Pituitary tumours in MEN1 syndrome — the new insight into the diagnosis and treatment

30.12.2019

Damian Rogoziński, Aleksandra Gilis-Januszewska, Anna Skalniak, Łukasz Kluczyński, Jacek Pantofliński, Alicja Hubalewska-Dydejczyk


Abstract
Pituitary tumours are a common pathology affecting 15–20% of the population. Only about 1‰ of adenomas are clinically manifested; among them, about two/thirds are hormonally active, most often secreting prolactin or growth hormone. Pituitary tumours are mainly an isolated pathology, without any genetic background. However, the latest studies pay special attention to the possibility of developing an adenoma as a result of genetic mutation. Among pituitary adenomas, the leading group of genetically determined lesions is related to a mutation in AIP or MEN1, followed by PRKAR1A, GRP101, DICER, and SDHx. The genetic basis of these pituitary tumours is related to positive family history, young age of the patient, aggressive clinical process, and resistance to treatment. Pituitary tumours occur in over 40% of patients with MEN1 syndrome — often in women, they are more than 1 cm in diameter, and secrete prolactin. They are usually diagnosed in the fourth decade of life and show a worse response to pharmacotherapy than sporadic ones. Confirmation of the genetic background of the pituitary tumour implies measurable implications; it might help to direct the diagnosis in patients’ family members, partially predict the development of the disease, and, above all, extend patients’ life expectancy.

Keywords: pituitary tumours; genetic; MEN1 syndrome; diagnostic; treatment

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