FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4368365104> ?p ?o ?g. }

• W4368365104 endingPage "S68" @default.
• W4368365104 startingPage "S68" @default.
• W4368365104 abstract "A 55-year-old male with Nelson's Syndrome was originally diagnosed with Cushing’s disease 5 years prior after the identification of a 15 x 13 mm pituitary adenoma and ACTH 174 pg/mL. He had typical symptoms including proximal weakness, easy bruising, abdominal striae, weight gain, and atraumatic vertebral fractures. Pathology following TSRPT at that time showed an ACTH-producing tumor with MIB1 index 20%. He had initial improvement of his Cushing's stigmata but one year later developed proximal muscle weakness, hypokalemia requiring replacement, worsening diabetes, and weight gain. Repeat MRI was negative for new/recurring lesion. One and a half years after initial TSRPT, he started on ketoconazole 400 mg three times daily and cabergoline 1 mg TID as a repeat MRI showed a recurring pituitary lesion measuring 13 x 14 x 9 mm with corresponding ACTH level 159 pg/mL. He underwent radiotherapy with 20 Gy in one fraction and two months later underwent bilateral adrenalectomy with cessation of ketoconazole and cabergoline. Two years later, his ACTH level increased to 1,342 pg/mL and he underwent another fraction of radiotherapy of 20 Gy. A repeat MRI showed a decrease in the size of pituitary lesion. However, eight months later, his ACTH levels peaked at 45,510 pg/mL and he underwent a second TSRPT and a stereotactic radiosurgery series of 54 Gy in 30 fractions over three months. Surgical pathology showed a low-grade neuroendocrine neoplasm without any mitotic figures and an MIB-1 index 15% Two months following the SRS series, his ACTH levels peaked at 188,567 pg/mL. He presented to the ED for abdominal pain and CT Abdomen showed possible metastatic lesions in the liver, one of which was subsequently biopsied and positive for pituitary carcinoma. He is currently undergoing capecitabine chemotherapy and an SRS series to the liver with plans to add temozolomide upon completion of the SRS. A key learning point is to suspect metastatic disease with drastic ACTH increases. PET scan imaging is recommended in a patient with rapid or significant increase in ACTH level with or without progression of a lesion centrally. Additionally, although the original histology did not show carcinoma, the elevated MIB-1 index should raise the suspicion for malignant possibility and therefore, increased surveillance. Functional pituitary carcinoma has the twofold task of treating the excess hormone production and controlling the spread of metastatic disease. Given the rarity of this type of cancer, a multi-disciplinary approach best serves the patient including endocrinology, oncology, (neurological) surgery, and radiation oncology. More data and studies are needed to definitively assess efficacy of chemotherapeutics including capecitabine and temozolomide for these types of tumors." @default.
• W4368365104 created "2023-05-05" @default.
• W4368365104 creator A5036519696 @default.
• W4368365104 creator A5046242661 @default.
• W4368365104 date "2023-05-01" @default.
• W4368365104 modified "2023-09-27" @default.
• W4368365104 title "Abstract #1393024: A Rare Case of ACTH-Producing Pituitary Carcinoma in Nelson’s Syndrome" @default.
• W4368365104 doi "https://doi.org/10.1016/j.eprac.2023.03.154" @default.
• W4368365104 hasPublicationYear "2023" @default.
• W4368365104 type Work @default.
• W4368365104 citedByCount "0" @default.
• W4368365104 crossrefType "journal-article" @default.
• W4368365104 hasAuthorship W4368365104A5036519696 @default.
• W4368365104 hasAuthorship W4368365104A5046242661 @default.
• W4368365104 hasBestOaLocation W43683651041 @default.
• W4368365104 hasConcept C126322002 @default.
• W4368365104 hasConcept C141071460 @default.
• W4368365104 hasConcept C16005928 @default.
• W4368365104 hasConcept C2777428134 @default.
• W4368365104 hasConcept C2779064019 @default.
• W4368365104 hasConcept C2779318953 @default.
• W4368365104 hasConcept C2779548794 @default.
• W4368365104 hasConcept C2779832395 @default.
• W4368365104 hasConcept C2781064554 @default.
• W4368365104 hasConcept C2781156865 @default.
• W4368365104 hasConcept C2910141127 @default.
• W4368365104 hasConcept C2989005 @default.
• W4368365104 hasConcept C509974204 @default.
• W4368365104 hasConcept C71315377 @default.
• W4368365104 hasConcept C71924100 @default.
• W4368365104 hasConceptScore W4368365104C126322002 @default.
• W4368365104 hasConceptScore W4368365104C141071460 @default.
• W4368365104 hasConceptScore W4368365104C16005928 @default.
• W4368365104 hasConceptScore W4368365104C2777428134 @default.
• W4368365104 hasConceptScore W4368365104C2779064019 @default.
• W4368365104 hasConceptScore W4368365104C2779318953 @default.
• W4368365104 hasConceptScore W4368365104C2779548794 @default.
• W4368365104 hasConceptScore W4368365104C2779832395 @default.
• W4368365104 hasConceptScore W4368365104C2781064554 @default.
• W4368365104 hasConceptScore W4368365104C2781156865 @default.
• W4368365104 hasConceptScore W4368365104C2910141127 @default.
• W4368365104 hasConceptScore W4368365104C2989005 @default.
• W4368365104 hasConceptScore W4368365104C509974204 @default.
• W4368365104 hasConceptScore W4368365104C71315377 @default.
• W4368365104 hasConceptScore W4368365104C71924100 @default.
• W4368365104 hasIssue "5" @default.
• W4368365104 hasLocation W43683651041 @default.
• W4368365104 hasOpenAccess W4368365104 @default.
• W4368365104 hasPrimaryLocation W43683651041 @default.
• W4368365104 hasRelatedWork W1967276862 @default.
• W4368365104 hasRelatedWork W2012488328 @default.
• W4368365104 hasRelatedWork W2026630854 @default.
• W4368365104 hasRelatedWork W2149018297 @default.
• W4368365104 hasRelatedWork W2408581373 @default.
• W4368365104 hasRelatedWork W2428589077 @default.
• W4368365104 hasRelatedWork W2616515826 @default.
• W4368365104 hasRelatedWork W2983577183 @default.
• W4368365104 hasRelatedWork W4377217833 @default.
• W4368365104 hasRelatedWork W2762420786 @default.
• W4368365104 hasVolume "29" @default.
• W4368365104 isParatext "false" @default.
• W4368365104 isRetracted "false" @default.
• W4368365104 workType "article" @default.