Objective To summarize the clinical features of pituitary carcinoma and discuss the diagnosis,treatment and prognosis.Methods Clinical manifestations,imaging,pathologic features of one case of pituitary carcinoma were analyzed and literatures about diagnosis,treatment and prognosis of pituitary carcinoma were reviewed.Results The patient manifested polyuria onset,headache and anterior pituitary dysfunction and MRI showed pituitary lesions.He had been undergone two transsphenoidal surgery in our hospital,pathologic examinations were respectively non-functioning adenomas and atypical pituitary adenoma and tumor proliferation index (Ki-67) both were more than 30％.He was recommended radiation therapy but refused.Five months later,he was diagnosed as primary pituitary gland cancer due to the tumor widespread intracranial metastasis and no other malignant lesions in body.Conclusions Primary pituitary carcinoma is a very rare tumor,mostly transformed from the invasive pituitary adenoma.It helps predict tumor proliferation and prognosis to test the level of Ki-67 index.Primary pituitary adenocarcinoma needs comprehensive treatment and the prognosis is related to the treatment response.

Pituitary adenoma is one common type of intracranial tumors, accounting for about 10% of intracranial tumors. Although pituitary adenomas are benign tumors, the complete resection and recurrence prevention remain challengeable due to aggressive growth of tumor, limited equipment conditions and surgical techniques of the surgeon. The proportion of recurrent pituitary adenomas is rising year by year and the difficulty of treatment also increases. This article reviews the diagnosis and treatment of recurrent pituitary adenomas based on the summary data of invasive or recurrent pituitary adenomas cases in our center, including indication for the second transsphenoidal surgery, surgical techniques, and prevention and treatment of postoperative complications, to provide reference for clinicians in this field.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.