The clinical aspects of pituitary tumour genetics

Endocrine. 2021 Mar;71(3):663-674. doi: 10.1007/s12020-021-02633-0. Epub 2021 Feb 4.

Abstract

Background: Pituitary tumours are usually benign and relatively common intracranial tumours, with under- and overexpression of pituitary hormones and local mass effects causing considerable morbidity and increased mortality. While most pituitary tumours are sporadic, around 5% of the cases arise in a familial setting, either isolated [familial isolated pituitary adenoma, related to AIP or X-linked acrogigantism], or in a syndromic disorder, such as multiple endocrine neoplasia type 1 or 4, Carney complex, McCune-Albright syndrome, phaeochromocytoma/paraganglioma with pituitary adenoma, DICER1 syndrome, Lynch syndrome, and USP8-related syndrome. Genetically determined pituitary tumours usually present at younger age and show aggressive behaviour, and are often resistant to different treatment modalities.

Subject: In this practical summary, we take a practical approach: which genetic syndromes should be considered in case of different presentation, such as tumour type, family history, age of onset and additional clinical features of the patient.

Conclusion: The identification of the causative mutation allows genetic and clinical screening of relatives at risk, resulting in earlier diagnosis, a better therapeutic response and ultimately to better long-term outcomes.

Keywords: FIPA; Genetics; MEN; Pituitary; Tumour.

Publication types

  • Review

MeSH terms

  • Adenoma* / genetics
  • DEAD-box RNA Helicases
  • Endopeptidases
  • Endosomal Sorting Complexes Required for Transport
  • Growth Hormone-Secreting Pituitary Adenoma*
  • Humans
  • Multiple Endocrine Neoplasia Type 1* / genetics
  • Pituitary Gland
  • Pituitary Neoplasms* / genetics
  • Ribonuclease III
  • Ubiquitin Thiolesterase

Substances

  • Endosomal Sorting Complexes Required for Transport
  • DICER1 protein, human
  • Ribonuclease III
  • Endopeptidases
  • USP8 protein, human
  • Ubiquitin Thiolesterase
  • DEAD-box RNA Helicases