https://repositorio.fleni.org.ar/xmlui/handle/123456789/266 2026-04-05T19:32:07Z 2026-04-05T19:32:07Z Slavinsky, Patricia González Pernas, Mariana Battistone, María Florencia Pingel, Jésica Sevlever, Gustavo Emilio Arakaki, Naomi Mezmezian, Mónica Beatriz Rojas, Estefanía Schultz, Marcelo Cervio, Andrés Eduardo Katz, Débora Adela https://repositorio.fleni.org.ar/xmlui/handle/123456789/1448 2025-11-06T14:38:52Z 2024-09-26T00:00:00Z

Adenomas hipofisiarios: ¿qué nos aporta la detección de factores de transcripción a la práctica clínica? Slavinsky, Patricia; González Pernas, Mariana; Battistone, María Florencia; Pingel, Jésica; Sevlever, Gustavo Emilio; Arakaki, Naomi; Mezmezian, Mónica Beatriz; Rojas, Estefanía; Schultz, Marcelo; Cervio, Andrés Eduardo; Katz, Débora Adela Resumen no disponible

2024-09-26T00:00:00Z Katz, Débora Adela Slavinsky, Patricia Pernas, Mariana Gonzalez Battistone, Maria Florencia Pingel, Jesica Arakaki, Naomi Mezmezian, Mónica Beatriz Sevlever, Gustavo Emilio Rojas, Estefanía Schultz, Marcelo Cervio, Andrés Eduardo https://repositorio.fleni.org.ar/xmlui/handle/123456789/1369 2025-05-29T16:09:12Z 2025-03-10T00:00:00Z

Refining pituitary adenoma classification: the role of transcription factors in diagnosis and risk assessment Katz, Débora Adela; Slavinsky, Patricia; Pernas, Mariana Gonzalez; Battistone, Maria Florencia; Pingel, Jesica; Arakaki, Naomi; Mezmezian, Mónica Beatriz; Sevlever, Gustavo Emilio; Rojas, Estefanía; Schultz, Marcelo; Cervio, Andrés Eduardo JOINT1942 Introduction: The new classification of pituitary tumors (WHO 2022) is based on transcription factors (TF) detected through immunohistochemistry (IHC) to determine tumor lineage. The aim of our study was to evaluate the usefulness of incorporating the WHO 2022 classification into the pathological study of pituitary adenomas (PA). Materials and Methods: We retrospectively analyzed records of adults with PA who underwent surgery between January 2023 and December 2024. Clinical, radiological (tumor size, cavernous sinus invasion), and histopathological data were reviewed, including IHC for hormones and TF: SF1, Tpit, Pit1, GATA3, and Ki-67%. High-risk PAs were identified according to WHO 2022 criteria. Tumors were classified as invasive if they had Knosp grade III or IV. Results: A total of 112 tumor samples were included. The majority belonged to the SF1 lineage (50%), followed by Pit1 (29%), TPIT (21%). With the incorporation of TF analysis, the diagnosis was modified in 19 patients:. • 11 clinically non-functioning adenomas (CNFA) with negative hormonal IHC were reclassified as gonadotropinomas (SF1+; n = 7), 1 corticotropinoma (TPIT+) and 1 null cell. • Only 2 CNFA were triple-negative but GATA3+. • 5 patients with acromegaly were reclassified as: 1 immature, 1 mature Pit1 lineage tumor, 2 acidophil stem cell tumors, and 1 plurihormonal (Pit1 and SF1). • 2 patients with thyrotropinoma were reclassified as immature and mature Pit1 lineage tumors. • 1 CNFA with IHC for PRL and GH was re3. • classified as plurihormonal (Pit1 and SF1). • 43 gonadotropinomas, 2 corticotropinomas, 1 acidophil stem cell, 3 Pit-1, and a plurihormonal tumor were GATA3+. • 31 patients with high-risk histological subtype tumors (7 reclassified with TF). These tumors were associated with invasiveness in 48% and Ki-67 ≥ 3% in 6.4%. • 81 patients with low-risk histology: 38% were invasive, and 3.7% had Ki-67 ≥ 3%. Conclusions: The addition of IHC for TF to routine diagnostics allows a more accurate classification of pituitary adenomas, particularly in cases with absent or low hormonal expression. IHC for GATA3 could be a useful marker for diagnosing gonadotropinomas and certain immature tumors. Diagnosing Pit1 adenomas presents challenges due to variability in hormonal expression, coexpression of transcription factors, and distinction between mature and immature types. The classification of tumors into high- and low-risk groups provides an additional parameter for individualized risk assessment, which should be considered along with clinical, radiological, and histopathological factors. These findings reinforce the need for molecular techniques to refine PitNET classification and enhance diagnostic precision. Keywords: pituitary neoplasms, tumor classification, WHO 2022.

2025-03-10T00:00:00Z Mallea-Gil, María Susana Glerean, Mariela Rogozinski, Amelia Ballarino, María Carolina Battistone, María Florencia Danilowicz, Karina Diez, Sabrina Fainstein Day, Patricia Furioso, Alejandra Guitelman, Mirtha Katz, Débora Adela Loto, Mónica Martinez, Marcela Miragaya, Karina Sosa, Soledad Slavinsky, Patricia Tkatch, Julieta Vitale, Nicolás Marcelo González Pernas, Mariana Soledad Pingel, Jesica https://repositorio.fleni.org.ar/xmlui/handle/123456789/1138 2025-01-06T17:42:41Z 2023-05-13T00:00:00Z

Craniopharyngiomas in adult patients: Retrospective, multicentric study in Buenos Aires, Argentina Mallea-Gil, María Susana; Glerean, Mariela; Rogozinski, Amelia; Ballarino, María Carolina; Battistone, María Florencia; Danilowicz, Karina; Diez, Sabrina; Fainstein Day, Patricia; Furioso, Alejandra; Guitelman, Mirtha; Katz, Débora Adela; Loto, Mónica; Martinez, Marcela; Miragaya, Karina; Sosa, Soledad; Slavinsky, Patricia; Tkatch, Julieta; Vitale, Nicolás Marcelo; González Pernas, Mariana Soledad; Pingel, Jesica Craniopharyngiomas are rare lesions derived from cell remnants of Rathke’s pouch, usually localized in the sellar and suprasellar areas. Objectives: To analyze clinical, endocrine and histological features in a group of patients from Buenos Aires city. To assess efficacy, number of surgeries and complications after surgery or other treatments. Material and methods: Multicentric, retrospective, transversal study. Adult patients with craniopharyngiomas were included. We assessed clinical, biochemical, MRI features, at diagnosis and after treatments, the follow-up and recurrence of tumors. Results: Ninety-seven patients, 49 women. Mean age at diagnosis: 41.4±16.04. Symptoms at diagnosis: visual field defects (VFD): 47.4%, headache: 14%, both symptoms: 14%, in this group with mass effect, the VFD reached 61.8%. Other symptoms at diagnosis: incidental findings: 8,2%, diabetes insipidus (DI) 5.2%, and others 11.2% (n:10): 4 hypopituitarism, 2 oligomenorrhea, 2 neurocognitive deficit, 1 behavior disorder, 1 intracranial hypertension. Supraselar extension was present in 88.7%. Endocrine tests showed: hyperprolactinemia 27.8% (Prolactin levels: 61.6 ng/ml (21-156). DI and panhypopituitarism (PHP) were present in 30.5 and 26% respectively; VFD 78.5%: hemianopsia (60.9%): 50/82, quadrantopsia 19% and blindness 10.5% (9/85). Basal BMI was 28.6±7.6. Surgical treatment (95/98): transcranial approach was performed in 71.1%, transsphenoidal approach was used in 25.8%; gross total resection was reached in 46.4%, subtotal 37.1% and partial resection 14.4%. Adamantinomatous type was found in 58.8%, papillary type in 13.4%. In the post-surgical assessment: 71.1% developed (PHP) (p .002) and DI 64.9% (p.002). VFD were 45.4% (40/88): hemianopsia 36.4%, quadrantopsia 9.5% and unilateral or bilateral amaurosis 9% (P 0.002 vs pre surgery). Tumor remnants were observed in 46.8% and recurrence rate was 19.6%. A second surgery was performed in 42.3%. Radiotherapy was indicated in 9.6%. Median time of follow-up was 57 months (4-427). Nine patients died, 4 related to the craniopharyngioma. Conclusions: In this cohort of adult patients with craniopharyngiomas, VFD was the main symptom. Transcranial approach was the predominant surgery; Adamantinomatous type was the most frequent. In the post-surgical assessment, there was significant improvement in the visual field, but a significant increase in the BMI of patients and in the number of subjects with PHP. A second surgery was performed in 42.3% and 9.6% was treated with radiotherapy. These patients with long-term morbidities need life-long follow-up by a multidisciplinary team.

2023-05-13T00:00:00Z Loto, Mónica Tkatch, Julieta Katz, Débora Adela Slavinsky, Patricia Alfieri, Analía Chervin, Alberto B. Rogozinski, Amelia Mallea-Gil, María Susana Ballarino, María Carolina Furioso, Alejandra Miragaya, Karina Battistone, María Florencia Sabate, María Isabel Szuman, Gabriela Glerean, Mariela Fainstein Day, Patricia Vitale, Nicolás Marcelo González Pernas, Mariana Soledad Sosa, Soledad Danilowicz, Karina https://repositorio.fleni.org.ar/xmlui/handle/123456789/273 2024-07-19T17:51:32Z 2019-04-30T00:00:00Z

MON-432 Symptomatic Pituitary Metastases: A Report of 16 Cases Loto, Mónica; Tkatch, Julieta; Katz, Débora Adela; Slavinsky, Patricia; Alfieri, Analía; Chervin, Alberto B.; Rogozinski, Amelia; Mallea-Gil, María Susana; Ballarino, María Carolina; Furioso, Alejandra; Miragaya, Karina; Battistone, María Florencia; Sabate, María Isabel; Szuman, Gabriela; Glerean, Mariela; Fainstein Day, Patricia; Vitale, Nicolás Marcelo; González Pernas, Mariana Soledad; Sosa, Soledad; Danilowicz, Karina Introduction: Pituitary Metastases (MTS) are infrequently seen in clinical practice. The incidence ranges from 0.14 to 28%. Breast and lung cancer are the primary sites that most frequently metastasize to sellar region, between the sixth and seventh decades of life. Most cases are diagnosed in patients with advanced malignant disease, however, in 20-30%, symptoms of pituitary involvement can precede the diagnosis of the primary tumor. Objectives: To evaluate symptoms at presentation, hormonal, radiological and histological findings, management and outcome of a series of patients with pituitary MTS. Patients and methods: medical records of 16 patients from eight Endocrine Centers were reviewed. Ten patients had histological confirmation of the pituitary MTS, 6 were not operated, being the diagnostic criteria the presence of sellar mass associated with diabetes insipidus (DI) and / or sudden-onset of neuro-ophthalmological symptoms in patients with confirmed primary neoplasia. Results: The median age was 54 years (range 35-70), 9 women (56.2%). The sites of the primary tumor were: 7 lung (44%), 5 breast (32%), 1 follicular thyroid carcinoma (6%), 1 Hodgkin lymphoma (6%), 1 poorly differentiated carcinoma (6%), and 1 clear cell renal carcinoma (6%). The median time between the diagnosis of the primary neoplasm and the occurrence of the pituitary MTS was 12 months (range: 3-120). In 9 patients (56.2%), the diagnosis of the primary neoplasm was made after the finding of the symptomatic sellar mass. DI was found in 14 patients (87.5%), adenohypophyseal deficit in 12 (75%), visual disorders in 10 (62.5 %), headache in 6 (37.5%) and cranial nerve deficits in 6 (37.5%). In 68.7% (11 patients), other MTS were detected. Fifteen patients were evaluated by MRI and one by CT: 13 (81.3%) harbored supra / parasellar masses, and the remaining 3 had lesions limited to the pituitary gland, with stalk thickening and lack of spontaneous neurohypophysis hyperintensity in 2 of them. In all cases diffuse gadolinium uptake was present. Fourteen patients died (87.5%), with a median survival time of 6,5 months (range: 1-36); the remaining 2 are still alive with a follow-up period of 4 and 12 months respectively. Conclusions: In this series of 16 patients with pituitary MTS, the most frequent primary neoplasms were lung and breast. Median age was lower than in published series. DI was the most common condition at presentation, followed by hypopituitarism and visual disorders. The short survival was related to the extent of the disease at the time of diagnosis. In more than half of the cases the diagnosis of primary neoplasia was made through the symptomatic pituitary mass. In the presence of a pituitary lesion with diffuse gadolinium uptake, associated with DI and / or acute visual deficit, pituitary MTS should be suspected even in patients without a history of oncological disease.

2019-04-30T00:00:00Z