Endocrinology and Metabolism

Original Article

Thyroid
Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP): Jae Hoon Moon, Eun Kyung Lee, Wonjae Cha, Young Jun Chai, Sun Wook Cho, June Young Choi, Sung Yong Choi, A Jung Chu, Eun-Jae Chung, Yul Hwangbo, Woo-Jin Jeong, Yuh-Seog Jung, Kyungsik Kim, Min Joo Kim, Su-jin Kim, Woochul Kim, Yoo Hyung Kim, Chang Yoon Lee, Ji Ye Lee, Kyu Eun Lee, Young Ki Lee, Hunjong Lim, Do Joon Park, Sue K. Park, Chang Hwan Ryu, Junsun Ryu, Jungirl Seok, Young Shin Song, Ka Hee Yi, Hyeong Won Yu, Eleanor White, Katerina Mastrocostas, Roderick J. Clifton-Bligh, Anthony Glover, Matti L. Gild, Ji-hoon Kim, Young Joo Park; Endocrinol Metab. 2025;40(2):236-246. Published online February 18, 2025; DOI: https://doi.org/10.3803/EnM.2024.2136

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Background
Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making.
Methods
This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes.
Conclusion
This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.

Citations

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Shared Decision-Making for Determining Treatment Strategies in Low-Risk Thyroid Cancer: Protocol of a Multicenter Cluster-Randomized Trial (MAeSTro-SDM)
Eun Kyung Lee, Min Joo Kim, Yul Hwangbo, Jae Hoon Moon, Sun Wook Cho, Young Jun Chai, June Young Choi, Yuh-Seog Jung, Kyu Eun Lee, Eun-Jae Chung, Kyungsik Kim, Su-jin Kim, Woochul Kim, Yoo Hyung Kim, Young Ki Lee, Jinsun Jang, Young Shin Song, Ka Hee Yi,
Journal of Korean Medical Science.2026;[Epub] CrossRef
Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP) (Endocrinol Metab 2025;40:236-46, Jae Hoon Moon et al.)
Eun Kyung Lee, Jae Hoon Moon, Young Joo Park
Endocrinology and Metabolism.2025; 40(4): 655. CrossRef
Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP) (Endocrinol Metab 2025;40:236-46, Jae Hoon Moon et al.)
Hoonsung Choi
Endocrinology and Metabolism.2025; 40(4): 653. CrossRef
Habitat imaging combined with multimodal analysis for preoperative risk stratification of papillary thyroid carcinoma
Jia-Wei Feng, You-Long Zhu, Lu Zhang, Yu-Xin Yang, An-Cheng Qin, Shui-Qing Liu, Yong Jiang
Insights into Imaging.2025;[Epub] CrossRef

Review Articles

Diabetes, obesity and metabolism
Epidemiology and Trends of Obesity and Bariatric Surgery in Korea: Kyungdo Han, Jin-Hyung Jung, Su-Min Jeong, Mee Kyoung Kim; Endocrinol Metab. 2024;39(5):678-685. Published online August 2, 2024; DOI: https://doi.org/10.3803/EnM.2024.2056

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The prevalence of obesity in Korea has steadily increased over the past decade, reaching 38.4% in 2021. Notably, the rate of class II– III obesity, defined as a body mass index (BMI) of 30 kg/m² or higher, exceeded 7% in the same year. Since January 2019, the National Health Insurance Service (NHIS) has provided coverage for bariatric surgery (BS) for eligible patients. Coverage is available for individuals with a BMI of 35 kg/m² or higher, or those with a BMI of 30 kg/m² or higher who also have obesity-related comorbidities. Additionally, partial reimbursement is offered for BS in patients with type 2 diabetes mellitus who have BMI values between 27.5 and 30 kg/m². From 2019 to 2022, the NHIS recorded 9,080 BS procedures, with sleeve gastrectomy being the most commonly performed. The average percentage of weight loss 198±99.7 days post-surgery was 17.9%, with 80.0% of patients losing more than 10% of their body weight. This article presents the trends in obesity and BS in Korea.

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Diabetes, obesity and metabolism
Regulation of Energy and Glucose Homeostasis by the Nucleus of the Solitary Tract and the Area Postrema: Kyla Bruce, Ameth N. Garrido, Song-Yang Zhang, Tony K.T. Lam; Endocrinol Metab. 2024;39(4):559-568. Published online August 1, 2024; DOI: https://doi.org/10.3803/EnM.2024.2025

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The central nervous system regulates feeding, weight and glucose homeostasis in rodents and humans, but the site-specific mechanisms remain unclear. The dorsal vagal complex in the brainstem that contains the nucleus of the solitary tract (NTS) and area postrema (AP) emerges as a regulatory center that impacts energy and glucose balance by monitoring hormonal and nutrient changes. However, the specific mechanistic metabolic roles of the NTS and AP remain elusive. This mini-review highlights methods to study their distinct roles and recent findings on their metabolic differences and similarities of growth differentiation factor 15 (GDF15) action and glucose sensing in the NTS and AP. In summary, future research aims to characterize hormonal and glucose sensing mechanisms in the AP and/or NTS carries potential to unveil novel targets that lower weight and glucose levels in obesity and diabetes.

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Region-Specific Adult Neural Stem Cell Niches of the Mediobasal Hypothalamus and Medulla Oblongata
Eriko Furube, Rena Fujii, Yuri Nambu, Daishi Hiratsuka, Ryoichi Yoshimura, Seiji Miyata
Stem Cell Reviews and Reports.2026; 22(1): 222. CrossRef
Adipocyte-derived extracellular vesicles are key regulators of central leptin sensitivity and energy homeostasis
Jin Wang, Xuhong Zhang, Ye Zhu, Haixiang Sun, Xuetao Chen, Zhicong Zhao, Nina Zhang, Chenyu Zhang, Liang Li, Yan Bi
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Original Article

Hypothalamus and pituitary gland
Obstructive Sleep Apnea Screening and Effects of Surgery in Acromegaly: A Prospective Study: Jaeyoung Cho, Jung Hee Kim, Yong Hwy Kim, Jinwoo Lee; Endocrinol Metab. 2024;39(4):641-652. Published online June 26, 2024; DOI: https://doi.org/10.3803/EnM.2024.1933

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Background
To identify a screening tool for obstructive sleep apnea (OSA) and evaluate the effects of endoscopic transsphenoidal surgery on improving OSA in patients with acromegaly.
Methods
We prospectively enrolled adults with acromegaly scheduled for endoscopic transsphenoidal surgery. All measurements were conducted when participants were admitted for a baseline work-up for acromegaly before surgery and surveillance approximately 3 to 6 months after surgery. Respiratory event index (REI) was used as a surrogate for apnea-hypopnea index (Trial Registration: NCT03526016).
Results
Of the 35 patients with acromegaly (median age, 47 years; 40% men; median body mass index, 24.4 kg/m²), 24 (68.6%) had OSA (REI ≥5/hour), 15 (42.9%) had moderate-to-severe OSA (REI ≥15/hour). At baseline, serum insulin-like growth factor 1 (IGF-1) levels were positively correlated with the REI (ρ=0.53, P=0.001). The sensitivity and negative predictive value of a Snoring, Tiredness, Observed apnea, high blood Pressure-Body mass index, age, Neck circumference, and Gender (STOP-Bang) score ≥ 3 were 93.3% and 87.5%, respectively, detecting moderate-to-severe OSA. Biochemical acromegaly remission was achieved in 32 (91.4%) patients. The median difference in the REI was –9.5/hour (95% confidence interval, –13.3 to –5.3). Half of the 24 patients diagnosed with OSA preoperatively had REI <5/hour postoperatively. In a linear mixed-effects model, changes in the REI across surgery were related to changes in IGF-1 levels.
Conclusion
The STOP-Bang questionnaire is a reliable tool for OSA among patients with acromegaly. Improvement in OSA severity after surgery is related to decreased IGF-1 levels.

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Change in apnea hypopnea index and sleep quality following treatment in acromegaly
Kavita Kadian, Ravi Gupta, Rajnish Arora, Kalyani Sridharan
Endocrine Research.2026; 51(1): 27. CrossRef
Correlation between obstructive sleep apnea and pituitary function in pituitary adenomas patients
Zitong Wang, Qi Li, Junjie Zhao, Hai Yu, Jiayi Du, Tingqin Huang, Yushan Xie, Zine Cao, Chendi Lu, Xinru Lv, Simin Zhu, Yanuo Zhou, Wei Hou, Yani Feng, Haiqin Liu, Xiaoyong Ren, Yewen Shi
Respiratory Medicine.2026; 252: 108660. CrossRef
Long-Term Prognosis and Systemic Impact of Acromegaly: Analyses Utilizing Korean National Health Insurance Data
Sangmo Hong, Kyungdo Han, Cheol-Young Park
Endocrinology and Metabolism.2025; 40(1): 1. CrossRef
Mechanisms associated with obstructive sleep apnea in achondroplasia
G. Dave Singh
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Gaspare Alfì, Danilo Menicucci, Dalì Antonia Ciampa, Vito Di Giura, Giulia Marconcini, Claudio Urbani, Fausto Bogazzi, Angelo Gemignani
Endocrines.2024; 5(3): 408. CrossRef

Review Article

Hypothalamus and pituitary gland
Update on Current Evidence for the Diagnosis and Management of Nonfunctioning Pituitary Neuroendocrine Tumors: Elizabeth Whyte, Masahiro Nezu, Constance Chik, Toru Tateno; Endocrinol Metab. 2023;38(6):631-654. Published online November 15, 2023; DOI: https://doi.org/10.3803/EnM.2023.1838

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Pituitary neuroendocrine tumors (PitNETs) are the third most frequently diagnosed intracranial tumors, with nonfunctioning PitNETs (nfPitNETs) accounting for 30% of all pituitary tumors and representing the most common type of macroPitNETs. NfPitNETs are usually benign tumors with no evidence of hormone oversecretion except for hyperprolactinemia secondary to pituitary stalk compression. Due to this, they do not typically present with clinical syndromes like acromegaly, Cushing’s disease or hyperthyroidism and instead are identified incidentally on imaging or from symptoms of mass effects (headache, vision changes, apoplexy). With the lack of effective medical interventions, first-line treatment is transsphenoidal surgical resection, however, nfPitNETs often have supra- or parasellar extension, and total resection of the tumor is often not possible, resulting in residual tumor regrowth or reoccurrence. While functional PitNETs can be easily followed for recurrence using hormonal biomarkers, there is no similar parameter to predict recurrence in nfPitNETs, hence delaying early recognition and timely management. Therefore, there is a need to identify prognostic biomarkers that can be used for patient surveillance and as therapeutic targets. This review focuses on summarizing the current evidence on nfPitNETs, with a special focus on potential new biomarkers and therapeutics.

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Original Article

Diabetes, Obesity and Metabolism
Association between the Blautia/Bacteroides Ratio and Altered Body Mass Index after Bariatric Surgery: Yoonhong Kim, Dooheon Son, Bu Kyung Kim, Ki Hyun Kim, Kyung Won Seo, Kyoungwon Jung, Seun Ja Park, Sanghyun Lim, Jae Hyun Kim; Endocrinol Metab. 2022;37(3):475-486. Published online June 29, 2022; DOI: https://doi.org/10.3803/EnM.2022.1481; Correction in: Endocrinol Metab 2022;37(4):701

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Background
Current evidence support that the gut microbiota plays a potential role in obesity. Bariatric surgery can reduce excess weight and decrease the risk of life-threatening weight-related health problems and may also influence gut microbiota. In this study, we aimed to investigate the changes in gut microbiota before and after bariatric surgery and evaluate the association of the gut microbial shift and altered body mass index (BMI) after bariatric surgery.
Methods
Between January 2019 and July 2020, stools from 58 patients scheduled for bariatric surgery were collected. Six months after bariatric surgery, stools from 22 of these patients were re-collected, and the changes in gut microbiota before and after bariatric surgery were evaluated. In addition, the differences in gut microbiota between patients with severe obesity (BMI >35 kg/m², n=42) and healthy volunteers with normal BMI (18.8 to 22.8 kg/m², n=41) were investigated.
Results
The gut microbiota of patients who underwent bariatric surgery showed increased α-diversity and differed β-diversity compared with those before surgery. Interestingly, Blautia was decreased and Bacteriodes was increased at the genus level after bariatric surgery. Further, the Blautia/Bacteroides ratio showed a positive correlation with BMI. To validate these results, we compared the gut microbiota from severely obese patients with high BMI with those from healthy volunteers and demonstrated that the Blautia/Bacteroides ratio correlated positively with BMI.
Conclusion
In the gut microbial analysis of patients who underwent bariatric surgery, we presented that the Blautia/Bacteroides ratio had changed after bariatric surgery and showed a positive correlation with BMI.

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Review Articles

Mineral, Bone & Muscle
Normocalcemic Primary Hyperparathyroidism: Need for a Standardized Clinical Approach: Guido Zavatta, Bart L. Clarke; Endocrinol Metab. 2021;36(3):525-535. Published online June 1, 2021; DOI: https://doi.org/10.3803/EnM.2021.1061

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Since normocalcemic primary hyperparathyroidism (NHPT) was first defined at the Third International Workshop on the Management of Asymptomatic Primary Hyperparathyroidism in 2008, many papers have been published describing its prevalence and possible complications. Guidelines for the management of this condition are still lacking, and making the diagnosis requires fulfillment of strict criteria. Recent studies have shown that intermittent oscillations of serum calcium just below and slightly above the normal limits are very frequent, therefore challenging the assumption that serum calcium must be consistently normal to make the diagnosis. There is debate if these variations in serum calcium outside the normal range should be included under the rubric of NHPT or, rather, a milder form of classical primary hyperparathyroidism. Innovative approaches to define NHPT have been proposed that still need to be validated in prospective studies. Non-classical complications, especially cardiovascular complications, have been associated with NHPT, indicating that hyperparathyroidism may be a cardiovascular risk factor. New associations between parathyroid hormone (PTH) and several other comorbidities have also been reported from observational studies, suggesting that excessive PTH secretion might cause tissue dysfunction independent of serum calcium. Heterogeneous studies using different definitions of NHPT, however, make it difficult to draw definitive conclusions regarding the role of PTH excess when complications other than osteoporosis or kidney stones are described. This review will focus on clinical aspects and suggest an approach to NHPT.

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10 Years Prospective Study for the Surgical Total Removal of Pituitary Tumor; Preliminary Report - 2, 5 Years Follow Up.: Eun Jig Lee, Sung Kil Lim, Kap Bum Huh, Sun Ho Kim, Dong Ik Kim, Byung Hee Lee, Ju Heon Yoon, Su Yeon Choi, Joong Uhn Choi, Sang Seop Chung, Kyu Chang Lee; J Korean Endocr Soc. 1994;10(2):85-94. Published online November 6, 2019

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Abstract PDF: The goal of the pituitary tumor surgery is restoration of the normal endocrine function and releaving the pressure effects of the tumor mass on the adjacent neural structures. The authors had proceeded with the 10 years prospective follow-up study for the endocrine function and recurrence of pituitary tumor in the patients who received the complete total resection of tumor mass by the means of total capsulectomy.The authors will discuss the preliminary result of 2.5 years follow-up of this study.

Original Article

Clinical Study
Factors Associated with Postoperative Diabetes Insipidus after Pituitary Surgery: Antonio L. Faltado, Anna Angelica Macalalad-Josue, Ralph Jason S. Li, John Paul M. Quisumbing, Marc Gregory Y. Yu, Cecilia A. Jimeno; Endocrinol Metab. 2017;32(4):426-433. Published online November 21, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.4.426

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Background

Determining risk factors for diabetes insipidus (DI) after pituitary surgery is important in improving patient care. Our objective is to determine the factors associated with DI after pituitary surgery.

Methods

We reviewed records of patients who underwent pituitary surgery from 2011 to 2015 at Philippine General Hospital. Patients with preoperative DI were excluded. Multiple logistic regression analysis was performed and a predictive model was generated. The discrimination abilities of the predictive model and individual variables were assessed using the receiving operator characteristic curve.

Results

A total of 230 patients were included. The rate of postoperative DI was 27.8%. Percent change in serum Na (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.15 to 1.69); preoperative serum Na (OR, 1.19; 95% CI, 1.02 to 1.40); and performance of craniotomy (OR, 5.48; 95% CI, 1.60 to 18.80) remained significantly associated with an increased incidence of postoperative DI, while percent change in urine specific gravity (USG) (OR, 0.53; 95% CI, 0.33 to 0.87) and meningioma on histopathology (OR, 0.05; 95% CI, 0.04 to 0.70) were significantly associated with a decreased incidence. The predictive model generated has good diagnostic accuracy in predicting postoperative DI with an area under curve of 0.83.

Conclusion

Greater percent change in serum Na, preoperative serum Na, and performance of craniotomy significantly increased the likelihood of postoperative DI while percent change in USG and meningioma on histopathology were significantly associated with a decreased incidence. The predictive model can be used to generate a scoring system in estimating the risk of postoperative DI.

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Review Articles

Metabolic Surgery in Korea: What to Consider before Surgery: Mi-Kyung Kim, Yoonseok Heo; Endocrinol Metab. 2017;32(3):307-315. Published online September 18, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.3.307

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Obesity is increasing globally and represents a significant global health problem because it predisposes towards various diseases, such as type 2 diabetes mellitus, cardiovascular disease, degenerative joint disease, and certain types of cancer. Numerous studies have shown that bariatric surgery reduces body mass and ameliorates obesity-related complications, such as hypertension and hyperglycemia, suggesting that surgery is the most effective therapeutic option for severely obese and obese diabetic patients. Recent international guidelines recommend surgical treatment for diabetic patients with class III obesity (body mass index [BMI] >40 kg/m²), regardless of their level of glycemic control or the complexity of their glucose-lowering regimens, and for patients with class II obesity (BMI 35.0 to 39.9 kg/m²) and hyperglycemia that is poorly controlled despite appropriate lifestyle and pharmacological therapy. The most popular procedures are Roux-en-Y gastric bypass and sleeve gastrectomy, but new procedures with better outcomes have been reported. For optimal surgical outcome, comprehensive management including assessments of a medical condition, nutrition, mental health, and social support is needed before and after surgery. However, there is still a lack of understanding regarding metabolic surgery in Korea. Therefore, this article reviews indications for metabolic surgery in patients with a specific focus on the situation in Korea.

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Obesity and Metabolism
Current Status of Bariatric and Metabolic Surgery in Korea: Youn-Baik Choi; Endocrinol Metab. 2016;31(4):525-532. Published online November 4, 2016; DOI: https://doi.org/10.3803/EnM.2016.31.4.525

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Bariatric surgery is considered to be the most effective treatment modality in maintaining long-term weight reduction and improving obesity-related conditions in morbidly obese patients. In Korea, surgery for morbid obesity was laparoscopic sleeve gastrectomy first performed in 2003. Since 2003, the annual number of bariatric surgeries has markedly increased, including adjustable gastric banding (AGB), Roux-en-Y gastric bypass, sleeve gastrectomy, mini-gastric bypass, and others. In Korea, AGB is much more common than in others countries. A large proportion of doctors, the public, and government misunderstand the necessity and effectiveness of bariatric surgery, believing that bariatric surgery has an unacceptably high morbidity, and that it is not superior to non-surgical treatments to improve obesity and obesity-related diseases. The effectiveness, safety, and cost-effectiveness of bariatric surgery have been well demonstrated. The Korean Society of Metabolic and Bariatric Surgery recommend bariatric surgery confining to morbidly obese patients (body mass index ≥40 or >35 in the presence of significant comorbidities).

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Ho Im Lee, Jung Suk Park
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Chan Hyuk Park, Seung-Joo Nam, Hyuk Soon Choi, Kyoung Oh Kim, Do Hoon Kim, Jung-Wook Kim, Won Sohn, Jai Hoon Yoon, Sung Hoon Jung, Yil Sik Hyun, Hang Lak Lee
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Adrenal gland
In Vivo Models for Incretin Research: From the Intestine to the Whole Body: Tae Jung Oh; Endocrinol Metab. 2016;31(1):45-51. Published online March 16, 2016; DOI: https://doi.org/10.3803/EnM.2016.31.1.45

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Incretin hormones are produced by enteroendocrine cells (EECs) in the intestine in response to ingested nutrient stimuli. The incretin effect is defined as the difference in the insulin secretory response between the oral glucose tolerance test and an isoglycemic intravenous glucose infusion study. The pathophysiology of the decreased incretin effect has been studied as decreased incretin sensitivity and/or β-cell dysfunction per se. Interestingly, robust increases in endogenous incretin secretion have been observed in many types of metabolic/bariatric surgery. Therefore, metabolic/bariatric surgery has been extensively studied for incretin physiology, not only the hormones themselves but also alterations in EECs distribution and genetic expression levels of gut hormones. These efforts have given us an enormous understanding of incretin biology from synthesis to in vivo behavior. Further innovative studies are needed to determine the mechanisms and targets of incretin hormones.

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Original Articles

Pituitary Apoplexy in Korea - Characteristics, Treatment Options and Outcomes.: Jung Ah Lim, Jin Taek Kim, Min Joo Kim, Tae Hyuk Kim, Yenna Lee, Hwa Young Cho, Chan Soo Shin, Kyong Soo Park, Hak Chul Jang, Bo Youn Cho, Hong Kyu Lee, Seong Yeon Kim; J Korean Endocr Soc. 2009;24(4):247-253. Published online December 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.4.247

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Abstract PDF

BACKGROUND
Reports on pituitary apoplexy in Korea are limited. There are two treatment options for pituitary apoplexy - surgical decompression and conservative management. In this study, we examined clinical presentation and outcomes following different therapies in Korean patients with pituitary apoplexy. METHODS: Clinical data and treatment outcomes from 52 patients with pituitary apoplexy who visited Seoul National University Hospital between January 1992 and June 2008 were reviewed retrospectively. Patients were divided into 2 groups according to management options (a surgery group vs. a conservative management group) and their outcomes were compared. For patients who underwent surgery due to neurological symptoms, outcomes were compared between early and late surgery groups. RESULTS: Headache (73.1%) was the most common presenting symptom, and more than half of the patients were reported to have visual symptoms. The most common type of pathology was a nonfunctioning pituitary adenoma (67.3%). Nine patients received conservative management and 43 underwent surgical decompression. Their recovery from neurological and endocrinological abnormalities were similar. Among patients who showed neurological symptoms, 9 underwent surgery within 1 week of symptom onset and 24 underwent surgery after 1 week. There was no significant difference between outcomes of early and late surgery groups except recovery from impaired visual deficit was greater in the late surgery group. CONCLUSION: Patients with pituitary apoplexy in Korea show similar clinical features as similar patients in other countries. In our study, there was no significant difference between clinical outcomes of the surgery group and the conservative treatment group.

Citations

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The Outcomes of Pituitary Apoplexy with Conservative Treatment: Experiences at a Single Institution
Youngbeom Seo, Yong Hwy Kim, Yun-Sik Dho, Jung Hee Kim, Jin Wook Kim, Chul-Kee Park, Dong Gyu Kim
World Neurosurgery.2018; 115: e703. CrossRef
Characteristics and Treatment Options of Pituitary Apoplexy
Dong-Sun Kim
Journal of Korean Endocrine Society.2009; 24(4): 237. CrossRef

Pituitary Hormonal Changes after Transsphenoidal Tumor Removal in Non-Functioning Pituitary Adenoma.: Min Suk Lee, Seung Jin Han, Eun Kyung Kim, Joo An Hwang, Yoon Sok Chung, Se Hyuk Kim, Kyung Gi Cho, Nae Jung Rim, Ho Sung Kim; J Korean Endocr Soc. 2009;24(3):181-188. Published online September 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.3.181

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Abstract PDF

BACKGROUND
The present study investigated the rates and the potential predictors of either new pituitary loss or recovery of hormonal function after transsphenoidal removal of a non-functioning pituitary adenoma. METHODS: Patients who underwent transsphenoidal removal of a non-functioning pituitary adenoma from January 2003 to December 2007 at Ajou University Medical Center were included in this retrospective analysis. Patients were excluded if they had a history of previous pituitary tumor surgery, or did not have preoperative pituitary hormonal data. RESULTS: Of 42 patients included in the analysis, 36 patients had hypopituitarism, 21 patients had "stalk compression" hyperprolactinemia, and 2 patients had normal pituitary function. At long term follow-up (longer than 6 months), 13 patients showed postoperative pituitary hormonal recovery in at least 1 hormonal axis, while 6 patients had developed postoperative hormonal loss in at least 1 hormonal axis. On analysis, neither preoperative serum prolactin level nor tumor size was related to postoperative pituitary hormonal changes. CONCLUSION: More than 1/3 of patients who underwent transsphenoidal surgery showed postoperative pituitary hormonal recovery.

Citations

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Childhood Onset Pituitary Adenoma: Clinical Presentations and Outcomes of 24 Cases
Hwa Young Kim, Hae Woon Jung, Jieun Lee, Ju Young Yoon, Young Ah Lee, Choong Ho Shin, Sei Won Yang
Annals of Pediatric Endocrinology & Metabolism.2012; 17(2): 82. CrossRef

Analysis of Clinical Features of Korean Patients with Adrenocortical Carcinoma.: Chan Ho Yoon, Tae Sik Jung, Hye Seung Jung, Eun Yonug Lee, Sung Jin Bae, Ji Youn Kim, Jae Hoon Chung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim; J Korean Endocr Soc. 2006;21(1):47-52. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.47

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Abstract PDF

BACKGROUND
Adrenocortical carcinoma (ACC) is an extremely rare tumor. Its early detection is difficult and its prognosis is poor. METHOD: We retrospectively analyzed the medical records of 13 patients with ACC between 1995 and 2005 at Samsung Medical Center. Their clinical features and prognosis were evaluated. RESULTS: The average age of the patients with ACC was 40 years (2~75 years). Eight patients were men and five were women. On the first visit, eight of 13 patients (62%) complained abdominal pain, and abdominal mass was palpable in five of 13 patients (38%). Urinary concentration of 17-ketosteroid collected for 24 hours was increased in two of eight patients (25%). Three out of 13 patients were identified as having functioning adrenal tumors (1 Cushing's syndrome and 2 androgen-producing tumors), and the other 10 patients had hormonally inactive adrenal tumors. Ten patients had tumors in left adrenal gland, and three had in right adrenal gland. At the time of diagnosis, four patients were classified as having stage II, seven as stage III, and two as stage IV. Twelve patients underwent adrenalectomy. One of them received additional chemotherapy, and two patients were treated with external radiation therapy after surgery. The other one patient was treated only with chemotherapy due to the presence of liver metastasis. It was possible to continue the regular follow-up in eight of 13 patients. The median duration of follow-up was 39 months (7~114 months). Six of them are still alive (three have no evidence of disease, one had persistence of disease, and two had recurrence of disease during follow-up period). Two patients died of multiple metastases and lung metastasis, respectively. CONCLUSION: Radical surgery is the only curative approach and is recommended for all patients with resectable tumors, even though in those patients with recurrent disease. There is no consensus concerning adjuvant therapy.

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Min Joo Kim, Jung Hee Kim, Tae Young Kim, Sang Wan Kim
Endocrinology and Metabolism.2011; 26(3): 243. CrossRef

Case Report

The Change of Thyroid Hormone by Short-term Antithyroid Drug Treatment for Preoperative Euthyroidism in TSH-secreting Pituitary Adenoma.: Min Hee Lee, Ji Hyun Park; J Korean Endocr Soc. 2005;20(3):261-267. Published online June 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.3.261

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Abstract PDF: Preoperative euthyroidism is needed to minimize the risk of intraoperative and postoperative complications, such as thyroid storm by surgery. Antithyroid drugs or steroid hormones are commonly used in primary hyperthyroidism for euthyroidism. However, there is no definite consensus for the preoperative management of a TSH secreting pituitary adenoma for the restoration of euthyroidism. Antithyroid drugs are not used for long-term the management of a TSH secreting pituitary adenoma, as they may cause rapid growth and greater invasiveness of the tumor due to a feedback mechanism, but they can be used for short-term management before neurosurgery. We experienced one case of a TSH secreting pituitary adenoma, which showed rapid free thyroid hormone increase due to the short term administration of antithyroid drugs for only 10 days. A somatostatin analogue, octreotide at a dose of 0.1mg, twice a day, was then tried. About 4 weeks later, her serum TSH and free T4 had normalized, with a concomitant clinical improvement. She subsequently underwent an uncomplicated trans-sphenoidal resection of the pituitary adenoma. Antithyroid drugs can induce a rapid thyroid hormone increase, but can only be used for a short-term period, so they should be administered with caution or their use reconsidered

Original Article

The Effect of Treatment Modalities on Survival Rates of Patients with Anaplastic Thyroid Carcinoma.: Jae Myoung Choi, Mi Jeong Kim, Seung Won Lee, Kyoung Eun Song, Yoon Sok Chung, Kwan Woo Lee, Dae Jung Kim, Sung Hee Choi, So Hun Kim, Min Ho Cho, Yumie Rhee, Chul Woo Ahn, Sung Kil Lim, Kyung Rae Kim; J Korean Endocr Soc. 2005;20(2):127-133. Published online April 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.2.127

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Abstract PDF

BACKGROUND
Anaplastic thyroid carcinoma represents 2% to 5% of all thyroid cancers and it is one of the most aggressive human cancers. Local extension at the time of diagnosis and distant metastases are almost always the rule. Its lethality is evidenced by a 5-year survival rate of 3.6% and a median survival time of 4 months. We retrospectively reviewed patients with this disease at 4 tertiary referral centers. METHODS: From 1990 to 2003, 19 cases(9 men and 10 women, mean age: 65.1+/-7.1 years) of anaplastic thyroid carcinoma were reviewed via the medical records. The overall survival rates according to the prognostic factors and the treatment modalities were analyzed. RESULTS: The presenting symptoms included rapidly enlarged neck masses in 16 patients, shortness of breath in 3 patients, hoarseness in 4 patients, dysphagia in 2 patients and chest wall pain in 1 patient. The mean diameter of tumor was 7.2cm. Local extension was seen in all of the cases that had undergone surgery. Distant metastases(lung 6, bone 2, abdominal carcinomatosis 2, brain 1 and mediastinum 1) were seen in 9 patients. Surgical treatment was performed in 10 patients. Radiotherapy was performed in 9 patients and chemotherapy was done in 5 patients; radiotherapy was performed alone in 2 patients, combination chemo-radiotherapy was performed in 3 patients, postoperative radiotherapy was performed in 2 patients and postoperative combination chemo-radiotherapy was performed in 2 patients. 4 patients were treated cons ervatively after the confirmative diagnosis. The overall median survival time was 123 days(range: 23~621 days); the median survival time was 129 days in the treatment group(n=15), and 27 days in the no treatment group (n=4), and significantly higher survival rates were observed for the treated patients(p=0.02). According to the treatment modalities, patients who underwent surgical treatment and postoperative radiotherapy and/or chemotherapy were observed to have significantly higher survival rates than patients in the radiotherapy and/or chemotherapy group(p=0.03), and also than those patients in the surgical treatment only group(p=0.04). CONCLUSION: We found that aggressive surgical treatment and postoperative radiotherapy and/or chemotherapy improved the survival rates of patients with anaplastic thyroid carcinoma even though local invasion and distant metastases was generally observed to occur

Citations

Citations to this article as recorded by

Anaplastic Thyroid Carcinoma: Experience of a Single Institute
Dongbin Ahn, Jin Ho Sohn
Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2012; 55(1): 37. CrossRef

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