Abstract

Substantial advances have been made recently in the pathobiology of pituitary tumors. Similar to many other endocrine tumors, over the last few years we have recognized the role of germline and somatic mutations in a number of syndromic or nonsyndromic conditions with pituitary tumor predisposition. These include the identification of novel germline variants in patients with familial or simplex pituitary tumors and establishment of novel somatic variants identified through next generation sequencing. Advanced techniques have allowed the exploration of epigenetic mechanisms mediated through DNA methylation, histone modifications and noncoding RNAs, such as microRNA, long noncoding RNAs and circular RNAs. These mechanisms can influence tumor formation, growth, and invasion. While genetic and epigenetic mechanisms often disrupt similar pathways, such as cell cycle regulation, in pituitary tumors there is little overlap between genes altered by germline, somatic, and epigenetic mechanisms. The interplay between these complex mechanisms driving tumorigenesis are best studied in the emerging multiomics studies. Here, we summarize insights from the recent developments in the regulation of pituitary tumorigenesis.

Highlights

  • Pituitary tumors (PTs) are common intracranial neoplasms with an overall prevalence estimated at 17% in a systematic review using post-mortem (14%) and radiologic studies (22%) [1]

  • While the majority of these would represent incidentalomas and usually of little clinical significance, the prevalence of clinically-presenting adenomas is higher in epidemiological studies conducted over the t last 10-15 years compared to older data, probably due to better diagnostic modalities, with 68-110 ip PTs clinically-presenting cases identified per 100,000 inhabitants [2,3,4,5,6,7,8]

  • We use the term pituitary tumor representing tumors d arising from the potentially hormone-producing cells of the anterior pituitary. te PTs are clinically categorized by their hormone-secreting characteristics, with over-secretion of Growth Hormone (GH), p prolactin, ACTH, TSH and LH/FSH or clinically non-functioning tumors

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Summary

INTRODUCTION

Pituitary tumors (PTs) are common intracranial neoplasms with an overall prevalence estimated at 17% in a systematic review using post-mortem (14%) and radiologic studies (22%) [1]. Histological characterization e has been based on immunohistochemical staining of pituitary hormones, with more recently cc transcription factors (PIT1 for GH, prolactin and TSH lineages, SF1 for gonadotroph lineages and TPIT Afor ACTH lineage) being added to the classification [13]. We have witnessed major advances in the biology of pituitary tumors, with the identification of several germline and somatic mutations and epigenetic mechanisms, such as DNA methylation, histone modifications and non-coding RNAs. In this review, genetic and epigenetic mechanisms contributing to pituitary tumorigenesis will be succinctly summarized with an emphasis on novel insights over the last ten years. The non-syndromic group consists of patients in whom no other organ than n the pituitary is involved, and is known as familial isolated pituitary adenoma (FIPA) [16].

AIP mutation-positive pituitary tumors
EPIGENETIC MECHANISMS OF TUMORIGENESIS
Histone modification
Other non-coding RNAs
Global gene expression profiles
Findings
References interpretation
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