2026-04-17T13:01:52Zhttps://recercat.cat/oai/request

oai:recercat.cat:2072/4852122025-08-31T18:17:11Zcom_2072_98col_2072_378192

Long term outcomes of pituitary adenomas in Multiple Endocrine Neoplasia type 1 : a nationwide study Valdés, Nuria Romero, Ana Diego, Estrella Calatayud, María Lamas, Cristina Araujo-Castro, Marta Álvarez-Escolá, Cristina Díaz, José A. Alcázar, Victoria Sastre, Julia Martínez, Rosa Oriola, Josep Paja, Miguel Sánchez-Sobrino, Paula Salinas, Isabel Recio-Córdova, José María Navarro, Elena Chiara, María Dolores Castaño, Luis Casterás, A. Pituitary adenomas Multiple Endocrine Neoplasia type 1 Non-functioning pituitary adenomas Prolactinomas Outcomes Microadenomas Macroadenomas Progression Introduction: Historically, Multiple Endocrine Neoplasia type 1 (MEN1)-related pituitary adenomas (PAs) were considered more aggressive and treatment-resistant than sporadic PAs. However, recent studies suggest similarities in their behavior. This study aimed to evaluate the long-term outcomes of MEN1 PAs and identify predictive factors. Methods: Nationwide multicenter retrospective cohort study of MEN1-related PAs with a minimum 1-year follow-up, collecting patient demographics, germline MEN1 pathogenic variants (PV), PA size, secretory profile, radiological characteristics, treatments, and outcomes. Results: We analyzed 84 PAs, 69%in females and 31% in males (P<0.001), diagnosed at a mean age of 35.2±14.9 years, mostly through screening (60.7%). Median follow-up was 9 years (IQR:4-16). Prolactin-secreting PAs (PRLomas) (53.5%) and microadenomas (65.5%) were most common. Dopamine agonist treatment was first line for 16 macroPRLomas and 25 microPRLomas, 60.9% of them achieved PRL normalization. There was no significant association observed with tumor size, sex, treatment duration or MEN1 PV. The risk of progression from micro-PA to invasive macro-PA was 7.2% (4/55), after 8 years (IQR:4-13), all of them were microPRLomas. Kaplan-Meier estimation curve showed significantly higher progression probability in microPRLomas than in other microadenomas subtypes (P=0.017) or microNFPAs (P=0.032). No differences were found between sex, age, or germline MEN1 PV. Conclusion: MEN1-related micro-PAs have a low risk of progressing to invasive macro-PAs, regardless of sex, age at diagnosis, or MEN1 germline PV. The risk is higher for microPRLomas over the long term. Therefore, long-term surveillance with reduced frequency, rather than intensive short-term monitoring, may be appropriate for patients with MEN1-related PAs. 2024 Article https://ddd.uab.cat/record/311598 urn:10.3389/fendo.2024.1427821 urn:oai:ddd.uab.cat:311598 urn:scopus_id:85207024464 urn:pmid:39439563 urn:pmc-uid:11493648 urn:pmcid:PMC11493648 urn:oai:pubmedcentral.nih.gov:11493648 http://hdl.handle.net/2072/485212 eng Frontiers in endocrinology ; Vol. 15 (October 2024) open access Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. https://creativecommons.org/licenses/by/4.0/ application/pdf