The novel concept of “Onco-Immuno-Endocrinology” led to the discovery of new clinical entity “paraneoplastic autoimmune hypophysitis”

Elsevier

Available online 26 April 2022, 101663

Best Practice & Research Clinical Endocrinology & Metabolism

Recent advances in tumor immunology have enabled to develop immune checkpoint inhibitors and to save many patients with advanced cancer. Various endocrine diseases are caused by autoimmune mechanisms; it is important to understand that many endocrine organs are targeted by autoimmunity. In addition, some of malignant tumors ectopically produce hormones and lead to a clinically relevant ectopic hormone syndrome as an endocrine paraneoplastic syndrome. Thus, interplay between oncology, immunology, and endocrinology is important. We have defined a new clinical entity “paraneoplastic autoimmune hypophysitis” as “hypophysitis associated with autoimmunity against pituitary antigens caused by an ectopic expression of these antigens in the tumor and resulting in a breakdown of immune tolerance”. To understand the pathophysiology of paraneoplastic autoimmune hypophysitis requires a fusion of the fields of oncology, immunology, and endocrinology; therefore, I propose a new concept of Onco-Immuno-Endocrinology.

Keywords

onco-immuno-endocrinology

pituitary

paraneoplastic autoimmune hypophysitis

paraneoplastic syndrome

hypophysitis

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