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Pituitary surgery

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https://www.readbyqxmd.com/read/28339047/hypothalamo%C3%A2-hypophysial-system-in-rats-with-autotransplantation-of-the-adrenal-cortex
#1
Nae Takizawa, Susumu Tanaka, Souichi Oe, Taro Koike, Tadashi Matsuda, Hisao Yamada
Patients with bilateral pheochromocytoma often require an adrenalectomy. Autotransplantation of the adrenal cortex is an alternative therapy that could potentially be performed instead of receiving glucocorticoid replacement following adrenalectomy. Adrenal cortex autotransplantation aims to avoid the side effects of long‑term steroid treatment and adrenal insufficiency. Although the function of the hypothalamo‑hypophysial system is critical for patients who have undergone adrenal cortex autotransplantation, the details of that system, with the exception of adrenocorticotropic hormone in the subjects with adrenal autotransplantation, have been overlooked for a long time...
March 24, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28332874/long-term-outcome-of-the-different-treatment-alternatives-for-recurrent-and-persistent-cushing-s-disease
#2
Ana Laura Espinosa-de-Los-Monteros, Ernesto Sosa-Eroza, Etual Espinosa, Victoria Mendoza, Rocio Arreola, Moises Mercado
BACKGROUND: Treatment alternatives for persistent and recurrent Cushing's disease (CD) include pituitary surgical reintervention, radiotherapy, pharmacotherapy and bilateral adrenalectomy (BA). The decision of which of these alternatives is better suited for the individual patient rests on clinical judgment and the availability of resources. OBJECTIVE: To evaluate the long-term efficacy of the different secondary interventions for persistent and recurrent Cushing's disease...
March 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28331423/a-case-of-unruptured-right-gastroepiploic-artery-aneurysm-successfully-resected-by-laparoscopic-surgery
#3
Yuki Murakami, Hiroaki Saito, Shota Shimizu, Yusuke Kono, Hirohiko Kuroda, Tomoyuki Matsunaga, Yoji Fukumoto, Tomohiro Osaki, Yoshiyuki Fujiwara
A 50-year-old woman was admitted to our hospital to undergo surgery to remove a pituitary adenoma. Preoperative dynamic computed tomography revealed an incidental right gastroepiploic arterial aneurysm (GEAA). After removal of the pituitary adenoma, we performed a laparoscopic right gastroepiploic aneurysmectomy. The postoperative course was uneventful. Right GEAAs should be treated at diagnosis owing to the high possibility of rupture. Laparoscopic right gastroepiploic aneurysmectomy is feasible and should be considered for the treatment of right GEAAs...
March 2017: Yonago Acta Medica
https://www.readbyqxmd.com/read/28329921/neuroendocrine-tumors-in-the-stomach-duodenum-and-pancreas-accompanied-by-novel-men1-gene-mutation
#4
Min A Yang, Woong Ki Lee, Hong Shik Shin, Sung Hyun Park, Byung Sun Kim, Ji Woong Kim, Jin Woong Cho, So Hee Yun
Multiple endocrine neoplasia type 1 (MEN1) syndrome is a relatively rare disease, characterized by the occurrence of multiple endocrine tumors in the parathyroid and pituitary glands as well as the pancreas. Here, we report a case of MEN1 with neuroendocrine tumors (NETs) in the stomach, duodenum, and pancreas. A 53-year-old man visited our hospital to manage gastric NET. Five years prior to his visit, he had undergone surgery for incidental meningioma. His brother had pancreatic nodules and a history of surgery for adrenal adenoma...
March 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28329436/prospective-evaluation-of-a-week-one-overnight-metyrapone-test-with-subsequent-dynamic-assessments-of-hypothalamic-pituitary-adrenal-axis-function-after-pituitary-surgery
#5
Katherine English, Warrick J Inder, Zara Weedon, Goce Dimeski, Jane Sorbello, Anthony W Russell, Emma L Duncan, Ross Cuneo
OBJECTIVE: To determine if an overnight metyrapone test (OMT) within the first week post pituitary surgery can definitively assess the hypothalamic-pituitary-adrenal (HPA) axis, compared with subsequent dynamic tests and glucocorticoid requirement at 6 months. DESIGN: Prospective study measuring morning cortisol levels on day 3 and 4 post-operatively, OMT day 5-7 and week 6, 250μg short Synacthen test (SST) week 6 and insulin tolerance test (ITT) week 7. PATIENTS AND MEASUREMENTS: Forty participants who underwent pituitary surgery at a single centre (Cushing's disease excluded) and were followed for at least 6 months...
March 22, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28326242/nasal-lobular-capillary-hemangioma-as-a-complication-after-an-endoscopic-transsphenoidal-gonadotrophin-producing-pituitary-adenoma-resection
#6
Dalila Forte, Amets Sagarribay Irañeta, Anabela Nabais, António Figueiredo, Manuela Mafra, Victor Gonçalves
Background Lobular capillary hemangioma is a rare benign tumor, most frequently located in the head or neck region, the nasal cavity being uncommonly affected. Its etiopathogenesis is not fully established, although traumatic and hormonal factors have been implied. Case Description A 50-year-old female patient underwent an uneventful endoscopic transsphenoidal removal of a pituitary cystic macroadenoma at our institution. Nasal packing was used in postoperative hemostasis. Histopathology was compatible with a gonadotrophin-producing adenoma...
January 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/28323946/outcome-of-non-functioning-pituitary-adenomas-that-regrow-after-primary-treatment-a-study-from-two-large-uk-centers
#7
Metaxia Tampourlou, Georgia Ntali, Shahzada Ahmed, Wiebke Arlt, John Ayuk, James V Byrne, Swarupsinh Chavda, Simon Cudlip, Neil Gittoes, Ashley Grossman, Rosalind Mitchell, Michael W O'Reilly, Alessandro Paluzzi, Andrew Toogood, John Ah Wass, Niki Karavitaki
Context: Despite the significant risk of regrowth of clinically non-functioning pituitary adenomas (CNFAs) after primary treatment, systematic data on the probability of further tumor progression and the effectiveness of management approaches are lacking. Objective: To assess the probability of further regrowth(s), predictive factors and outcomes of management approaches in patients with CNFA who have been diagnosed with adenoma regrowth after primary treatment...
March 2, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28323918/elucidating-the-role-of-the-desmosome-protein-p53-apoptosis-effector-related-to-pmp-22-perp-in-growth-hormone-tumors
#8
Katja Kiseljak-Vassiliades, Taylor S Mills, Yu Zhang, Mei Xu, Kevin O Lillehei, B K Kleinschmidt-DeMasters, Margaret E Wierman
Purpose: Densely granulated (DG) and sparsely granulated (SG) growth hormone (GH) pituitary adenomas differ in biological behavior which may be correlated with their known differences in cytoplasmic keratin distribution and E-cadherin expression. We desired to explore candidate genes which might further explain this behavior. Methods: Exon expression microarray was performed on 21 GH tumors (10 SG and 11 DG) and 20 normal control pituitaries from autopsy. Results: Bioinformatic analyses confirmed a differential molecular signature between normal pituitary and GH tumors as well as between the GH tumor subtypes...
February 9, 2017: Endocrinology
https://www.readbyqxmd.com/read/28321384/operative-strategies-to-minimize-complications-following-resection-of-pituitary-macroadenomas
#9
Jayesh P Thawani, Ashwin G Ramayya, Jared M Pisapia, Kalil G Abdullah, John Y-K Lee, M Sean Grady
Introduction We sought to identify factors associated with increased length of stay (LOS) and morbidity in patients undergoing resection of pituitary macroadenomas. Methods We reviewed records of 203 consecutive patients who underwent endoscopic endonasal resection of a pituitary macroadenoma (mean age = 55.7 [16-88]) years, volume = 11.3 (1.0-134.3) cm(3). Complete resection was possible in 60/29.6% patients. Mean follow-up was 575 days. Multivariate logistic regression was performed using MATLAB...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321378/hemi-transseptal-approach-for-pituitary-surgery-a-follow-up-study
#10
Naif Fnais, Salvatore Di Maio, Susan Edionwe, Anthony Zeitouni, Denis Sirhan, Constanza J Valdes, Marc A Tewfik
Objectives The hemi-transseptal (Hemi-T) approach was developed to overcome the potential drawbacks of the nasoseptal flap (NSF) in endoscopic endonasal transsphenoidal skull base surgery. In this study, we describe further refinements on the Hemi-T approach, and report long-term outcomes as compared with traditional methods of skull base reconstruction. Design A retrospective case-control study. Setting Montreal Neurological Institute and Jewish General Hospital, Montreal, Canada. Participants Patients who underwent endoscopic endonasal transsphenoidal approach to skull base pathology...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321374/ectopic-pituitary-adenomas-presenting-as-sphenoid-or-clival-lesions-case-series-and-management-recommendations
#11
Bobby A Tajudeen, Edward C Kuan, Nithin D Adappa, Joseph K Han, Rakesh K Chandra, James N Palmer, David W Kennedy, Marilene B Wang, Jeffrey D Suh
Background An ectopic pituitary adenoma presenting as a clival or sphenoid mass is a rare clinical occurrence that may mislead the clinician and result in unnecessary interventions or potential medicolegal consequences. Here, we present one of the largest multi-institutional case series and review the literature with an emphasis on radiological findings and critical preoperative workup. Methods Retrospective chart review. Results Nine patients were identified with ectopic pituitary adenomas of the sphenoid or clivus...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321373/a-review-of-skull-base-tumor-clinical-trials-past-trends-and-future-opportunities
#12
Anand Devaiah, Charles Murchison
Objective Tumors of the anterior and lateral skull base (TALSB) are relatively rare but can be devastating to patients. By examining trials focused on TALSB, we can characterize the studies that predominate and better understand current directions of study. This gives us a better understanding of future studies to pursue. Study Design This is a retrospective analysis. Settings We set skull base tumor clinical trials in the United States which are listed in ClinicalTrials.gov. Subjects and Methods We used the information available on ClinicalTrials...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321371/anatomic-variations-in-pituitary-endocrinopathies-implications-for-the-surgical-corridor
#13
Edward C Kuan, Frederick Yoo, Won Kim, Karam W Badran, Thomas E Heineman, Ali R Sepahdari, Marvin Bergsneider, Marilene B Wang
Objectives/Hypotheses Functioning pituitary adenomas may produce endocrinopathies such as acromegaly and Cushing syndrome. Both conditions lead to characteristic anatomic variations as a result of hormonally induced abnormal soft tissue deposition. We evaluate the anatomic differences between acromegalics and Cushing disease patients and compare these dimensions to controls. Design Radiographic review of preoperative magnetic resonance images (MRI) of the pituitary gland. Setting Tertiary academic medical center...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28301972/efficacy-of-transsphenoidal-surgery-in-achieving-biochemical-cure-of-growth-hormone-secreting-pituitary-adenomas-among-patients-with-cavernous-sinus-invasion-a-systematic-review-and-meta-analysis
#14
Vanessa Briceno, Hasan A Zaidi, Joanne A Doucette, Kaho B Onomichi, Amer Alreshidi, Rania A Mekary, Timothy R Smith
OBJECTIVES: Growth hormone-secreting pituitary adenomas in adults can result in severe craniofacial disfigurement and potentially fatal medical complications. Surgical resection leading to remission of the disease is dependent on complete surgical resection of the tumor. Lesions that invade the cavernous sinus may not be safely accessible via an endonasal transsphenoidal surgery (TSS), and the rates of biochemical remission of patients with residual disease vary widely in the literature...
March 16, 2017: Neurological Research
https://www.readbyqxmd.com/read/28300715/operative-learning-curve-after-transition-to-endoscopic-transsphenoidal-pituitary-surgery
#15
Tasneem Shikary, Norberto Andaluz, Jareen Meinzen-Derr, Collin Edwards, Philip Theodosopoulos, Lee A Zimmer
OBJECTIVES: No clear consensus yet defines the endpoints for operative learning curves in the transition to minimally invasive endoscopic techniques. This retrospective review of our first 202 patients who underwent endoscopic pituitary resection examines the statistical learning curve related to operative times--a measure of our surgical team's efficiency and complication rates, a reflection of surgical skill and maturity. METHODS: Retrospective chart review included patient demographics, tumor type, operative times, complication rates, and follow-up...
March 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28298041/randomized-double-blinded-placebo-controlled-trial-comparing-two-multimodal-opioid-minimizing-pain-management-regimens-following-transsphenoidal-surgery
#16
Deborah M Shepherd, Heidi Jahnke, William L White, Andrew S Little
OBJECTIVE Pain control is an important clinical consideration and quality-of-care metric. No studies have examined postoperative pain control following transsphenoidal surgery for pituitary lesions. The study goals were to 1) report postoperative pain scores following transsphenoidal surgery, 2) determine if multimodal opioid-minimizing pain regimens yielded satisfactory postoperative pain control, and 3) determine if intravenous (IV) ibuprofen improved postoperative pain scores and reduced opioid use compared with placebo...
March 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28295370/the-human-endolymphatic-sac-expresses-natriuretic-peptides
#17
Martin Nue Møller, Svend Kirkeby, Jonas Vikeså, Finn Cilius Nielsen, Per Cayé-Thomasen
OBJECTIVES/HYPOTHESIS: The function of the human endolymphatic sac (ES) has been enigmatic for decades. Hypotheses include controlling endolymphatic fluid homeostasis and inner ear immunological defense. Additionally, several studies indicate a possible endocrine capacity and a yet undefined role in intracranial pressure homeostasis. However, no direct evidence of such capacity exists. This study aims to explore and identify the hypothesized endocrine capacity of the human ES. STUDY DESIGN: DNA microarrays and immunohistochemistry were used for analyses of fresh human ES tissue samples...
March 14, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28292619/obesity-and-female-infertility-potential-mediators-of-obesity-s-impact
#18
REVIEW
Darcy E Broughton, Kelle H Moley
The worldwide upward trend in obesity has been dramatic, now affecting more than 20% of American women of reproductive age. Obesity is associated with many adverse maternal and fetal effects prenatally, but it also exerts a negative influence on female fertility. Obese women are more likely to have ovulatory dysfunction due to dysregulation of the hypothalamic-pituitary-ovarian axis. Women with polycystic ovarian syndrome who are also obese demonstrate a more severe metabolic and reproductive phenotype. Obese women have reduced fecundity even when eumenorrheic and demonstrate poorer outcomes with the use of in vitro fertilization...
March 11, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28291643/successful-treatment-of-pituitary-carcinoma-with-concurrent-radiation-temozolomide-and-bevacizumab-after-resection
#19
Waseem Touma, Spencer Hoostal, Richard A Peterson, Andres Wiernik, Karen S SantaCruz, Emil Lou
The optimal treatment of pituitary carcinomas (PC) is unknown. Treatment includes surgical resection, radiation, and more recently, temozolomide (TMZ). Pituitary adenomas have relatively high expression of vascular endothelial growth factor; therefore, bevacizumab, an antiangiogenic agent, has been used in a small number of aggressive or malignant pituitary tumors after recurrence. However, it has not been administered concurrently with other chemotherapeutic agents or combined with radiation therapy in PC...
March 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28290971/delayed-diagnosis-of-tsh-secreting-adenoma-attributed-to-worsening-post-traumatic-stress-disorder-symptoms-in-a-military-veteran-because-of-provider-anchoring-bias
#20
Shyam K Daya, Andrew O Paulus, Ernest E Braxton, Penny J Vroman, Derek A Mathis, Ryan Lin, Mark W True
INTRODUCTION: Anchoring bias occurs when clinicians hold on to previously known information about a patient, with failure to consider the full realm of possibilities to explain new findings. We present a case of delayed diagnosis of thyroid-stimulating-hormone-secreting pituitary adenoma (TSHoma), a rare disorder, in a military veteran whose symptoms were misconstrued as being caused from worsening of his prior diagnosis of post-traumatic stress disorder (PTSD). Anchoring bias in this case led to 2-year delay in the correct diagnosis...
March 2017: Military Medicine
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