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Introduction: Craniopharyngiomas (CPs) are benign and rare tumors found in adults. Their location close to vital neurovascular structures makes traditional treatment modalities (surgery and radiation) challenging and potentially fraught with morbidity. The 2021 WHO classification has divided what was previously considered two subtypes of craniopharyngioma into separate entities. Identification of specific molecular driver mutations in each type- BRAF V600E in papillary craniopharyngiomas (PCP) and CTNNB1 in adamantinomatous craniopharyngiomas (ACP) has resulted in a paradigm shift in the management of adult CPs. Methods: In this study, we describe our experience in treating PCPs with targeted therapy and highlight nuances in management accounting for current evidence. This review also explores the current scope and application of precision oncology in adult CPs including the experience with ongoing trials and prospects for future research. Results: The high prevalence of targetable mutation in cases of PCP and the efficacy of BRAF inhibitors alone or in combination with MEK inhibitors has improved the disease control in these patients. In the current scenario, while surgery is warranted to obtain histopathological diagnosis, radical resection and its associated risks can be avoided. In case of ACPs, dysregulation of multiple pathways has been implicated. This has prompted the use of a variety of targeted therapies with inconsistent outcomes. The results of ongoing and future trials may define its role in management. Conclusion: Precision oncology is a promising addition to the treatment armamentarium of adult CPs. [ABSTRACT FROM AUTHOR]

This article discusses the management of hypophysitis, a rare and challenging inflammatory disorder. The study analyzed data from 12 adult patients with hypophysitis, examining their demographics, treatment modalities, laboratory findings, histopathological results, and radiological images. The results showed that corticosteroid therapy is the main treatment strategy, but diagnostic accuracy remains difficult due to the wide range of imaging findings. Younger patients have a higher risk of recurrence, and controlling blood glucose levels and body mass index is important in preventing recurrence. Surgical intervention can confirm the diagnosis and improve symptoms, and radiation therapy may be effective for resistant cases. [Extracted from the article]

This article discusses the successful treatment of recurrent lymphocytic hypophysitis (LH) using fractionated stereotactic radiotherapy (FSRT). LH is a rare autoimmune inflammation of the pituitary gland that can mimic pituitary adenomas. The authors conducted a systematic literature review and found that FSRT can be a viable alternative treatment for refractory cases of LH. The study included eight patients, and seven of them achieved a complete clinical response after one course of radiation. FSRT offers long-term disease control while minimizing radiation exposure to nearby critical structures. However, further studies are needed to determine the long-term effects, optimal dose planning, and patient selection criteria for FSRT. [Extracted from the article]

This article discusses the occurrence of hypothyroidism following endoscopic endonasal resection of thyrotropin-secreting pituitary adenomas (TSHomas). The study conducted a retrospective review of patients who underwent this surgical procedure and found that postoperative hypothyroidism was a common outcome. The article emphasizes the importance of recognizing this potential outcome for appropriate postoperative management and patient counseling. The authors suggest that further research and larger case series are needed to gain more insights into the mechanism and peri-operative management of these patients. [Extracted from the article]

Background: McCune‐Albright syndrome is a rare disorder characterized by polyostotic fibrous dysplasia (FD), café‐au‐lait skin pigmentation, and endocrine dysfunction. Extensive FD in the craniofacial region can present significant challenges in terms of disease control and carries a high risk of permanent visual impairment. Methods: We present a case of medically and surgically resistant FD that required nine optic nerve decompressions. Results: The condition was ultimately controlled with the use of the denosumab agent. Conclusion: The case highlights the importance and potential efficacy of denosumab in resistant FD management, particularly in cases involving sensitive organs. [ABSTRACT FROM AUTHOR]

Introduction: Pituitary carcinomas are poorly understood, rare entities. They are distinguished from adenomas not by histopathological features but rather by the presence of metastases. Objective: We discuss the diagnosis, mechanism of dissemination and pathogenesis based on a review of the literature and illustrated by a singular case. Case Report: A 59-year-old male presented with a dural-based posterior fossa lesion. He had been diagnosed with a pituitary chromophobe adenoma 43 years earlier that was treated at the time with surgery and radiation therapy. A presumptive diagnosis of a radiation-induced meningioma was made and surgery was recommended. At surgery the tumour resembled a pituitary adenoma. Histopathology, laboratory findings, and the patient's medical history confirmed the final diagnosis of a prolactin-secreting pituitary carcinoma. To our knowledge, this is the longest reported interval between the pituitary adenoma and metastatic lesion diagnosis (43 years). Conclusion: Management should be tailored to individual patient and may include a combination of treatments (surgery, radiation therapy, chemotherapy, and hormone-targeted therapy). Functionally active tumours may be monitored with hormone levels as tumour markers. [ABSTRACT FROM AUTHOR]