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Pituitary surgery

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https://www.readbyqxmd.com/read/28735124/inherent-tumor-characteristics-that-limit-effective-and-safe-resection-of-giant-nonfunctioning-pituitary-adenomas
#1
Hiroshi Nishioka, Takayuki Hara, Yuichi Nagata, Noriaki Fukuhara, Mitsuo Yamaguchi-Okada, Shozo Yamada
BACKGROUND: Surgical treatment of giant pituitary adenomas is sometimes challenging. We present our surgical series of giant nonfunctioning adenomas to shed light on the limitations of effective and safe tumor resection. METHODS: The preoperative tumor characteristics, surgical approaches, outcome, and histology of giant nonfunctioning adenoma (>40 mm) in 128 consecutive surgical patients are reviewed. The follow-up period ranged from 19 to 113 (mean 62.2) months...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28721598/a-retrospective-review-of-34-cases-of-pediatric-pituitary-adenoma
#2
Nannan Zhang, Peizhi Zhou, Yu Meng, Feng Ye, Shu Jiang
PURPOSE: The purpose of this paper is to study invasiveness, tumor features and clinical symptoms of pediatric pituitary adenoma, and to discuss some inconclusive results in prior studies. METHODS: We retrospectively reviewed 34 cases of children (<20 year-old) who were pathologically diagnosed with pituitary adenoma and surgically treated from 2010 to 2017. Data of general information, clinical symptoms, invasive behaviors, surgery approaches, and tumor features were collected and analyzed...
July 18, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28721221/pasireotide-successful-treatment-of-a-sparsely-granulated-tumour-in-a-resistant-case-of-acromegaly
#3
W K M G Amarawardena, K D Liyanarachchi, J D C Newell-Price, R J M Ross, D Iacovazzo, M Debono
The granulation pattern of somatotroph adenomas is well known to be associated with differing clinical and biochemical characteristics, and it has been shown that sparsely granulated tumours respond poorly to commonly used somatostatin receptor ligands (SRLs). We report a challenging case of acromegaly with a sparsely granulated tumour resistant to multiple modalities of treatment, ultimately achieving biochemical control with pasireotide. A 26-year-old lady presented with classical features of acromegaly, which was confirmed by an oral glucose tolerance test...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28721217/an-fsh-and-tsh-pituitary-adenoma-presenting-with-precocious-puberty-and-central-hyperthyroidism
#4
Guadalupe Vargas, Lourdes-Josefina Balcazar-Hernandez, Virgilio Melgar, Roser-Montserrat Magriña-Mercado, Baldomero Gonzalez, Javier Baquera, Moisés Mercado
A 19-year-old woman with a history of isosexual precocious puberty and bilateral oophorectomy at age 10 years because of giant ovarian cysts, presents with headaches and mild symptoms and signs of hyperthyroidism. Hormonal evaluation revealed elevated FSH and LH levels in the postmenopausal range and free hyperthyroxinemia with an inappropriately normal TSH. Pituitary MRI showed a 2-cm macroadenoma with suprasellar extension. She underwent successful surgical resection of the pituitary tumor, which proved to be composed of two distinct populations of cells, each of them strongly immunoreactive for FSH and TSH, respectively...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28720027/long-term-alteration-of-the-hypothalamic-pituitary-adrenal-axis-in-children-undergoing-cardiac-surgery-in-the-first-6-months-of-life
#5
Monica McGauran, Brigid Jordan, Roseriet Beijers, Irma Janssen, Candice Franich-Ray, Carolina de Weerth, Michael Cheung
Children with congenital heart disease (CHD) have poorer neurodevelopmental and psychological outcomes. The mechanisms underlying this remain unclear. One mechanism could be that the stressful experience of cardiac surgery early in life influences long-term hypothalamic-pituitary-adrenal (HPA) axis regulation. Dysregulation of the HPA axis has been linked to poorer neurocognitive and psychological outcomes in other study populations. This case-control study aims to compare HPA-axis regulation (circadian rhythm and reactivity) using salivary cortisol in 3- to 5-year-olds with CHD who did and did not have cardiac surgery prior to 6 months of age...
July 18, 2017: Stress: the International Journal on the Biology of Stress
https://www.readbyqxmd.com/read/28710189/use-of-cabergoline-for-the-management-of-persistent-cushing-s-disease-in-pregnancy
#6
Kathleen Su-Yen Sek, Doddabele Srinivasa Deepak, Kok Onn Lee
Cushing's disease (CD) is rare during pregnancy and is associated with significant maternal and fetal complications. It is important to control hypercortisolism during pregnancy, either surgically or medically, for a successful maternal and fetal outcome. We report a patient with recurrent CD who was treated with low-dose cabergoline (CAB) for persistent hypercortisolism throughout pregnancy. A 36-year-old woman was diagnosed with CD at the age of 23. She underwent trans-sphenoidal surgery with initial complete remission...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28705797/cyclical-cushing-s-how-best-to-catch-the-ups-and-downs
#7
Malik Asif Humayun, Tanya Hart, Tristan Richardson
A 68-year-old man with a background of hypertension and type 2 diabetes presented with fluctuating symptoms of muscle aches and pains and tiredness. His initial work-up for the possibility of hypercortisolaemia showed a completely variable pattern, with 24-hour cortisol excretion and serum cortisol post 1 mg dexamethasone suppression test ranging from normal to significantly elevated. A series of salivary cortisol with symptom diary confirmed the cyclical nature of hypercortisolaemia, and his concomitant adrenocorticotropic hormone (ACTH) levels were elevated...
July 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28693130/novel-association-of-men1-gene-mutations-with-parathyroid-carcinoma
#8
Luigia Cinque, Angelo Sparaneo, Filomena Cetani, Michelina Coco, Celeste Clemente, Massimiliano Chetta, Teresa Balsamo, Claudia Battista, Eliana Sanpaolo, Elena Pardi, Leonardo D'Agruma, Claudio Marcocci, Evaristo Maiello, Geoffrey N Hendy, David E C Cole, Alfredo Scillitani, Vito Guarnieri
Inactivating mutations of the multiple endocrine neoplasia 1 (MEN1) gene cause MEN1 syndrome, characterized by primary hyperparathyroidism (pHPT), and parathyroid and gastro-entero-pancreatic pituitary tumors. At present, only 14 cases of malignant parathyroid tumor have been associated with the syndrome, with 6 cases carrying an inactivating mutation of the MEN1 gene. The present study presents the case of a 48-year-old female who presented with multigland pHPT and multiple pancreatic lesions. The patient underwent surgery several times for the excision of parathyroid hyperplasia, carcinoma and adenoma...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28690985/metabolic-syndrome-induced-by-anticancer-treatment-in-childhood-cancer-survivors
#9
REVIEW
Hee Won Chueh, Jae Ho Yoo
The number of childhood cancer survivors is increasing as survival rates improve. However, complications after treatment have not received much attention, particularly metabolic syndrome. Metabolic syndrome comprises central obesity, dyslipidemia, hypertension, and insulin resistance, and cancer survivors have higher risks of cardiovascular events compared with the general population. The mechanism by which cancer treatment induces metabolic syndrome is unclear. However, its pathophysiology can be categorized based on the cancer treatment type administered...
June 2017: Annals of Pediatric Endocrinology & Metabolism
https://www.readbyqxmd.com/read/28690090/-pituitary-hyperplasia-due-to-primary-hypothyroidism
#10
M Ammar, F HadjKacem, A Maalej, G Abid, N Charfi, M Abid
INTRODUCTION: Pituitary hyperplasia due to primary hypothyroidism is rare and underdiagnosed. CASE REPORT: We report an 18-year-old patient referred for a pituitary mass revealing primary hypothyroidism. Biological parameters confirmed severe primary hypothyroidism and hyperprolactinemia. Outcome was favorable with l-thyroxin supplementation resulting in TSH and prolactin levels normalization and pituitary mass resolution. CONCLUSION: Pituitary hyperplasia due to primary hypothyroidism, although rare, should be recognized to avoid unnecessary surgery leading to irreversible complications...
July 6, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28689230/the-extended-transnasal-transsphenoidal-approach-for-anterior-skull-base-meningioma-considerations-in-patient-selection
#11
Joseph P Castlen, David J Cote, Hasan A Zaidi, Edward R Laws
PURPOSE: In this study, we set out to define our institutional criteria for patient eligibility for transsphenoidal resection of parasellar meningiomas, and to report our experience with extended transnasal approaches for these lesions. We aimed to discuss the important considerations of patient selection and risk stratification to optimize outcomes for patients with these difficult lesions, and also include considerations that should be reviewed during surgical approach selection. METHODS: Medical records from Brigham and Women's Hospital were retrospectively reviewed for all patients who underwent transsphenoidal surgery for pituitary disease with the senior author from April 2008 to March 2017 (938 procedures)...
July 8, 2017: Pituitary
https://www.readbyqxmd.com/read/28687446/preservation-of-hormonal-function-by-identifying-pituitary-gland-at-endoscopic-surgery
#12
Stefan Linsler, Renate Hero-Gross, Bettina Friesenhahn-Ochs, Salman Sharif, Frank Lammert, Joachim Oertel
OBJECTIVE: The endonasal endoscopic approach has been established for perisellar tumor surgery with a higher resection rate and reduced complications. We analyzed the potential to identify the pituitary gland under endoscopic view, at surgery and see its relation to postoperative hormonal insufficiency in endonasal endoscopic procedures. METHODS: Between January 2011 and January 2014, 70 cases of pituitary adenomas with preoperative intact pituitary function underwent endoscopic endonasal transsphenoidal procedures for intrasellar pathologies...
July 4, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28685507/recent-progress-in-the-medical-therapy-of-pituitary-tumors
#13
REVIEW
Fabienne Langlois, Shirley McCartney, Maria Fleseriu
Management of pituitary tumors is multidisciplinary, with medical therapy playing an increasingly important role. With the exception of prolactin-secreting tumors, surgery is still considered the first-line treatment for the majority of pituitary adenomas. However, medical/pharmacological therapy plays an important role in controlling hormone-producing pituitary adenomas, especially for patients with acromegaly and Cushing disease (CD). In the case of non-functioning pituitary adenomas (NFAs), pharmacological therapy plays a minor role, the main objective of which is to reduce tumor growth, but this role requires further studies...
June 2017: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28680614/granulomatous-hypophysitis-rare-disease-with-challenging-diagnosis
#14
Mohannad E Elgamal, Rawia M H Mohamed, Tarek Fiad, Essam A Elgamal
Granulomatous hypophysitis is rare pathology that mimics pituitary adenoma. Diagnosis is only confirmed by histopathology examination. Trans-sphenoidal surgery is considered diagnostic when descent tissue specimen is obtained and therapeutic by decompressing optic pathway and the sella. Pathological findings always reveal granulomatous areas, multinucleated giant cells, plasma cells, and lymphocytes.
July 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28676954/ovarian-hyperstimulation-syndrome-due-to-follicle-stimulating-hormone-secreting-pituitary-adenomas
#15
Amelia Caretto, Roberto Lanzi, Cecilia Piani, Michela Molgora, Pietro Mortini, Marco Losa
PURPOSE: Gonadotroph adenomas are pituitary adenomas with inefficient and variable secretory characteristics, that is why they are usually considered as a subgroup of nonfunctioning pituitary adenomas (NFPA) and are recognized only at immunohistochemistry. When gonadotroph adenomas secrete active hormones, they may cause spontaneous ovarian hyperstimulation syndrome (OHSS) in premenopausal women. Aim of our study is to describe three women with OHSS diagnosed before the removal of the adenoma and to calculate the prevalence of OHSS in premenopausal women with a clinical diagnosis of NFPA...
July 4, 2017: Pituitary
https://www.readbyqxmd.com/read/28676462/risks-and-benefits-of-endoscopic-transsphenoidal-surgery-for-non-functioning-pituitary-adenomas-in-patients-of-the-9th-decade
#16
Rares Chinezu, Franklin Fomekong, Héllène Lasolle, Jacqueline Trouillas, Alexandre Vasiljevic, Gerald Raverot, Emmanuel Jouanneau
BACKGROUND: The population over 80 years of age (very elderly) is increasing and the management of these patients with pituitary surgery is controversial. Our study aimed to determine the prevalence of pituitary tumors in the elderly and to determine the safety of endoscopic transsphenoidal pituitary surgery for non-functioning pituitary adenomas in patients aged over 80. METHODS: This retrospective study included elderly (65-75 years old) and very elderly consecutive patients operated between 2007 and 2015 for non-functioning pituitary adenomas...
July 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28676314/cerebrospinal-fluid-leaks-after-transsphenoidal-surgery-effect-of-a-polyethylene-glycol-hydrogel-dural-sealant
#17
REVIEW
Erlick A C Pereira, Carly A Grandidge, Victoria A Nowak, Simon A Cudlip
To investigate cerebrospinal fluid (CSF) leak rates after mainly endoscopic endonasal transsphenoidal surgery with and without polyethylene glycol hydrogel dural sealant (DuraSeal®), we prospectively collected data from a single-centre consecutive case series over four years from January 2007 to December 2010 inclusive. 250 patients were identified (135 male, 115 female; median age 52years, range 14-83). 180 patients received DuraSeal® (72%). 85 (34%) had intra-operative dural breach and 13 (5.2%) developed post-operative CSF leaks (3 without intra-operative dural breach) requiring lumbar drainage or formal repair...
July 1, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28675823/endothelial-immunocytochemical-expression-of-pituitary-il-1%C3%AE-and-its-relation-to-acth-positive-cells-is-regulated-by-corticosterone-in-the-male-rat
#18
María Carmen Iglesias-Osma, Enrique J Blanco, Marta Carretero-Hernández, María José García-Barrado, Leonardo Catalano-Iniesta, Manuel Carretero, Virginia Sánchez-Robledo, José Carretero
Interleukin-1 beta (IL-1β) is a cytokine linking the neuroendocrine system and metabolic homeostasis. We have previously demonstrated the relevance of IL-1β for maintaining the pituitary ACTH-producing cells by immuno-blocking its effects in pituitary cultures. However, the morphological characteristics and the intimate relationship of the pituitary cells expressing IL-1β and ACTH remain unknown. For determining pituitary variations of immunoreactivity for IL-1β and its relation with ACTH-positive cells under stress situations, we performed an immunohistochemical analysis of the expression of IL-1β and ACTH in the pituitary gland of adult rats, in the absence or presence of corticosterone, by establishing different groups: untreated, sham-operated, and bilaterally adrenalectomized animals...
July 1, 2017: Cytokine
https://www.readbyqxmd.com/read/28675669/a-two-year-audit-of-outcomes-of-pituitary-surgery-at-an-australian-teaching-hospital
#19
Timothy M E Davis, Imran Badshah, Jocelyn Drinkwater, Emily Kusich, Erin Latkovic, Neville Knuckey
BACKGROUND: There is evidence that cure rates and complications are influenced by the case load in neurosurgical centres performing transsphenoidal pituitary surgery. Although Australian centres may perform relatively small numbers of these procedures, there have been few published audits of their performance. AIMS: To conduct an audit of surgery for pituitary tumours between 2012 and 2014 in the only public hospital neurosurgical unit in the state of Western Australia...
July 4, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28673886/newly-diagnosed-sellar-tumors-in-cancer-patients-a-diagnostic-challenge-and-management-dilemma
#20
Carlos R Goulart, Smita Upadhyay, Leo F S Ditzel Filho, Andre Beer-Furlan, Ricardo L Carrau, Luciano M Prevedello, Daniel M Prevedello
OBJECTIVE: The use of PET CT for staging in cancer patients and the widespread use of MRI led to an increased incidence of incidental sellar mass detection. The imaging findings can be suggestive of a benign pituitary tumor but metastasis can never be completely ruled out with non-invasive work-up. Appropriate diagnosis of these sellar masses is critical as the treatment paradigm might change in the presence of a pituitary metastasis. Moreover, definitive tissue diagnosis might prevent unnecessary radiotherapy to the skull base or even the need for systemic treatment when benign pituitary disease is confirmed...
June 30, 2017: World Neurosurgery
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