Evidence map›Paper›PMID 39388031›Full record

ArticleEndocrine pathology2024

High-Grade Progression, Sarcomatous Transformation, and/or Metastasis of Pituitary Neuroendocrine Neoplasms (PitNENs): The UCSF Experience.

Merryl Terry, Minh P Nguyen, Vivian Tang, Ekin Guney, Krishna L Bharani, Sonika Dahiya, Ondrej Choutka, Ewa Borys, Gerald Reis, Lewis Blevins and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Endocrine pathology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Merryl TerryDepartment of Pathology, Division of Neuropathology, University of California San Francisco, San Francisco, CA, USA.
Minh P NguyenDepartment of Pathology, Division of Neuropathology, University of California San Francisco, San Francisco, CA, USA.
Vivian TangDepartment of Pathology, Division of Neuropathology, University of California San Francisco, San Francisco, CA, USA.
Ekin GuneyDepartment of Pathology, Division of Neuropathology, University of California San Francisco, San Francisco, CA, USA.
Krishna L BharaniDepartment of Pathology, Stanford University, Palo Alto, CA, USA.
Sonika DahiyaDepartment of Pathology, Washington University, St. Louis, MO, USA.
Ondrej ChoutkaDepartment of Neurosurgery, Saint Alphonsus Neuroscience Institute, Boise, ID, USA.
Ewa BorysDepartment of Pathology, Loyola University, Chicago, IL, USA.
Gerald ReisDepartment of Pathology, Memorial Healthcare System, Hollywood, FL, USA.
Lewis BlevinsDepartment of Endocrinology, University of California San Francisco, San Francisco, CA, USA.
Manish K AghiDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
Sandeep KunwarDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
John DeGrootDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
David R RaleighDepartment of Pathology, Division of Neuropathology, University of California San Francisco, San Francisco, CA, USA.
Melike PekmezciDepartment of Pathology, Division of Neuropathology, University of California San Francisco, San Francisco, CA, USA.
Andrew W BollenDepartment of Pathology, Division of Neuropathology, University of California San Francisco, San Francisco, CA, USA.
Soonmee ChaDepartment of Radiology, University of California San Francisco, San Francisco, CA, USA.
Nancy M JosephDepartment of Pathology, Division of Neuropathology, University of California San Francisco, San Francisco, CA, USA.
Arie PerryDepartment of Pathology, Division of Neuropathology, University of California San Francisco, San Francisco, CA, USA. arie.perry@ucsf.edu.ORCID http://orcid.org/0000-0002-8300-7261

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pituitary neuroendocrine tumors (PitNET) that metastasize comprise ~ 0.2% of adenohypophyseal tumors are aggressive and are challenging to treat. However, many non-metastatic tumors are also aggressive. Herein, we review 21 specimens from 13 patients at UCSF with metastatic PitNETs (CSF or systemic, N = 7 patients), high-grade pituitary neuroendocrine neoplasms (HG-PitNEN, N = 4 patients), and/or PitNETs with sarcomatous transformation (PitNET-ST, N = 5 patients). We subtyped cases using the World Health Organization (WHO) and International Agency for Research on Cancer (IARC) criteria for neuroendocrine neoplasms (NENs). Lineage subtypes included acidophil stem cell, null cell, thyrotroph, corticotroph, lactotroph, and gonadotroph tumors. The median Ki-67 labeling index was 25% (range 5-70%). Lack of p16 was seen in 3 cases, with overexpression in 2. Strong diffuse p53 immunopositivity was present in 3 specimens from 2 patients. Loss of Rb expression was seen in 2 cases, with ATRX loss in one. Molecular analysis in 4 tumors variably revealed TERT alterations, homozygous CDKN2A deletion, aneuploidy, and mutations in PTEN, TP53, PDGFRB, and/or PIK3CA. Eight patients (62%) died of disease, 4 were alive at the last follow-up, and 1 was lost to the follow-up. All primary tumors had worrisome features, including aggressive lineage subtype, high mitotic count, and/or high Ki-67 indices. Additional evidence of high-grade progression included immunohistochemical loss of neuroendocrine, transcription factor, and/or hormone markers. We conclude that metastatic PitNET is not the only high-grade form of pituitary NEN. If further confirmed, these histopathologic and/or molecular features could provide advanced warning of biological aggressiveness and be applied towards a future grading scheme.

Indexed as

Disease ProgressionNeuroendocrine TumorsPituitary NeoplasmsAdultAgedCell Transformation, NeoplasticFemaleHumansMaleMiddle AgedNeoplasm GradingNeoplasm MetastasisSarcomaYoung AdultGradingMetastasisNeuroendocrine neoplasmsPituitary carcinomaPituitary neuroendocrine carcinomaPituitary neuroendocrine tumorPituitary sarcoma

Identifiers

PMID39388031
PMCPMC11659330

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.