau PM; Schumacher OP
TI -
Prolactin-secreting pituitary adenoma: occurrence following prenatal
exposure to diethylstilbestrol.
SO - Cleve Clin Q 1982 Winter;49(4):249-54
9
UI - 6833458
AU - Ho KY; Smythe GA; Lazarus L
TI -
Prolactin response to dopamine synthesis inhibition using
monoiodotyrosine in subjects on oral contraceptives and patients with
pathological hyperprolactinemia.
SO - J Clin Endocrinol Metab 1983 Apr;56(4):692-6
10
UI - 6839760
AU - Hulting AL; Werner S; Hagenfeldt K
TI -
Oral contraceptive steroids do not promote the development or growth of
prolactinomas.
SO - Contraception 1983 Jan;27(1):69-73
Seventy women with prolactinomas, age 19-38 years, were studied in order
to evaluate a possible relationship between the use of steroidal oral
contraceptives (o.c.) and the development of prolactin-producing
adenomas. Sixty-seven patients were admitted for investigation because
of menstrual bleeding disturbances and three patients because of
galactorrhea. Forty-three patients (61%) had used o.c. Thirty-six out of
forty-three women (83%) experienced their menstrual disturbances and/or
galactorrhea when using o.c. or immediately after discontinuing the
pill. Patients who had used o.c. had shorter duration of symptoms, lower
S-prolactin levels and less pronounced enlargement of the sella turcica.
These tendencies indicate that o.c. lead to an earlier manifestation of
clinically latent prolactin-producing tumours. With or without previous
o.c., the patients showed a low total fertility rate, indicating a
notably long, clinically undiagnosed period of disease. The accumulated
usage of o.c. by the women with prolactinomas was not higher than among
the total female population of the same age in Sweden. Furthermore,
patients on o.c. for several years did not show a more advanced form of
the disease than women who had not taken the pill. Thus, the present
study provides no support for the hypothesis that o.c. promote the
growth of prolactin-producing pituitary adenomas.
11
UI - 6879408
AU - Hyde-Rowan MD; Roessmann U; Brodkey JS
TI -
Vasospasm following transsphenoidal tumor removal associated with the
arterial changes of oral contraception.
SO - Surg Neurol 1983 Aug;20(2):120-4
A case of fatal cerebral vasospasm after transsphenoidal removal of a
pituitary macroadenoma with suprasellar extension is reported. On the
second postoperative day the patient developed headache, lethargy, and
cardiorespiratory arrest. Five days later, after recovery from this
episode, she developed signs of involvement of the left hemisphere. At
that time she demonstrated severe cerebral vasospasm, which was worse in
the left supraclinoid segment of the internal carotid artery, and she
died 19 days postoperatively. Postmortem examination showed left
hemispheric and hypothalamic infarction with subsequent herniation. In
addition, pathologic arterial changes usually related to use of oral
contraceptives were present.
12
UI - 6120108
AU - Jones JR; Kemmann E; Norwood PK
TI -
Oral contraceptive exposure of amenorrheic women with and without
prolactinomas.
SO - Int J Gynaecol Obstet 1981 Oct;19(5):381-7
The purpose of this study was to determine the extent of oral
contraceptive (OC) exposure of women with secondary amenorrhea of
hypothalamic-pituitary etiology. In 93 of 126 women with secondary
amenorrhea sufficient data were obtained regarding menstrual history and
OC exposure: 26 patients had evidence of a prolactinoma, an additional
26 patients had idiopathic hyperprolactinemia without evidence of a
pituitary tumor, and 41 had "pure" dysfunction hypothalamic-pituitary
amenorrhea. After stratification by age at diagnosis and parity the
estimated odds ratio for past oral contraceptive usage showed no
differences among the three groups (odds ratios between 0.74 and 1.48).
Using the chi-square test the proportion of subjects who had regular
menses before oral contraceptive intake and developed anovulation
immediately after discontinuance ("post pill amenorrhea") in the three
groups also showed no difference (x2 = 0.60, P = 0.74). These data
indicate that non-ovulatory patients are likely to have been exposed to
OC, and do not indicate that patients with prolactinomas differ in the
extent of their OC exposure from other specified groups of patients with
secondary.
13
UI - 11949829
AU - Schefter JK; Allen G; Cmelak AJ; Johnson M; Toms S; Duggan D; Blevins LS
TI -
The utility of external beam radiation and intracystic 32P radiation in
the treatment of craniopharyngiomas.
SO - J Neurooncol 2002 Jan;56(1):69-78
AD - The Pituitary Center at Vanderbilt, Vanderbilt University School of
Medicine, Nashville, TN 37232-6303, USA.
BACKGROUND: The management of craniopharyngiomas has historically been
controversial in terms of the extent of initial surgical resection and
the use of additional treatments. Various options include radical
excision versus a more conservative surgical approach followed by
external beam radiation; most recently, intracystic 32P radiation has
been used in selected patients. METHODS: We reviewed our experience with
25 patients with craniopharyngiomas treated between 1984 and 1999 to
assess the effectiveness of external beam radiation and intracystic 32P
radiation therapy in preventing progression and recurrence of local
disease. RESULTS: All patients underwent surgery as a component of
initial therapy for their histologically-proven craniopharyngiomas.
Fifteen patients additionally received external beam radiation.
Forty-five percent of patients who underwent incomplete resections
followed by external beam radiation required additional therapy. In
contrast, 80% of patients who had incomplete resections without
post-operative external beam radiation required further treatment. Seven
patients had intracystic 32P colloid injections. Neither of the two
patients receiving 32P intracystic radiation as part of their initial
therapy needed further treatment. Only one of the five patients
receiving 32P intracavitary radiation for disease progression following
initial therapy required further intervention. Of the remaining four
patients, three enjoyed responses to treatment and one had stable
disease. CONCLUSIONS: Our observations support the use of external beam
radiation for prevention of tumor progression in adults unable to
receive a complete surgical resection. Our results additionally suggest
that intracystic 32P radiation results in control of cystic components
of craniopharyngiomas in the majority of cases.
14
UI - 12140091
AU - Hucumenoglu S; Kaya H; Kotiloglu E; Erdem G; Demiray E; Ekicioglu G
TI -
AgNOR values are not helpful in the differential diagnosis of pituitary
adenomas.
SO - Clin Neurol Neurosurg 2002 Sep;104(4):293-9
AD - SSK Ankara Training and Research Hospital, Department of Pathology,
Hosdere C. No. 164/3 06550 Y. Ayranci, Ankara, Turkey.
shucumenoglu21@hotmail.com
Nucleolar organizer regions (NOR) are chromosomal segments in which
ribosomal RNA is encoded. AgNOR technique, which reveals these regions,
has rarely been used in the diagnosis and preceding the prognosis of
pituitary adenoma. The purpose of this study was to determine and
evaluate the correlation of hormonal profile with AgNOR counts, the
correlation of recurrence with AgNOR counts, and to determine the
consistency between the evaluations of the two independent observers.
This study covers 33 patients with pituitary adenoma. The slides were
stained with hematoxylin and eosin. Silver colloid method was used for
NOR, and immunohistochemistry for hormone expressions. Consistency was
significant between the two pathologists (for hormonal profile, the
Kappa test was used and P<0.001; for AgNOR count, intra-class
correlation coefficient was 0.83). There was no significant correlation
between mean AgNOR counts and hormone expressions (P>0.05), and there
was also no correlation between mean AgNOR counts and tumor sizes
(P>0.05). While no difference between recurrent and non-recurrent
patients was found with respect to mean AgNOR numbers (P>0.05),
nucleolar silver staining in the form of AgNOR clusters was more
frequently detected in recurrent cases.
15
UI - 12140100
AU - Czirjak S; Bezzegh A; Gal A; Racz K
TI -
Intraoperative bilateral cavernous sinus sampling for ACTH measurements
during transsphenoidal pituitary surgery in patients with Cushing's
disease.
SO - Clin Neurol Neurosurg 2002 Sep;104(4):334-8
AD - National Institute of Neurosurgery, Semmelweis University, Budapest,
Hungary.
Intraoperative bilateral cavernous sinus sampling combined with rapid
ACTH measurement was performed in a pilot study in seven patients with
Cushing's disease during transsphenoidal pituitary surgery before and
immediately after removal of the ACTH-producing pituitary microadenoma.
Before tumor removal a gradient in ACTH concentrations greater than
1.5:1 toward the side of the tumor was found in six patients whereas
ACTH concentrations in the right and left cavernous sinuses were similar
in one patient with a midline tumor. Immediately after tumor removal,
six of seven patients showed variable decreases in ACTH levels in the
ipsilateral and/or contralateral side, whereas in one patient the ACTH
levels in cavernous sinuses failed to reflect successful tumor removal.
These results indicate that intraoperative bilateral cavernous sinus
sampling combined with rapid ACTH measurement may be useful to confirm
and lateralize ACTH-producing pituitary microadenomas during surgery,
but ACTH levels measured immediately after tumor removal do not always
predict surgical cure.
16
UI - 12140106
AU - Kemaloglu S; Ozkan U; Ziyal I; Bukte Y; Ceviz A
TI -
Coexistence of a cerebellopontine epidermoid cyst with a pituitary
adenoma.
SO - Clin Neurol Neurosurg 2002 Sep;104(4):364-6
AD - Department of Neurosurgery, School of Medicine, Dicle University,
Diyarbakir, Turkey. mserdarkemaloglu@yahoo.com
We report on an 18-year-old girl with the coexistence of an epidermoid
cyst in the cerebellopontine angle (CPA) with a pituitary adenoma. The
clinical course and histopathological characteristics were reviewed. The
patient presented with headache, vision loss and amenorea. Computerised
tomographic (CT) scan and magnetic resonance imaging (MRI) examinations
demonstrated a solid sellar lesion with supra-sellar extension. There
was another mass lesion in the CPA with prepontine extension. The
tumours were removed surgically. Histopathological examination revealed
an epidermoid cyst in the prepontine area and a pituitary adenoma in the
sellar region. This has been the second case to be reported in the
literature with the coexistence of an epidermoid cyst and a pituitary
adenoma.
17
UI - 12197795
AU - Mason PW; Krawiecki N; Meacham LR
TI -
The use of dextroamphetamine to treat obesity and hyperphagia in
children treated for craniopharyngioma.
SO - Arch Pediatr Adolesc Med 2002 Sep;156(9):887-92
AD - Inova Fairfax Hospital for Children, Fairfax, Va, USA
BACKGROUND: Obesity and attention difficulties are known complications
following surgical treatment for craniopharyngioma. Treatments to date
have been largely disappointing. OBJECTIVE: To examine the use of the
central nervous system stimulant dextroamphetamine sulfate to regulate
appetite and subsequent weight gain in children treated for
craniopharyngioma. SETTING: A multidisciplinary clinic specializing in
pediatric brain tumors. PATIENTS: Five consecutive patients with
significant weight gain and poor attention following surgical treatment
for craniopharyngioma were selected for the study. INTERVENTION:
Children enrolled in the study were treated with dextroamphetamine, and
growth, laboratory, and behavioral assessments were conducted for 24
months. RESULTS: Mean +/- SD body mass index (weight in kilograms
divided by height in meters squared) increased from 21 +/- 3.5 before
the operation to 32 +/- 2.8 by the start of the protocol. Body mass
indices remained stable throughout the protocol. No changes were
observed in insulin levels or caloric intake, but the children were more
active when taking dextroamphetamine. Parents noted a significant
improvement in hyperactivity (mean +/- SD, 1.2 +/- 0.4 to 0.6 +/- 0.2; P
=.05), scored with the Conners Parent and Teacher Rating Scales.
Teachers noted a similar improvement. CONCLUSIONS: During
dextroamphetamine treatment, weight gain stabilized in children who had
experienced obesity following surgical resection for craniopharyngioma.
In addition, parents and teachers noted significant improvements in
children's overall activity and attention. Further studies are needed to
determine if the improvements are stable and if earlier intervention can
prevent the initial obesity.
18
UI - 12197494
AU - Mastronardi L; Guiducci A
TI -
Are nonfunctioning pituitary adenomas extending into the cavernous sinus
aggressive and/or invasive?
SO - Neurosurgery 2002 Aug;51(2):521-2; discussion 522
19
UI - 12193874
AU - Roux FX; Page P; Nataf F; Devaux B; Djian MC; Joly LM
TI -
[The endonasal approach to pituitary adenomas: experience in 105
procedures]
SO - Ann Endocrinol (Paris) 2002 Jun;63(3):187-92
AD - Service de Neurochirurgie, Department de Neuro Anesthesie Reanimation,
Centre Hospitalier Sainte-Anne, 1 rue Cabanis, 75014 Paris, France.
roux@chsa.broca.inserm.fr
OBJECTIVE: The endonasal approach to the sella turcica is supposed to
simplify surgical techniques and reduce the risk and sequelae linked to
removal of pituitary adenomas. We report our experience with 105
procedures using this approach. Method: The series included 45 men and
60 women, aged 17 to 83 years. Their intrasellar lesions were: 43
non-functional adnomas, 37 prolactinomas, 7 GH- adenomas, 9 corticotrop
adenomas, 9 miscellaneous lesions (abscess, Rathke cleft cysts, empty
sella). Mean duration of the procedures was 50 minutes. Mean hospital
stay was 4 days. RESULTS: There were no deaths. Morbidity included: 1
(0.95%) rhinorrhea associated with meningitis which cured without
sequelae, 11 (10.5%) transient diabetes insipidus lasting no longer than
48 hours, 2 cases of permanent diabetes insipidus (1 non-functional
macroadenoma, 1 pituitary abscess), 1 transient hyposmia (3 months), 2
transient nasal obstructions. There were no cases of septal perforation,
nasal deformation, partial or complete mucosal anesthesia, nasal pain,
dental pain, or epistaxis. CONCLUSION: This surgical approach is easier
to perform and causes less rhinological sequelae than the sublabial
transsphenoidal approach. It allows an as effective tumor removal than
the latter. Hospitalization stay is significantly shortened.
20
UI - 12193879
AU - Rebai R; Rekik N; Boudawara MZ; Khannous M; Bahloul K; Chaari S; Abid M;
TI -
Ben Mansour H
[Ectopic prolactinoma of the sphenoidal sinus: case report]
SO - Ann Endocrinol (Paris) 2002 Jun;63(3):226-30
AD - Service de Neurochirurgie, Tunisie, France.
A 34-year-old woman was hospitalized for exploration of amenorrhea and
galactorrhea. She had experienced primary sterility, diagnosed 11 years
earlier. Endocrine tests demonstrated hyperprolactinemia (serum
prolactin 594 ng/ml). Magnetic resonance imaging (MRI) showed a soft
tissue mass located within the posterior part of the sphenoidal sinus.
The pituitary gland appeared normal. Medical treatment with
bromocriptine was unsuccessful. Transsphenoidal tumor resection was
performed. Histology reported adenoma, which was consistent with
prolactin-producing tumor demonstrated by immunohistochemical staining
for prolactin. Because of the persistence of hyperprolactinemia related
to an intra-sphenoidal tumor remnant, bromocriptine (15 mg/d) was
initiated. Menses ensued and prolactin level declined (49 ng/ml). One
year later, the tumor remnant had disappeared on the MRI and the patient
became pregnant. Ectopic adenomas of the sphenoidal sinus are of
particular interest due to the diagnostic difficulties encountered.
Nevertheless, the nature of the lesion can be determined from the
endocrine manifestations. Some of these tumors respond to medical
treatment, similar to intra sellar tumors. Surgery remains however the
only means of obtaining definitive diagnosis and cure.
21
UI - 10404841
AU - Nakamura S; Ohtsuru A; Takamura N; Kitange G; Tokunaga Y; Yasunaga A;
TI -
Shibata S; Yamashita S
Prop-1 gene expression in human pituitary tumors.
SO - J Clin Endocrinol Metab 1999 Jul;84(7):2581-4
AD - Department of Neurosurgery, Nagasaki University School of Medicine,
Japan.
A novel type of pituitary-specific transcription factor, Prophet of
Pit-1 (Prop-1) gene (PROP1), expresses in just early embryonic stage in
mouse and closely related as a causative gene in combined pituitary
hormone deficiency. We studied PROP1 expression to further clarify its
correlation with tumorigenesis and biological behavior in human
pituitary adenomas. Eighteen pituitary adenomas and three normal
pituitary glands were examined for the expression of PROP1 and POU1F1 by
using RT-PCR Pituitary adenomas were diagnosed as non-functioning
adenomas (n = 11), prolactinomas (n=5), GH-producing adenoma (n = 1) and
ACTH-producing adenoma (n = 1). One of non-functioning adenomas was
pituitary carcinoma with cerebellar metastasis and CSF dissemination.
Our results demonstrated PROP1 expression in all pituitary tumors
examined, in contrast, POU1F1 was detected in 14 of pituitary tumors.
PROP1 was also expressed in normal pituitary gland, however, it was not
in normal brain tissue, glioblastomas (cell lines and tumor tissues) and
meningioma. Our data indicated that PROP1 expression was observed
constantly both in the pituitary tumors and normal human adult pituitary
tissues, suggesting that PROP1 is an essential transcriptional factor
for pituitary specific gene expression in human. Therefore, detection of
PROP1 might be a useful indicator for differentiating pituitary
adenomas, regardless of their hormonal phenotypes, from other brain
tumors.
22
UI - 11709386
AU - Sarkar PK; Manapuzha R; Ahmad S; Ritch AE
TI -
Fluctuating confusional state due to massive macro-prolactinoma
resulting in obstructive hydrocephalus.
SO - Age Ageing 2001 Sep;30(5):426-8
23
UI - 12093137
AU - Walker DG; Ohaegbulam C; Black PM
TI -
Frameless stereotaxy as an alternative to fluoroscopy for
transsphenoidal surgery: use of the InstaTrak-3000 and a novel headset.
SO - J Clin Neurosci 2002 May;9(3):294-7
AD - Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA
02115, USA.
Our aim was to evaluate the applicability of an electromagnetic-based
frameless stereotactic system for use in transsphenoidal surgery. The
system utilizes a novel headset that acts as a replaceable fiducial
frame as well as a fixation point for the system's transmitter. It can
replace the fluoroscope as a guide to navigation in the sphenoid sinus
and sella. The system was used in a consecutive series of 11 patients
undergoing transsphenoidal surgery. It was used in conjunction with
intraoperative fluoroscopy. We found the Instatrak-3000 to correlate
well with lateral fluoroscopic images, and provide additional
information in the axial and coronal planes.The InstaTrak-3000 frameless
stereotactic system is accurate and obviates the need for intraoperative
fluoroscopy during transsphenoidal surgery. Compared to other frameless
systems, it avoids the use of fiducial skin markers and head fixation.
In common with other frameless stereotactic systems, it provides
additional information important for safely approaching the sella and
avoids intraoperative radiation exposure for the patient and operating
room staff. Copyright 2002 Published by Elsevier Science Ltd.
24
UI - 12296634
AU - Pollock BE; Nippoldt TB; Stafford SL; Foote RL; Abboud CF
TI -
Results of stereotactic radiosurgery in patients with hormone-producing
pituitary adenomas: factors associated with endocrine normalization.
SO - J Neurosurg 2002 Sep;97(3):525-30
AD - Department of Neurological Surgery, Mayo Clinic and Foundation,
Rochester, Minnesota 55905, USA. pollock.bruce@mayo.edu
OBJECT: The goal of this study was to determine factors associated with
endocrine normalization after radiosurgery is performed in patients with
hormone-producing pituitary adenomas. METHODS: Between 1990 and 1999, 43
patients with hormone-producing pituitary adenomas underwent
radiosurgery: 26 patients with growth hormone (GH)-producing tumors,
nine with adrenocorticotrophic hormone-producing tumors, seven with
tumors that produced prolactin (PRL) alone, and one with a tumor that
secreted both GH and PRL. The median patient age was 42 years.
Thirty-seven patients (86%) had undergone surgery earlier and in 30
(70%) there was tumor extension into the cavernous sinus. The
product-limit method was used to calculate endocrine normalization while
patients were not receiving any hormone-suppressive medication. The
median follow-up period after radiosurgery was 36 months (range 12-108
months). In 20 patients (47%) there was normalization of hormone
secretion at a median of 14 months (range 2-44 months) after
radiosurgery; no correlation was found between tumor type and cure.
Actuarial cure rates were 20, 32, and 61% at 1, 2, and 4 years
posttreatment. Multivariate analysis demonstrated that the absence of
hormone-suppressive medications at the time of radiosurgery (relative
risk 8.9, 95% confidence interval [CI] 1.2-68.7, p = 0.04) and maximum
radiation doses greater than 40 Gy (relative risk 3.9, 95% CI 1.3-11.7,
p = 0.02) correlated with an endocrine cure. A new anterior pituitary
deficiency developed in seven patients (16%), temporal lobe necrosis was
identified in two patients, an asymptomatic internal carotid artery
stenosis was detected in two patients, and unilateral blindness occurred
in one patient. CONCLUSIONS: Radiosurgery provides an endocrine cure for
many patients with persistent or recurrent hormone-producing pituitary
adenomas. Further study is needed to determine whether pituitary
hormone-suppressive medications have a radioprotective effect.
25
UI - 7750482
AU - Rauch C; Li JY; Croissandeau G; Berthet M; Peillon F; Pagesy P
TI -
Characterization and localization of an immunoreactive growth
hormone-releasing hormone precursor form in normal and tumoral human
anterior pituitaries.
SO - Endocrinology 1995 Jun;136(6):2594-601
AD - INSERM U-223, Faculte de Medecine Pitie-Salpetriere, Paris, France.
Arguments favor an in situ synthesis of GH-releasing hormone (GHRH) in
the normal and tumoral human anterior pituitary. These tissues may
express human (h) GHRH messenger RNA, contain hGHRH-(1-44)-NH2, and
secrete in vitro an immunoreactive form (ir-form) of the peptide. Here,
we characterize and localize the precursor of hGHRH in human anterior
pituitary tissues using RIAs specific for the C-terminus or the
midportion of hGHRH-(1-44)-NH2, size-exclusion chromatography, HPLC,
Western blotting, and immunocytochemistry. The anterior pituitary
ir-forms were compared to those found in hypothalamus, posterior
pituitary, and GHRH-secreting endocrine pancreatic tumors. Three
ir-forms of hGHRH with mol wt of 30-45, and 5 kilodaltons (kDa) were
detected. The 30- to 45-kDa ir-form was very likely to consist of hGHRH
bound to proteins. The 5-kDa ir-form represented mature forms of hGHRH.
It was the major form in tissues actively synthesizing and/or secreting
hGHRH. Nontumoral anterior pituitaries contained significant amounts of
mature hGHRH. The 10-kDa form was identified as a hGHRH precursor
ir-form. In addition to its expected presence in the hypothalamus and
GHRH-secreting tumors, normal and tumoral human anterior pituitaries
contained an identical ir-form of the hGHRH precursor. Cells
immunoreactive for the hGHRH precursor were observed in pituitary
adenomas. Evidence for precursor and mature ir-forms of hGHRH in
anterior pituitary tissues provides conclusive arguments for the
endogenous synthesis of the neuropeptide.
26
UI - 12201824
AU - Hauache OM; Rocha AJ; Maia AC; Maciel RM; Vieira JG
TI -
Screening for macroprolactinaemia and pituitary imaging studies.
SO - Clin Endocrinol (Oxf) 2002 Sep;57(3):327-31
AD - Department of Endocrinology, Fleury Diagnostic Center, Sao Paulo,
Brazil. omar.hauache@fleury.com.br
OBJECTIVE: Hyperprolactinaemia is caused by high levels of monomeric,
dimeric or macro forms of prolactin in circulation, the monomeric form
being predominant in patients with prolactinomas. Macroprolactinaemia,
however, is common and is associated with asymptomatic cases. In this
study, we reviewed our records regarding clinical and imaging
investigations in patients who were found to have hyperprolactinaemia
predominantly due to the presence of macroprolactin and compared them
with the findings observed in patients whose prolactin molecular size
consisted predominantly of the monomeric form. PATIENTS AND METHODS: We
conducted a retrospective study of 113 consecutive patients (nine men
and 104 women, aged 19-67 years, median age 39 years) with
hyperprolactinaemia who were screened for the presence of macroprolactin
by polyethylene glycol precipitation and/or chromatography and submitted
to pituitary magnetic resonance imaging (MRI) and/or computerized
tomography (CT). RESULTS: Fifty-two of 113 patients (46%) had
hyperprolactinaemia due to macroprolactin, whereas the remaining 61
patients (54%) had their hyperprolactinaemia confirmed by the
predominance of the monomeric form. Both groups shared similar mean
prolactin levels (79.9 +/- 63.6 micro g/l, median of 62.0 micro g/l, and
97.9 +/- 155.4 micro g/l, median of 61.0 micro g/l, respectively). Of
the patients with macroprolactinaemia, 46% had no symptoms of
hyperprolactinaemia, whereas only 10% of the patients who screened
negative for macroprolactin were asymptomatic. There was an association
between macroprolactinaemia and negative pituitary imaging findings:
normal pituitary images were found in 78.9% of patients who had
macroprolactinaemia and in 25% of patients with monomeric
hyperprolactinaemia. In addition, none of the patients with
macroprolactinoma (seven cases) had macroprolactinaemia. CONCLUSIONS:
The presence of macroprolactinaemia does not exclude the possibility of
a pituitary adenoma and consequently may not prevent pituitary imaging
studies. However, our data demonstrate that all asymptomatic patients
who screened positive for macroprolactin had normal pituitary imaging
studies. Patient samples showing hyperprolactinaemia should be first
tested for macroprolactin, before the patient is submitted to imaging
studies. We suggest that imaging studies should be ordered in patients
with macroprolactinaemia when indicated by clinically relevant features.
As a result, unnecessary anxiety and costly medical procedures may be
prevented.
27
UI - 12201834
AU - Blackhurst G; Strachan MW; Collie D; Gregor A; Statham PF; Seckl JE
TI -
The treatment of a thyrotropin-secreting pituitary macroadenoma with
octreotide in twin pregnancy.
SO - Clin Endocrinol (Oxf) 2002 Sep;57(3):401-4
AD - Endocrinology Unit, Molecular Medicine Centre, University of Edinburgh,
UK. gblackhurst@ed.ac.uk
TSH-secreting pituitary tumours are rare but difficult to treat due to a
combination of refractory hyperthyroidism and low surgical cure rates.
We describe the case of a 21-year-old woman who, despite twin pregnancy,
became euthyroid and had dramatic tumour shrinkage on octreotide
treatment. To our knowledge, this is the first description of the use of
octreotide for a TSH-secreting pituitary adenoma throughout pregnancy.
28
UI - 12172918
AU - Figarella-Branger D; Dufour H; Fernandez C; Bouvier-Labit C; Grisoli F;
TI -
Pellissier JF
Pituicytomas, a mis-diagnosed benign tumor of the neurohypophysis:
report of three cases.
SO - Acta Neuropathol (Berl) 2002 Sep;104(3):313-9
AD - Service d'Anatomie Pathologique et de Neuropathologie, Hopital de la
Timone, chemin de l'Armee d'Afrique, 13005 Marseille, France.
Dominique.Figarella-Branger@medecine.univ-mrs.fr
Pituicytoma is a rare benign primary tumor of the neurohypophysis,
occurring in the sellar and suprasellar spaces. We report here three new
cases with immunohistochemical and electron microscopic study.
Particular attention was paid to the expression of some cell adhesion
molecules. These tumors were characterized by bundles of elongated cells
strongly immunoreactive to anti-vimentin, S-100 protein, neural cell
adhesion molecule and neuron-specific enolase antibodies. Glial
fibrillary acidic protein (GFAP) was not recorded. It expressed the very
late antigen alpha2 (VLAalpha2), but not VLAalpha5, and lacked
epithelial markers expression (epithelial membrane antigen, E-cadherin),
and specific neuronal markers (synaptophysin, chromogranin,
neurofilament). Staining for pituitary hormones was negative. At the
ultrastructural level, tumor/blood vessel basal lamina and cytoplasmic
intermediate filaments were observed but desmosome or pericellular basal
lamina were lacking. In one case few secretory granules were recorded.
Differential diagnoses include granular cell tumors, pilocytic
astrocytomas and spindle cell tumors such as solitary fibrous tumors,
fibroblastic meningiomas and schwannomas. However, the unique pattern of
antigenic expression and ultrastructural features of pituicytomas
distinguish this rare tumor. As a subpopulation of pituicytes (which are
distinctive glial cells of the neurophypophysis), some pituicytomas do
not expressed GFAP. This suggests that pituicytomas presumably arise
from pituicytes at various stages of their differentiation.
29
UI - 12027873
AU - Lania A; Gangi E; Romoli R; Losa M; Travaglini P; Meringolo D; Ambrosi
TI -
B; Faglia G; Beck-Peccoz P; Spada A
Impaired estrogen-induced negative feedback on gonadotropin secretion in
patients with gonadotropin-secreting and nonfunctioning pituitary
adenomas.
SO - Eur J Clin Invest 2002 May;32(5):335-40
AD - University of Milan, Ospedale Maggiore IRCCS, San Raffaele IRCCS, Milan,
Italy.
BACKGROUND: Several in vitro studies suggest that gonadotropin-secreting
pituitary adenomas (Gn-omas) and non functioning pituitary adenomas
(NFPA) originate from gonadotroph cells. Patients with Gn-oma and NFPA
frequently show abnormal gonadotropin response to TRH. The aim of the
study was to investigate whether the estrogen-induced negative feedback
is operating in either patients with Gn-oma or NFPA. MATERIALS AND
METHODS: Serum gonadotropin levels were evaluated at 24 h after
ethinylestradiol administration (1 mg per os; EE2 test) in seven
patients with a diagnosis of Gn-oma, based on the presence of high
follicle-stimulating hormone (FSH) and/or lutenising hormone (LH) levels
with normal or high levels of sex steroids, in 22 patients with NFPA
with normal or low levels of gonadotropin and sex steroids, and 30 sex-
and age-matched healthy subjects. A normal response to EE2 test was
arbitrarily defined as a serum LH and FSH decrease of at least 40 and
30% below basal levels. RESULTS: Among patients with Gn-oma, only one
had a normal FSH inhibition and another, a normal LH inhibition. Among
the 22 patients with NFPA, the EE2 test caused a normal FSH or LH
reduction in 10 and 15, respectively, while a normal reduction of both
FSH and LH was observed in nine. CONCLUSIONS: The study demonstrates
that estrogen-induced negative feedback of gonadotropin secretion is
disrupted in almost all patients with Gn-oma and in half of those with
NFPA. This defective feedback is reminiscent of the resistance to
thyroid hormones and glucocorticoids observed in patients with
thyroid-stimulating hormone- (TSH-) and adrenocorticotropic hormone-
(ACTH-)secreting adenomas, respectively.
30
UI - 12235306
AU - Pearce JM
TI -
Pituitary tumours and acromegaly (Pierre Marie's disease).
SO - J Neurol Neurosurg Psychiatry 2002 Oct;73(4):394
AD - jmspearce@freenet.co.uk
31
UI - 11081197
AU - Jin L; Kulig E; Qian X; Scheithauer BW; Young WF Jr; Davis DH; Seidah
TI -
NG; Chretien M; Lloyd RV
Distribution and regulation of proconvertases PC1 and PC2 in human
pituitary adenomas.
SO - Pituitary 1999 May;1(3-4):187-95
AD - Department of Laboratory Medicine, Mayo Clinic, Rochester, MN 55905,
USA.
Pituitary adenomas are members of the family of neuroendocrine cells and
tumors which have secretory granules containing
chromogranins/secretogranins and other proteins. Pituitary adenomas
express the neuroendocrine specific proconvertases PC1 (also known as
PC3) and PC2, which are important for the proteolytic processing of
chromogranins/secretogranins molecules. We examined the distribution of
PC1 and PC2 in primary cultures of 20 pituitary adenomas and analyzed
the regulation of the proconvertase mRNAs and proteins by various
secretagogues including hypothalamic hormones and phorbol ester to
determine the role of PC1 and PC2 in CgA processing in pituitary
adenomas. Although PC2 was present in all adenomas, there was a
differential distribution of PC1 with PRL adenomas expressing lower
levels of PC1 compared to other adenoma types by RT-PCR analysis, in
situ hybridization and immunostaining. Treatment of primary cultures of
pituitary adenomas with phorbol 12-myristrate 13-acetate (PMA) resulted
in an increase in pancreastatin (PST) secretion in most pituitary
adenomas and increased PC1 mRNA and protein expression in gonadotroph
adenomas, but not in other types of adenomas. Analysis of a human
pituitary adenoma cell line, immortalized by recombinant defective
adenovirus (HP75), which expressed chromogranin A, FSH, PC1 and PC2
showed that PST was secreted by these immortalized cells. Treatment with
TGF beta 1 resulted in an increase in PST secretion and in PC1 mRNA and
protein. These results indicate that a) there is a differential
distribution of PC1 in human pituitary adenomas with PRL adenomas
expressing very little PC1 mRNA and protein and b) that PC1 expression
in gonadotropin hormone-producing adenomas is regulated by PMA and TGF
beta 1. These findings support the observation that chromogranin A is a
substrate for the endoproteinase PC1 in human pituitary adenoma cells.
32
UI - 11859832
AU - Perez Falero RA; Bermejo Sanchez JC; Dejongh Cobo E
TI -
Image-guided transorbital roof craniotomy via a suprabrow approach: a
surgical series of 72 patients.
SO - Neurosurgery 2001 Dec;49(6):1485-6; discussion 1487
33
UI - 11859833
AU - Mariniello G; Bonavolonta G; Cappabianca P; de Divitiis E
TI -
Image-guided transorbital roof craniotomy via a suprabrow approach: a
surgical series of 72 patients.
SO - Neurosurgery 2001 Dec;49(6):1486-7
34
UI - 11883703
AU - Beinfeld MC; Wang W
TI -
CCK processing by pituitary GH3 cells, human teratocarcinoma cells NT2
and hNT differentiated human neuronal cells evidence for a
differentiation-induced change in enzyme expression and pro CCK
processing.
SO - Life Sci 2002 Feb 1;70(11):1251-8
AD - Department of Pharmacology and Experimental Therapeutics, Tufts
University School of Medicine, Boston, MA 02111, USA.
Margery.Beinfeld@tufts.edu
Human teratocarcinoma Ntera2/c 1.D1 (NT2) cells express very low levels
of the prohormone convertase enzyme PC1, moderate levels of PC2 and
significant levels of PC5. When infected with an adenovirus which
expresses rat CCK mRNA, several glycine-extended forms were secreted
that co-eluted with CCK 33, 22 and 12. Amidated CCK is not produced
because these cells appear to lack the amidating enzyme. Pituitary GH3
cells express high levels of PC2 and PC5. CCK adenovirus-infected GH3
cells secrete amidated versions of the same peptides as NT2 cells.
Differentiation of NT2 cells into hNT cells with retinoic acid and
mitotic inhibitors increased expression of PC5 and decreased expression
of PCI and PC2. CCK adenovirus-infected differentiated hNT cells also
secrete glycine extended CCK products and the major molecular form
produced co-eluted with CCK 8 Gly. These experiments demonstrate that
the state of differentiation of this neuronal cell line influences its
expression of PC 1,2, and 5 and its cleavage of pro CCK and suggests
that these cells may make an interesting model to study how
differentiation alters prohormone processing. These results also support
the hypothesis that PC5 in differentiated neuronal cells is capable of
processing pro CCK to glycine-extended CCK 8.
35
UI - 7923822
AU - Hashimoto K; Koga M; Kouhara H; Arita N; Hayakawa T; Kishimoto T; Sato B
TI -
Expression patterns of messenger ribonucleic acids encoding prohormone
convertases (PC2 and PC3) in human pituitary adenomas.
SO - Clin Endocrinol (Oxf) 1994 Aug;41(2):185-91
AD - Department of Medicine III, Osaka University Hospital, Suita-shi, Japan.
OBJECTIVE: Prohormone convertases (PC2 and PC3) have been reported to
play an important role for prohormone processing in rodent pituitaries.
However, expression of mRNAs encoding these enzymes has not been
characterized in human pituitaries. In addition, altered or insufficient
prohormone processing has been reported in some human pituitary
adenomas. Thus, the expression patterns of these mRNAs in non-tumorous
and tumorous human pituitaries should be examined. DESIGN: Total RNAs
were extracted from non-tumorous or tumorous human pituitaries to
analyse PC2 and PC3 mRNA expression. SAMPLES: Five ACTH producing
adenomas, 11 GH producing adenomas, one PRL producing adenoma and five
non-functioning adenomas were obtained at surgery. Two non-tumorous
pituitaries were also included in this study. MEASUREMENTS: The contents
were quantitatively measured by Northern blot analysis using rat PC3
cDNA or human PC2 cDNA as a probe. The method was also developed fo
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