Pituitary adenoma in patients with multiple endocrine neoplasia type 1: a cohort study
Maelle Le Bras
(1)
,
Hélène Leclerc
(2)
,
Olivia Rousseau
(3)
,
Pierre Goudet
(4)
,
Thomas Cuny
(5)
,
Frederic Castinetti
(6)
,
Catherine Bauters
(7)
,
Philippe Chanson
(8)
,
Antoine Tabarin
(9)
,
Sebastien Gaujoux
(10)
,
Sophie Christin-Maitre
(11)
,
Philippe Ruszniewski
(12, 13)
,
Francoise Borson-Chazot
(14)
,
Isabelle Guilhem
(15)
,
Philippe Caron
(16)
,
Bernard Goichot
(17)
,
Albert Beckers
(18)
,
Brigitte Delemer
(19)
,
Isabelle Raingeard
(20)
,
Bruno Vergès
(4)
,
Sarra Smati
(1, 21)
,
Matthieu Wargny
(1, 21)
,
Bertrand Cariou
(1, 21)
,
Samy Hadjadj
(1, 21)
1
ITSN -
PHU 2 - Institut du Thorax et du Sytème Nerveux [CHU Nantes]
2 CHU Nantes - Centre Hospitalier Universitaire de Nantes
3 CIC Nantes - Centre d’Investigation Clinique de Nantes
4 CHU Dijon
5 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
6 AMU - Aix Marseille Université
7 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
8 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
9 Centre médico chirurgical Magellan - Hôpital Haut-Lévêque - CHU de Bordeaux
10 AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris]
11 CHU Saint-Antoine [AP-HP]
12 Hôpital Beaujon [AP-HP]
13 UPCité - Université Paris Cité
14 HCL - Hospices Civils de Lyon
15 Hôpital Sud [CHU Rennes]
16 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
17 Hôpital de Hautepierre [Strasbourg]
18 CHU-Liège - Centre Hospitalier Universitaire de Liège
19 AP-HP Hôpital universitaire Robert-Debré [Paris]
20 CHU Montpellier
21 Nantes Univ - Nantes Université
2 CHU Nantes - Centre Hospitalier Universitaire de Nantes
3 CIC Nantes - Centre d’Investigation Clinique de Nantes
4 CHU Dijon
5 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
6 AMU - Aix Marseille Université
7 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
8 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
9 Centre médico chirurgical Magellan - Hôpital Haut-Lévêque - CHU de Bordeaux
10 AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris]
11 CHU Saint-Antoine [AP-HP]
12 Hôpital Beaujon [AP-HP]
13 UPCité - Université Paris Cité
14 HCL - Hospices Civils de Lyon
15 Hôpital Sud [CHU Rennes]
16 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
17 Hôpital de Hautepierre [Strasbourg]
18 CHU-Liège - Centre Hospitalier Universitaire de Liège
19 AP-HP Hôpital universitaire Robert-Debré [Paris]
20 CHU Montpellier
21 Nantes Univ - Nantes Université
Maelle Le Bras
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- Fonction : Auteur correspondant
- PersonId : 1240415
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Frederic Castinetti
- Fonction : Auteur
- PersonId : 16755
- IdHAL : frederic-castinetti
- ORCID : 0000-0002-1808-8800
- IdRef : 113296061
Philippe Chanson
- Fonction : Auteur
- PersonId : 1329835
- IdHAL : philippe-chanson
- ORCID : 0000-0001-5096-5722
- IdRef : 029294452
Philippe Caron
- Fonction : Auteur
- PersonId : 1321942
- ORCID : 0000-0001-5391-7582
- IdRef : 056739737
Matthieu Wargny
- Fonction : Auteur
- PersonId : 1092281
- ORCID : 0000-0001-6027-9486
- IdRef : 199131872
Bertrand Cariou
- Fonction : co dernier-auteur
Samy Hadjadj
- Fonction : co dernier-auteur
Résumé
Objective: Pituitary adenoma (PA) is one of the three major components of multiple endocrine neoplasia type 1 (MEN1). Recent studies have suggested that MEN1-associated PAs are less aggressive than initially estimated. We propose an analysis of the outcome of PAs with a standard of care treatment in a nationwide cohort of MEN1 patients. Design: Retrospective observational nationwide cohort study using the MEN1 patient registry from the French Group of Endocrine Tumours (GTE). Methods: The GTE database population consists of 1435 patients with MEN1. This analysis focused on 551 patients recruited after 2000 with at least 3 years of follow-up. The study outcome was tumour progression of PA defined by an increase in Hardy classification (HC) during follow-up according to referring physician regular reports. Results: Among 551 MEN1 patients (index and related), 202 (36.7%) had PA, with 114 (56.4%) diagnosed by MEN1related screening. PAs were defined according to HC as microadenoma (grade I) in 117 cases (57.9%), macroadenoma in 59 (29.2%) with 20 HC grade II and 39 HC grades III-IV and unspecified in 26 (12.8%). They were prolactinomas in 92 cases (45.5%) and non-secreting in 73 (36.1%). After a median follow-up of 3 years among the 137 patients with HC grades I-II, 4 patients (2.9%) presented tumour progression. Conclusion: PAs in patients with MEN1 are less aggressive than previously thought. Tumour progression is rare with a standard of care monitoring and treatment, especially in related patients who mostly present non-secreting microadenoma. MRI monitoring for asymptomatic MEN1 patients should be reduced accordingly.