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Abstract Context Somatostatin analogs (SSAs) effectively control growth hormone secretion in first- and second-line treatment of acromegaly. Their effect on glucose metabolism is still debated. Objective To address the following questions: (1) Do SSAs affect fasting plasma glucose (FPG), fasting plasma insulin, glycosylated hemoglobin (HbA1c), glucose load (glucose levels after 2-hour oral glucose tolerance test), homeostatic model assessment of insulin resistance (HOMA-I), homeostatic model assessment of pancreatic β-cell function (HOMA-β), triglycerides, weight, or body mass index? (2) Do lanreotide and octreotide affect metabolism differently? (3) Does their effect depend on disease control? Design We performed a meta-analysis of prospective interventional trials treating acromegaly with SSAs. Inclusion criteria: all studies reporting glycometabolic outcomes before and after SSAs with a minimum 6-month follow-up. Results The inclusion criteria were met by 47 studies treating 1297 subjects (631 females). SSA treatment effectively lowered fasting plasma insulin [effect size (ES), −6.67 mU/L; 95% confidence interval (CI), −8.38 to −4.95 mU/L; P < 0.001], HOMA-I (ES, −1.57; CI, −2.42 to −0.72; P < 0.001), HOMA-β (ES, −47.45; CI, −73.15 to −21.76; P < 0.001), and triglycerides (ES, −0.37 mmol/L; CI, −0.47 to −0.27 mmol/L; P < 0.001). SSAs worsened glucose levels after a 2-hour oral glucose tolerance test (ES, 0.59 mmol/L; CI, 0.05 to 1.13 mmol/L; P = 0.032), but not FPG. A mild but significant increase in HbA1c (ES, 0.12%; CI, 0.00% to 0.25%; P = 0.044) was found in subjects treated with octreotide. Conclusions SSA treatment in acromegaly patients, while improving disease control, reduces insulin levels, increases after-load glucose, and, ultimately, increases HbA1c levels without affecting FPG. The findings suggest that clinicians treating acromegaly with SSAs should consider targeting postprandial glucose. The current meta-analysis evaluated the effect of somatostatin analogs treatment on glucose metabolism in acromegaly.

Objectives: Information prescriptions consist in making specific health care information available to patients on their disease from accredited sources, in order to help them understand and manage their disease, stimulating informed participation in health care. In the literature, a few studies have investigated the real effectiveness of prescribing information on the health management of oncological diseases. The scope of our pilot study was to investigate the effectiveness of information prescription, evaluating both patient satisfaction and perception, but also its possible impact on adherence to follow-up programs. Methods: Prospective pilot study enrolling patients with thyroid cancer. They received informative scientific material on thyroid cancer, dispensed by clinical librarians of the Institute's Library. Results: 101 patients were enrolled (81% were women with a total mean age of 49.39 years). 26% of patients accessed the institute’s library receiving patient information materials. Comparing data of people who completed the project with those who did not, no differences in sex, age and tumour characteristics were found. We found no statistical differences in terms of adherence to follow-up visits between the two groups of patients, but health information was able to effectively respond to the requests or needs of most patients. Participating patients have improved awareness and knowledge of their disease, patient-doctor relationships, adherence to treatment and communication with family members regarding their disease status, with a final positive impact on one’s psychological well-being and global satisfaction obtained in 65% of people. Conclusions: This is the first Italian study carried out in the field of oncological endocrinology, demonstrating the positive role health information has on patients’ psychological health and thyroid cancer knowledge.

Inositols have demonstrated a role in cancer prevention and treatment in many kinds of neoplasms. Their molecular mechanisms vary from the regulation of survival and proliferative pathways to the modulation of immunity and oxidative stress. The dysregulation of many pathways and mechanisms regulated by inositols has been demonstrated in endocrine and neuroendocrine tumors but the role of inositol supplementation in this context has not been clarified. The aim of this review is to summarize the molecular basis of the possible role of inositols in endocrine and neuroendocrine tumors, proposing it as an adjuvant therapy.

Background: Solitary fibrous tumors are uncommon fibroblastic neoplasms. These tumors are characterized by the recurrent NAB2-STAT6 gene fusion, which is a hallmark of solitary fibrous tumors (SFTs), particularly those arising in the thoracic cavity. While SFTs are mostly found in the abdomen and pleura, they can occur in various locations, including the head and neck region (6% of cases of SFTs). Solitary fibrous tumors of the thyroid (SFTTs) are extremely rare, accounting for only 0.1% of all thyroid tumors. The gold standard imaging modality for thyroid tumors is ultrasonography, even though distinctive characteristics for these types of neoplasms are absent, making pre-operative diagnosis more challenging. Aim: The aim of this study is to perform a systematic literature review and to describe our case by analyzing the main clinical features, histological diagnostic features and treatments of this rare tumor, in order to clarify the behavior and molecular characteristics of SFTTs. Methods: A comprehensive systematic literature review was conducted according to the PRISMA guidelines for SFTTs. We searched the PubMed and EMBASE databases for articles published up to November 2025. The inclusion criteria include confirmed diagnosis of SFTT, while articles describing unrelated neoplasms or articles that were not in English were excluded. A standardized form was used to extract information on the imaging characteristics, histological diagnosis, treatment and outcome. Results: As of 2025, a total of 43 articles were selected, with 61 reported cases of SFTT in the English literature. Pre-operative diagnosis of SFTT is controversial and usually requires immunohistochemical confirmation. In our case, molecular analysis identified, for the first time, a NAB2ex6–STAT6ex17 fusion, contributing to the molecular characterization of this rare tumor. Conclusions: SFTTs are rare and difficult to diagnose; thus, they require a multidisciplinary approach for accurate diagnosis and management. The combination of imaging, cytology, histopathology, and molecular testing is essential in distinguishing SFTTs from other thyroid malignancies. Surgical excision remains the mainstay of treatment, and long-term follow-up is recommended due to the potential risk of recurrence or metastasis.

Background Neuroendocrine tumors (NETs) early diagnosis is a clinical challenge that require a deep understanding of molecular and genetic features of this heterogeneous group of neoplasms. However, few biomarkers exist to aid diagnosis and to predict prognosis and treatment response. In the oncological field, tumor-educated platelets (TEPs) have been implicated as central players in the systemic and local responses to tumor growth, thereby altering tumor specific RNA profile. Although TEPs have been found to be enriched in RNAs, few studies have investigated the potential of a type of RNA, circular RNAs (circRNA), as platelet-derived biomarkers for cancer. In this proof-of-concept study, we aim to demonstrate whether the circRNAs signature of tumor educated platelets can be used as a liquid biopsy biomarker for the detection of gastroenteropancreatic (GEP)-NETs and the prediction of the early response to treatment. Methods We performed a 24-months, prospective proof-of-concept study in men and women with histologically proven well-differentiated G1-G2 GEP-NET, aged 18–80 years, naïve to treatment. We performed a RNAseq analysis of circRNAs obtained from TEPs samples of 10 GEP-NETs patients at baseline and after 3 months from therapy (somatostatin analogs or surgery) and from 5 patients affected by non-malignant endocrinological diseases enrolled as a control group. Results Statistical analysis based on p < 0.05 resulted in the identification of 252 circRNAs differentially expressed between GEP-NET and controls of which 109 were up-regulated and 143 were down-regulated in NET patients. Further analysis based on an FDR value ≤ 0.05 resulted in the selection of 5 circRNAs all highly significant downregulated. The same analysis on GEP-NETs at baseline and after therapy in 5 patients revealed an average of 4983 remarkably differentially expressed circRNAs between follow-up and baseline samples of which 2648 up-regulated and 2334 down-regulated, respectively. Applying p ≤ 0.05 and FDR ≤ 0.05 filters, only 3/5 comparisons gave statistically significant results. Conclusions Our findings identified for the first time a circRNAs signature from TEPs as potential diagnostic and predictive biomarkers for GEP-NETs.

Background Tumor consistency recently emerged as a key factor in surgical planning for pituitary adenomas, but its impact on postoperative endocrine function is still unclear. Our study aimed to evaluate the impact of tumor consistency on the development of postoperative pituitary deficiencies. Methods Single-center, retrospective analysis of consecutive pituitary surgeries performed between January 2017 and January 2021 at Policlinico Umberto I in Rome. All patients underwent radiological and biochemical evaluations at baseline, and hormone assessments 3 and 6 months after pituitary surgery. Postoperative MRI studies were used to determine resection rates following surgery. Data on tumor consistency, macroscopic appearance, neurosurgical approach, and intraoperative complications were collected. Results Fifty patients [24 women, mean age 57 ± 13 years, median tumor volume 4800 mm 3 [95% CI 620–8828], were included. Greater tumor volume (χ 2  = 14.621, p  = 0.006) and male sex (χ 2  = 12.178, p  < 0.001) were associated with worse preoperative endocrine function. All patients underwent transsphenoidal adenomectomy. Fibrous consistency was observed in 10% of patients and was associated with a Ki-67 greater than 3% (χ 2  = 8.154, p  = 0.04), greater risk of developing postoperative hormone deficiencies (χ 2  = 4.485, p  = 0.05, OR = 8.571; 95% CI: 0.876–83.908), and lower resection rates (χ2 = 8.148, p  = 0.004; OR 1.385, 95% CI; 1.040–1.844). Similarly, worse resection rates were observed in tumors with suprasellar extension (χ2 = 5.048, p  = 0.02; OR = 6.000, 95% CI; 1.129–31.880) and CSI (χ2 = 4.000, p  = 0.04; OR = 3.857, 95% CI; 0.997–14.916). Conclusions Tumor consistency might provide useful information about postoperative pituitary function, likely due to its impact on surgical procedures. Further prospective studies with larger cohorts are needed to confirm our preliminary findings.

Thyroid cancer is more aggressive in elderly patients due to biological causes related to age, histotype, and the advanced stage at diagnosis. In the elderly, both the diagnosis and treatment of thyroid cancer impact quality of life. This review aimed to collect and discuss the different therapeutic approaches in elderly patients affected by thyroid cancer. Our analysis examined the therapeutic surgical approach according to age and how this affects the prognosis of patients with thyroid cancer, along with how iodine 131 therapy is tolerated and how effective it is. Furthermore, we investigated whether levothyroxine suppressive therapy is always necessary and safe in elderly patients with thyroid cancer and the safety and efficacy of systemic therapy in the elderly. We also intended to identify peculiar features of thyroid cancer in elderly subjects and to evaluate how the disease and its treatment affect their quality of life.

Background: The current possible treatments of advanced medullary carcinoma (MTC) include different drugs belonging to the class of tyrosine kinase inhibitors (TKIs): vandetanib, cabozantinb, and selpercatinib. Although the effects of these TKIs have been well described in clinical trials, the real-practice evidence of the effectiveness and safety of these treatment is scant. This real-world case series aims to describe a niche of patients with advanced MTC treated with more than one TKI by focusing on treatment responses and any reported adverse events (AEs) and to provide additional insight on the individualized approach to the management of metastatic MTC. Methods: Five patients with a diagnosis of metastastic MTC, treated with at least two different molecules of TKIs, were retrospectively selected. Results: Three patients obtained a partial response (one with cabozantinb, one with selpercatinib, and one with vandetanib), and two patients obtained disease stability (both of them treated with all three TKIs, the first two lines discontinued for AEs). The AE profile agreed with the known clinical trials AEs except for non-neoplastic ascites related to selpercatinib and lung cavitations of non-neoplastic tissue related to cabozantinb. The latter was an AE never described so far in patients receiving TKIs. Conclusions: The best management of MTC relies on an individualized approach, keeping in mind and dealing with the potential toxicity in order to minimize the treatment withdrawal.

Gut microbiota is represented by different microorganisms that colonize the intestinal tract, mostly the large intestine, such as bacteria, fungi, archaea and viruses. The gut microbial balance has a key role in several functions. It modulates the host’s metabolism, maintains the gut barrier integrity, participates in the xenobiotics and drug metabolism, and acts as protection against gastro-intestinal pathogens through the host’s immune system modulation. The impaired gut microbiota, called dysbiosis, may be the result of an imbalance in this equilibrium and is linked with different diseases, including cancer. While most of the studies have focused on the association between microbiota and gastrointestinal adenocarcinomas, very little is known about gastroenteropancreatic (GEP) neuroendocrine neoplasms (NENs). In this review, we provide an overview concerning the complex interplay between gut microbiota and GEP NENs, focusing on the potential role in tumorigenesis and progression in these tumors.

D-chiro-inositol (DCI) is a natural compound detectable in cell membranes, which is highly conserved as a biological signaling molecule. In mammals, its function is primarily characterized in the intracellular transduction cascade of insulin. In particular, insulin signal promotes the release of pivotal DCI-containing molecules. In fact, impaired release of DCI is a common feature of insulin-resistant tissues, and insulin-sensitizing pharmaceuticals induce higher concentrations of free DCI. Moreover, it also plays important roles in several other processes. DCI is involved in the regulation of steroidogenesis, due to its regulatory effects on steroidogenic enzymes, including 17α-hydroxylase, 3β-hydroxysteroid dehydrogenase, and aromatase. Such regulation of various enzymes indicates a mechanism by which the body regulates different processes via a single molecule, depending on its concentration. DCI also reduces the expression of integrin β3, which is an adhesion molecule involved in embryo implantation and cellular phenomena such as survival, stemness, and invasiveness. In addition, DCI seems to have important anti-inflammatory activities, like its 3-O-methyl-ether, called pinitol. In vitro evidence demonstrates that treatment with both compounds induces a reduction in pro-inflammatory factors—such as Nf-κB—and cytokines—such as TNF-α. DCI then plays important roles in several fundamental processes in physiology. Therefore, research on such molecule is of primary importance.