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https://www.readbyqxmd.com/read/29134164/visual-outcomes-after-endoscopic-pituitary-surgery-in-patients-presenting-with-preoperative-visual-deficits
#1
Felipe Fredes, Gabriel Undurraga, Pablo Rojas, Felipe Constanzo, Carolina Lazcano, Jaime Pinto, Thomas Schmidt
Introduction  Pituitary adenomas represent 15% of primary brain tumors. Visual disturbance is a common clinical manifestation of these neoplasms due, among other factors, to local mass effect on the optic system. Objective  To evaluate changes of the visual fields in patients undergoing endoscopic endonasal approach (EEA) for pituitary adenomas and to find predictive factors for successful visual field outcome. Material and Methods  This is a cross-sectional study. A review was conducted of medical records of consecutive patients with tumors of the sellar region undergoing EEA between January 2008 and December 2012 at the Skull Base Unit of Guillermo Grant Benavente Hospital, University of Concepción, Concepción, Chile, and who had undergone pre- and postoperative visual field evaluation...
December 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29117664/pituitary-abscess-with-unusual-clinical-course
#2
Milica Medić Stojanoska, Duško Kozić, Mladen Bjelan, Petar Vuleković, Nada Vučković, Bojan Vuković, Branka Kovačev Zavišić
The aim is to present unusual clinical course and magnetic resonance imaging (MRI) features of pituitary abscess. A 59-year-old man presented with fever, polyuria, polydipsia and marked weight loss within the last two months. Basic endocrinology tests revealed the presence of anterior pituitary dysfunction, associated with central diabetes insipidus and increased levels of inflammatory markers. The presence of expansile sellar lesion, showing restricted diffusion signal pattern compatible with acute pituitary pyogenic abscess was found on MRI...
December 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29110337/pituitary-atypical-teratoid-rhabdoid-tumor-in-a-patient-with-prolactinoma-a-unique-description
#3
Valeria Barresi, Simona Lionti, Alessandro Raso, Felice Esposito, Salvatore Cannavò, Filippo F Angileri
Atypical teratoid rhabdoid tumor (ATRT) is an aggressive tumor of the CNS and characteristically occurs in the pediatric age. In adulthood, ATRT is rare and it is mainly localized in the cerebral hemispheres. Only 16 cases of ATRT have been described in the sellar region up to now. Interestingly, all sellar ATRTs occurred in adult female patients. Herein we report a novel case of sellar ATRT in a patient with previous history of lactotroph adenoma. Similar to other sellar ATRTs, this case occurred in a female adult patient...
November 6, 2017: Neuropathology: Official Journal of the Japanese Society of Neuropathology
https://www.readbyqxmd.com/read/29076466/-a-supraorbital-trans-eyebrow-approach-in-surgery-of-chiasmatic-sellar-and-anterior-cranial-fossa-tumors
#4
A G Alekseev, A A Pichugin, V I Danilov
OBJECTIVE: to analyze 31 resections of chiasmatic-sellar region (CSR) and anterior cranial fossa (ACF) tumors using the supraorbital trans-eyebrow approach (STA). MATERIAL AND METHODS: We analyzed medical histories of 31 patients who underwent tumor resection using STA in the period between October 2013 and April 2017. We analyzed the age and gender of patients, size and location of the tumor, presence of a neurological deficit, vision and olfactory functions before and after surgery, surgery duration, amount of intraoperative blood loss, rate of frontal sinus trephination and nasal liquorrhea, hemorrhagic and ischemic complications after surgery, Simpson grade of tumor resection, patient's condition before and after surgery (Glasgow Outcome Scale and Karnofsky Scale), and degree of patient satisfaction with the cosmetic result of surgery...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/29056398/transsphenoidal-surgery-for-pituitary-tumors-and-other-sellar-masses
#5
REVIEW
Tina J Owen, Linda G Martin, Annie V Chen
Transsphenoidal surgery is an option for dogs and cats with functional and nonfunctional pituitary masses or other sellar and parasellar masses. An adrenocorticotropic hormone-secreting tumor causing Cushing disease is the most common clinically relevant pituitary tumor in dogs, and the most common pituitary tumor seen in cats is a growth hormone-secreting tumor causing acromegaly. Transsphenoidal surgery can lead to rapid resolution of clinical signs and provide a cure for these patients. Because of the risks associated with this surgery, it should only be attempted by a cohesive pituitary surgery group with a sophisticated medical and surgical team...
October 20, 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/29050159/-value-of-diffusion-weighted-imaging-in-differentiating-sellar-malignant-germ-cell-tumors-from-raniopharyngioma
#6
Y F Guo, J L Cheng, Y Zhang, C Y Zhang, W J Wang
Objective: To investigate the diagnostic value of diffusion-weighted imaging (DWI) and apparent diffusion coefficient(ADC) values in the differentiation of sellar malignant germ cell tumors and raniopharyngioma. Methods: This retrospective study included 36 patients(14 cases of malignant germ cell tumor and 22 patients with raniopharyngioma) with histopathologically-confirmed sellar tumors from January 2013 to April 2017 in the First Affiliated Hospital of Zhengzhou University.All patients underwent conventional MRI and DWI before the treatment...
October 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29040718/the-mcconnell-s-capsular-arteries-and-their-relevance-in-endoscopic-endonasal-approach-to-the-sellar-region
#7
Cristian Ferrareze Nunes, André Beer-Furlan, Francesco Doglietto, Ricardo Luis Carrau, Daniel Monte-Serrat Prevedello
BACKGROUND: The McConnell's capsular arteries (MCCA) were first described in 1953. They consist of medial branches of the cavernous internal carotid artery (ICA) and are divided in anterior and inferior capsular arteries. OBJECTIVE: To highlight the anatomy of the MCCA and its importance in the surgical treatment of tuberculum sellae and planum sphenoidale tumors through an endoscopic endonasal approach. METHODS: Ten cadaveric specimens fixed in formalin and perfused with colored silicone were dissected...
October 13, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28989046/modular-classification-of-endoscopic-endonasal-transsphenoidal-approaches-to-the-sellar-region-anatomical-quantitative-study
#8
Francesco Belotti, Francesco Doglietto, Alberto Schreiber, Marco Ravanelli, Marco Ferrari, Davide Lancini, Vittorio Rampinelli, Lena Hirtler, Barbara Buffoli, Andrea Bolzoni Villaret, Roberto Maroldi, Luigi Fabrizio Rodella, Piero Nicolai, Marco Maria Fontanella
BACKGROUND: Endoscopic visualization does not necessarily correspond to an adequate working space. The need of balancing invasiveness and adequacy of sellar tumor exposure has recently led to the description of multiple endoscopic endonasal transsphenoidal approaches. Comparative anatomical data on these variants are lacking. OBJECT: To quantitatively compare endoscopic endonasal transsphenoidal approaches to the sella and parasellar region, using the concept of "surgical pyramid"...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28985037/postoperative-sinonasal-morbidity-in-sellar-reconstruction-mucosal-autograft-versus-acellular-dermal-allograft
#9
Christopher R Roxbury, J Trent Magruder, Murugappan Ramanathan, Michael Lim, Gary L Gallia, Masaru Ishii, Douglas D Reh
BACKGROUND: Sellar pathology is increasingly addressed using the expanded endonasal approach (EEA). Although avascular graft reconstruction is an acceptable means to prevent cerebrospinal fluid leak, there are few data regarding sinonasal morbidity in these patients. In this study we compare rates of persistent postoperative crusting (PPC) and rhinosinusitis in patients undergoing sellar reconstruction with mucosal autografting and acellular dermal allografting (ADA). METHODS: Patients undergoing the EEA between 2008 and 2014 were categorized into 2 subgroups: mucosal reconstruction and ADA reconstruction...
October 6, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28960156/identification-and-repair-of-intraoperative-cerebrospinal-fluid-leaks-in-endonasal-transsphenoidal-pituitary-surgery-surgical-experience-in-a-series-of-1002-patients
#10
Ben A Strickland, Joshua Lucas, Brianna Harris, Edwin Kulubya, Joshua Bakhsheshian, Charles Liu, Bozena Wrobel, John D Carmichael, Martin Weiss, Gabriel Zada
OBJECTIVE Cerebrospinal fluid (CSF) rhinorrhea is among the most common complications following transsphenoidal surgery for sellar region lesions. The aim of this study was to review the authors' institutional experience in identifying, repairing, and treating CSF leaks associated with direct endonasal transsphenoidal operations. METHODS The authors performed a retrospective review of cases involving surgical treatment of pituitary adenomas and other sellar lesions at the University of Southern California between December 1995 and March 2016...
September 29, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28948361/extent-of-surgical-resection-and-tumor-size-predicts-prognosis-in-granular-cell-tumor-of-the-sellar-region
#11
Abdul-Kareem Ahmed, Hassan Y Dawood, David L Penn, Timothy R Smith
BACKGROUND: Rarely, granular cell tumor (GCT) occurs in the sellar region. The natural history of this clinical entity is not well known. This study sought to determine the clinical features and long-term outcome of GCT of the sellar region. METHODS: Institutional databases, the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database, and PubMed/EMBASE were searched for GCT of the sellar region. Patient-level data were extracted where available, including age, sex, symptoms, tumor size and location, presumed diagnosis, surgical approach and result, subtotal resection (STR) and gross-total resection (GTR), use of radiation, and outcome...
November 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28945870/patient-level-factors-influencing-of-hospital-costs-and-short-term-patient-reported-outcomes-after-transsphenoidal-resection-of-sellar-tumors
#12
Jian Guan, Michael Karsy, Erica F Bisson, William T Couldwell
BACKGROUND: Identifying which factors influence treatment costs of transsphenoidal surgery for removal of sellar lesions can be complex. OBJECTIVE: To identify which patient-level factors are associated with higher costs and evaluate the relationship between expenditures and short-term patient-reported outcomes. METHODS: We used an institutional database tool to review prospectively collected data on patients (≥10 yr old) undergoing transsphenoidal sellar surgery...
September 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28945054/intracranial-stereotactic-radiosurgery
#13
Andrew A Fanous, Dheerendra Prasad, David Mathieu, Andrew J Fabiano
Stereotactic radiosurgery (SRS) is the use of a single high dose of radiation, stereotactically directed to an intracranial region of interest, in order to create a lesion or obliterate a preexisting one. This technology has evolved over the years into the use of multiple radiation sources oriented at a variety of angles, thus permitting the creation of various treatment target shapes. This allows for non-open surgical treatment of intracranial pathologies, which significantly decreases the risk of morbidity...
September 22, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28942513/loco-regional-extensions-of-central-nervous-system-germ-cell-tumors-a-retrospective-radiological-analysis-of-100-patients
#14
Loïc Duron, Flavie Sadones, Philippe Thiesse, Cécile Cellier, Claire Alapetite, François Doz, Didier Frappaz, Hervé J Brisse
PURPOSE: The current staging system of central nervous system (CNS) germ cell tumors (GCT) includes a binary classification in "localized" or "metastatic" disease based on the absence or presence of leptomeningeal dissemination. Loco-regional tumor dissemination has been barely described whereas its accurate definition might be useful in terms of prognosis and treatment, especially for radiation therapy planning. Our purpose was therefore to describe MR patterns and prevalence of loco-regional extensions of these tumors...
September 23, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28935625/topographic-diagnosis-of-craniopharyngiomas-the-accuracy-of-mri-findings-observed-on-conventional-t1-and-t2-images
#15
R Prieto, J M Pascual, L Barrios
BACKGROUND AND PURPOSE: The topography of craniopharyngiomas has proved fundamental in predicting the involvement of vital brain structures and the possibility of achieving a safe radical resection. Beyond the imprecise term "suprasellar," indiscriminately used for craniopharyngiomas, an accurate definition of craniopharyngioma topography should be assessed by preoperative MR imaging. The objective of this study was to investigate the MRI findings that help define craniopharyngioma topography...
September 21, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28924485/hypogonadotropic-hypogonadism-in-human-immunodeficiency-virus-infected-men-uncommonly-low-testosterone-levels
#16
Ana Coelho Gomes, José Maria Aragüés, Sílvia Guerra, Joana Fernandes, Mário Rui Mascarenhas
Hypogonadotropic hypogonadism (HH) is common and occurs prematurely in HIV-infected men. However, HH with very low testosterone has not been described. Three men with normal pubertal development and HIV1 diagnosis at the ages of 22, 34 and 35 years. All complained of decreased libido, anejaculation and erectile dysfunction thirteen years, six months and one year after HIV diagnosis, respectively. Two had depressive syndrome and two were treated with antiretroviral therapy. Laboratory tests revealed isolated HH in all...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28918496/recurrent-papillary-craniopharyngioma-with-brafv600e-mutation-treated-with-neoadjuvant-targeted-therapy
#17
Elham Rostami, Petra Witt Nyström, Sylwia Libard, Johan Wikström, Olivera Casar-Borota, Olafur Gudjonsson
Craniopharyngiomas are histologically benign but locally aggressive tumors in the sellar region that may cause devastating neurological and endocrine deficits. They tend to recur following surgery with high morbidity; hence, postoperative radiotherapy is recommended following sub-total resection. BRAFV600E mutation is the principal oncogenic driver in the papillary variant of craniopharyngiomas. Recently, a dramatic tumor reduction has been reported in a patient with BRAFV600E mutated, multiply recurrent papillary craniopharyngioma using a combination therapy of BRAF inhibitor dabrafenib and MEK inhibitor trametinib...
November 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28914872/-the-efficacy-of-desmopressin-in-the-treatment-of-central-diabetes-insipidus-after-resection-of-chiasmo-sellar-region-tumors
#18
L I Astaf'eva
Central diabetes insipidus (CDI) is a neuroendocrine disease, the pathogenesis of which is associated with abnormal secretion of the antidiuretic hormone. One of the specific causes of CDI is neurosurgical resection of chiasmatic-sellar region tumors. AIM: to study the efficacy and safety of desmopressin in CDI patients after resection of chiasmatic-sellar region (CSR) tumors. MATERIAL AND METHODS: Examination and treatment of patients were performed at a hospital for 7-14 days after surgery and then were continued after discharge...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28887281/cerebrospinal-fluid-leak-rhinorrhea-after-systemic-erlotinib-chemotherapy-for-metastatic-lung-cancer-a-familiar-problem-from-an-unfamiliar-culprit
#19
Blake Priddy, Douglas A Hardesty, André Beer-Furlan, Bradley Otto, Daniel M Prevedello
BACKGROUND: Cerebrospinal fluid (CSF) rhinorrhea after medical therapy for pituitary prolactinoma is a rare but well-described phenomenon. To our knowledge, no CSF leaks have been reported after targeted medical treatment of pituitary or anterior skull base metastases. We report this unusual case to raise awareness of spontaneous CSF leaks in the setting of skull base metastatic disease. CASE PRESENTATION: A 66-year-old woman presented with epidermal growth factor receptor-mutant stage IV adenocarcinoma of the lung...
September 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28887280/transsphenoidal-surgery-for-mixed-pituitary-gangliocytoma-adenomas
#20
Matthew J Shepard, Mohamed A Elzoghby, Daffer Ghanim, M Beatriz S Lopes, John A Jane
OBJECTIVE: Most sellar gangliocytomas are discovered with a concurrent pituitary adenoma, also known as a mixed gangliocytoma-adenoma (MGA). MGAs are rare with less than 100 cases reported in the literature and only one previously documented surgical series. As MGAs are radiologically indistinguishable from pituitary adenomas, their diagnosis is often made following surgery. This, combined with the paucity of clinical outcome data for these tumors, makes their diagnosis and management challenging...
September 5, 2017: World Neurosurgery
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