{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T02:38:28Z","timestamp":1783391908278,"version":"3.54.6"},"reference-count":63,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Posterior pituitary tumors (PPTs) are rare, non-neuroendocrine neoplasms derived from pituicytes of the neurohypophysis or infundibulum. According to the 2025 WHO classification, PPTs comprise four distinct but related low-grade entities: pituicytoma, granular cell tumor of the sellar region, spindle cell oncocytoma, and ependymal pituicytoma. All share nuclear TTF-1 expression, confirming their common origin, but differ in morphology, immunophenotype, and ultrastructure. Histologically, pituicytomas consist of bipolar spindle cells in fascicles; granular cell tumors show polygonal cells with PAS-positive, diastase-resistant cytoplasmic granules; spindle cell oncocytomas display oncocytic change and abundant mitochondria; and ependymal pituicytomas exhibit perivascular pseudorosettes and EMA positivity in apical or dot-like patterns. Immunohistochemically, all are S100 and vimentin positive, and negative for pituitary hormones and lineage-specific transcription factors. Clinically, PPTs are typically non-functioning but may be associated with corticotroph or somatotroph hyperfunction. Imaging features are nonspecific. Surgical resection is the treatment of choice, although hypervascularity and adherence\u2014especially in spindle cell oncocytomas\u2014can hinder complete excision. Radiotherapy is reserved for recurrences. Molecular analyses reveal recurrent alterations in MAPK\/PI3K pathways (e.g., HRAS, BRAF, FGFR1, NF1, TSC1) and suggest a shared histogenesis. Copy number imbalances correlate with reduced progression-free survival in some subtypes. Despite a generally favorable prognosis, recurrence\u2014particularly in spindle cell oncocytomas\u2014necessitates long-term follow-up. The WHO 2025 update provides a unified framework for classification, diagnosis, and prognostic stratification of these rare tumors.<\/jats:p>","DOI":"10.3390\/jcm14134553","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T03:33:25Z","timestamp":1750995205000},"page":"4553","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Histopathological Types, Clinical Presentation, Imaging Studies, Treatment Strategies, and Prognosis of Posterior Pituitary Tumors: An Updated Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0126-1985","authenticated-orcid":false,"given":"Pedro","family":"Iglesias","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro Majadahonda, C. Joaqu\u00edn Rodrigo, 1, 28222 Majadahonda, Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Puerta de Hierro Segovia de Arana, 28222 Majadahonda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"ref_1","unstructured":"Feingold, K.R., Anawalt, B., Blackman, M.R., Boyce, A., Chrousos, G., Corpas, E., de Herder, W.W., Dhatariya, K., Dungan, K., and Hofland, J. (2000). Development and Microscopic Anatomy of the Pituitary Gland. Endotext, MDText.com, Inc."},{"key":"ref_2","unstructured":"Ilahi, S., and Ilahi, T.B. (2025). Anatomy, Adenohypophysis (Pars Anterior, Anterior Pituitary). StatPearls, StatPearls Publishing."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"171300","DOI":"10.1016\/j.peptides.2024.171300","article-title":"Structure and Function of Neurohypophysial Hormones","volume":"182","author":"Iwasaki","year":"2024","journal-title":"Peptides"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e13307","DOI":"10.1111\/bpa.13307","article-title":"Posterior Pituitary Tumors and Other Rare Entities Involving the Pituitary Gland","volume":"35","author":"Roncaroli","year":"2025","journal-title":"Brain Pathol."},{"key":"ref_5","unstructured":"(2025). The WHO Classification of Tumours, WHO. [5th ed.]. Endocrine and Neuroendocrine Tumours."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.wneu.2020.09.023","article-title":"Primary Tumors of the Posterior Pituitary Gland: A Systematic Review of the Literature in Light of the New 2017 World Health Organization Classification of Pituitary Tumors","volume":"145","author":"Whipple","year":"2021","journal-title":"World Neurosurg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1007\/s11154-019-09484-1","article-title":"Primary Tumors of the Posterior Pituitary: A Systematic Review","volume":"20","author":"Marengo","year":"2019","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1007\/s00401-017-1769-8","article-title":"The 2017 World Health Organization Classification of Tumors of the Pituitary Gland: A Summary","volume":"134","author":"Lopes","year":"2017","journal-title":"Acta Neuropathol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s11102-021-01189-6","article-title":"Epidemiology of Common and Uncommon Adult Pituitary Tumors in the U.S. According to the 2017 World Health Organization Classification","volume":"25","author":"Castellanos","year":"2022","journal-title":"Pituitary"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1093\/ajcp\/aqae067","article-title":"Pituitary Neuroendocrine Tumors and Granular Cell Pituicytomas at Autopsy: Incidence, Cell Types, Locations, and Histogenesis in 150 Pituitary Glands","volume":"162","author":"Tomita","year":"2024","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Li, J., Chen, S., Tan, H., Yu, Y., Tang, Y., Cai, B., and Li, J. (2025). Oncocytic Pituicytoma in a Patient with Cushing\u2019s Disease: A Case Report and Narrative Literature Review. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1487120"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"luaf071","DOI":"10.1210\/jcemcr\/luaf071","article-title":"A Rare Case of Pituicytoma During Pregnancy","volume":"3","author":"Wu","year":"2025","journal-title":"JCEM Case Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1007\/s00401-021-02377-1","article-title":"Genetic and Epigenetic Characterization of Posterior Pituitary Tumors","volume":"142","author":"Schmid","year":"2021","journal-title":"Acta Neuropathol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1093\/jnen\/nlaa139","article-title":"Clinical-Pathological, Immunohistochemical, and Genetic Characterization of a Series of Posterior Pituitary Tumors","volume":"80","author":"Barresi","year":"2021","journal-title":"J. Neuropathol. Exp. Neurol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s12020-020-02399-x","article-title":"Adenohypophyseal Hyperfunction Syndromes and Posterior Pituitary Tumors: Prevalence, Clinical Characteristics, and Pathophysiological Mechanisms","volume":"70","author":"Iglesias","year":"2020","journal-title":"Endocrine"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s11102-025-01518-z","article-title":"Clinical, Surgical, and Endocrine Outcome Following Treatment of Posterior Pituitary Tumors: A Retrospective Cohort Study","volume":"28","author":"Kremenevski","year":"2025","journal-title":"Pituitary"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Lamback, E., da Silva Camacho, A.H., Castro Araujo, A.C., Wildemberg, L.E., Cabrera Filho, F.D., Andreiuolo, F., Kasuki, L., Ventura, N., Chimelli, L., and Gadelha, M.R. (2025). TTF1-Positive Posterior Pituitary Tumors: A Single-Center Experience of 10 Years. Endocrine, 1\u201310.","DOI":"10.1007\/s12020-025-04214-x"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1002\/path.1700690115","article-title":"A Glioma of the Posterior Lobe of the Pituitary Gland","volume":"69","author":"Scothorne","year":"1955","journal-title":"J. Pathol. Bacteriol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1097\/00000478-200003000-00004","article-title":"Pituicytoma: A Distinctive Low-Grade Glioma of the Neurohypophysis","volume":"24","author":"Brat","year":"2000","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s40618-018-0923-z","article-title":"Clinical Features, Diagnosis and Therapy of Pituicytoma: An Update","volume":"42","author":"Pian","year":"2019","journal-title":"J. Endocrinol. Investig."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3417","DOI":"10.3892\/ol.2016.5119","article-title":"Pituicytoma: A Report of Three Cases and Literature Review","volume":"12","author":"Yang","year":"2016","journal-title":"Oncol. Lett."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1111\/neup.12291","article-title":"The Clinicopathological Features of Pituicytoma and the Differential Diagnosis of Sellar Glioma","volume":"36","author":"Wang","year":"2016","journal-title":"Neuropathology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.5858\/2009-0167-CR.1","article-title":"Pituicytoma: Characterization of a Unique Neoplasm by Histology, Immunohistochemistry, Ultrastructure, and Array-Based Comparative Genomic Hybridization","volume":"134","author":"Phillips","year":"2010","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/s40478-019-0722-6","article-title":"Histologic, Immunohistochemical, and Molecular Features of Pituicytomas and Atypical Pituicytomas","volume":"7","author":"Viaene","year":"2019","journal-title":"Acta Neuropathol. Commun."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1046\/j.1440-1827.2000.01080.x","article-title":"A Case of Atypical Granular Cell Tumor of the Neurohypophysis","volume":"50","author":"Kasashima","year":"2000","journal-title":"Pathol. Int."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1111\/neup.12448","article-title":"Sellar and Suprasellar Granular Cell Tumor of the Neurohypophysis: A Rare Case Report and Review of the Literature","volume":"38","author":"Jiang","year":"2018","journal-title":"Neuropathology"},{"key":"ref_27","first-page":"58","article-title":"Symptomatic Granular Cell Tumor of the Neurohypophysis","volume":"103","author":"Lee","year":"2004","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1111\/neup.12907","article-title":"Granular Cell Tumor of the Neurohypophysis Presenting as a Third Ventricle Mass","volume":"43","author":"Lopez","year":"2023","journal-title":"Neuropathology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"110328","DOI":"10.1016\/j.ijscr.2024.110328","article-title":"Pituitary Spindle Cell Oncocytoma: Two Cases Report and Literature Review","volume":"124","author":"Hsieh","year":"2024","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"517","DOI":"10.3171\/2018.4.JNS18211","article-title":"Spindle Cell Oncocytoma of the Pituitary Gland","volume":"131","author":"Cote","year":"2019","journal-title":"J. Neurosurg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.1097\/PAS.0b013e31829723e7","article-title":"Spindle Cell Oncocytomas and Granular Cell Tumors of the Pituitary Are Variants of Pituicytoma","volume":"37","author":"Mete","year":"2013","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.jocn.2017.02.017","article-title":"Spindle Cell Oncocytoma: Report of Two Cases with Massive Bleeding and Review of the Literature","volume":"39","author":"Billeci","year":"2017","journal-title":"J. Clin. Neurosci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"616","DOI":"10.3171\/jns.2006.105.4.616","article-title":"Ependymoma of the Pituitary Fossa. Case Report and Review of the Literature","volume":"105","author":"Mukhida","year":"2006","journal-title":"J. Neurosurg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.humpath.2008.08.013","article-title":"Ependymoma of the Sella Turcica: A Variant of Pituicytoma","volume":"40","author":"Scheithauer","year":"2009","journal-title":"Hum. Pathol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.wneu.2017.10.134","article-title":"Pituitary Ependymoma: A Case Report and Review of the Literature","volume":"110","author":"Wang","year":"2018","journal-title":"World Neurosurg."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Zhao, L., Jiang, Y., Wang, Y., Bai, Y., Liu, L., and Li, Y. (2021). Case Report: Sellar Ependymomas: A Clinic-Pathological Study and Literature Review. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.551493"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1080\/02688697.2018.1472212","article-title":"Correlations between Clinical Hormone Change and Pathological Features of Pituicytoma","volume":"32","author":"Chang","year":"2018","journal-title":"Br. J. Neurosurg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1007\/s12020-018-1774-2","article-title":"Posterior Pituitary Tumours: The Spectrum of a Unique Entity. A Clinical and Histological Study of a Large Case Series","volume":"63","author":"Vidal","year":"2019","journal-title":"Endocrine"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.3174\/ajnr.A2717","article-title":"Pituicytoma, Spindle Cell Oncocytoma, and Granular Cell Tumor: Clarification and Meta-Analysis of the World Literature since 1893","volume":"32","author":"Covington","year":"2011","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1080\/02688697.2018.1464121","article-title":"Non-Adenomatous Pituitary Tumours Mimicking Functioning Pituitary Adenomas","volume":"34","author":"Feng","year":"2020","journal-title":"Br. J. Neurosurg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1007\/s12022-021-09677-y","article-title":"Co-Occurrence of Pituitary Neuroendocrine Tumors (PitNETs) and Tumors of the Neurohypophysis","volume":"32","author":"Saeger","year":"2021","journal-title":"Endocr. Pathol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s11102-014-0569-6","article-title":"Incidence of Cushing\u2019s Syndrome and Cushing\u2019s Disease in Commercially-Insured Patients <65 Years Old in the United States","volume":"18","author":"Broder","year":"2015","journal-title":"Pituitary"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.wneu.2019.12.085","article-title":"Pituicytoma Associated with Acromegaly and Cushing Disease","volume":"136","author":"Villalonga","year":"2020","journal-title":"World Neurosurg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1007\/s11102-016-0754-x","article-title":"Epidemiology of Acromegaly: Review of Population Studies","volume":"20","author":"Lavrentaki","year":"2017","journal-title":"Pituitary"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.humpath.2015.08.017","article-title":"Synchronous Pituitary Adenoma and Pituicytoma","volume":"47","author":"Neidert","year":"2016","journal-title":"Hum. Pathol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1210\/clinem\/dgab901","article-title":"Pituitary MRI Standard and Advanced Sequences: Role in the Diagnosis and Characterization of Pituitary Adenomas","volume":"107","author":"Gadelha","year":"2022","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1097\/RCT.0b013e3181e289c0","article-title":"Magnetic Resonance Imaging Features of Pituicytomas: Analysis of 10 Cases","volume":"34","author":"Hammoud","year":"2010","journal-title":"J. Comput. Assist. Tomogr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1016\/j.jocn.2009.09.047","article-title":"Diagnostic and Clinical Implications of Pituicytoma","volume":"17","author":"Furtado","year":"2010","journal-title":"J. Clin. Neurosci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"108977","DOI":"10.1016\/j.ijscr.2023.108977","article-title":"Supra-Sellar Granular Cell Tumor: Report of a Case with Literature Review","volume":"112","author":"Sassi","year":"2023","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/s11102-013-0515-z","article-title":"Surgical Management of Pituicytomas: Case Series and Comprehensive Literature Review","volume":"17","author":"Feng","year":"2014","journal-title":"Pituitary"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1871","DOI":"10.1007\/s003300000488","article-title":"MR Imaging Findings in Granular Cell Tumor of the Neurohypophysis: A Difficult Preoperative Diagnosis","volume":"10","author":"Iglesias","year":"2000","journal-title":"Eur. Radiol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Hasiloglu, Z.I., Ure, E., Comunoglu, N., Tanriover, N., Oz, B., Gazioglu, N., and Mihmanli, I. (2016). New Radiological Clues in the Diagnosis of Spindle Cell Oncocytoma of the Adenohypophysis. Clin. Radiol., 71.","DOI":"10.1016\/j.crad.2016.04.022"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Jin, S., Xu, Q., Sun, C., Zhang, Y., Wang, Y., Wang, X., Guan, X., Li, D., Li, Y., and Zhang, C. (2025). Preoperative Prediction of Non-Functional Pituitary Neuroendocrine Tumors and Posterior Pituitary Tumors Based on MRI Radiomic Features. J. Imaging Inform. Med., 1\u201312.","DOI":"10.1007\/s10278-025-01400-1"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"104239","DOI":"10.1016\/j.bas.2025.104239","article-title":"Posterior Transpetrosal Approach to a Suprasellar Retroinfundibular Pituicytoma: A Case Report and Comprehensive Literature Review","volume":"5","author":"Justo","year":"2025","journal-title":"Brain Spine"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/s11102-018-0905-3","article-title":"Management of Pituicytomas: A Multicenter Series of Eight Cases","volume":"21","author":"Lefevre","year":"2018","journal-title":"Pituitary"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2209","DOI":"10.1007\/s00701-017-3337-3","article-title":"Extent of Surgical Resection and Tumor Size Predicts Prognosis in Granular Cell Tumor of the Sellar Region","volume":"159","author":"Ahmed","year":"2017","journal-title":"Acta Neurochir."},{"key":"ref_57","first-page":"220","article-title":"Pituicytoma: A Rare Tumor of the Sella","volume":"14","author":"Zaki","year":"2023","journal-title":"A Case Report and Review of Literature for Diagnosis and Management. Surg. Neurol. Int."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1111\/cns.12709","article-title":"Pituicytoma-An Outlook on Possible Targeted Therapies","volume":"23","author":"Mende","year":"2017","journal-title":"CNS Neurosci. Ther."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"37054","DOI":"10.18632\/oncotarget.9244","article-title":"MAPK Activation and HRAS Mutation Identified in Pituitary Spindle Cell Oncocytoma","volume":"7","author":"Miller","year":"2016","journal-title":"Oncotarget"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"3955","DOI":"10.21873\/anticanres.13549","article-title":"Panniculitis Under Successful Targeted Inhibition of the MAPK\/ERK Signaling Pathway in a Patient With BRAF V600E-Mutated Spindle Cell Oncocytoma of the Pituitary Gland","volume":"39","author":"Sollfrank","year":"2019","journal-title":"Anticancer. Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1007\/s00701-022-05109-w","article-title":"Dabrafenib Monotherapy for a Recurrent BRAFV600E-Mutated TTF-1-Positive Posterior Pituitary Tumor","volume":"164","author":"Barrit","year":"2022","journal-title":"Acta Neurochir."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e5657","DOI":"10.1097\/MD.0000000000005657","article-title":"Malignant Adenohypophysis Spindle Cell Oncocytoma with Repeating Recurrences and a High Ki-67 Index","volume":"96","author":"Kong","year":"2017","journal-title":"Medicine"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1080\/02688697.2018.1533107","article-title":"Spindle Cell Oncocytoma of the Neurohypophysis with Metastasis to the Sphenoparietal Sinus and Immunohistochemical Negativity for S100 and Epithelial Membrane Antigen (EMA)","volume":"37","author":"Witte","year":"2023","journal-title":"Br. J. Neurosurg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/13\/4553\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:59:34Z","timestamp":1760032774000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/13\/4553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,26]]},"references-count":63,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["jcm14134553"],"URL":"https:\/\/doi.org\/10.3390\/jcm14134553","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,26]]}}}