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https://www.readbyqxmd.com/read/28918496/recurrent-papillary-craniopharyngioma-with-brafv600e-mutation-treated-with-neoadjuvant-targeted-therapy
#1
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...
September 16, 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
#2
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
#3
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 EGFR-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
#4
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
https://www.readbyqxmd.com/read/28885368/successful-management-of-octreotide-insensitive-thyrotropin-secreting-pituitary-adenoma-with-bromocriptine-and-surgery-a-case-report-and-literature-review
#5
REVIEW
Chengxian Yang, Huanwen Wu, Jing Wang, Mingming Hu, Xiaoping Xing, Xinjie Bao, Renzhi Wang
RATIONALE: Case reports concerning the value of dopamine agonists in the treatment of patients with thyrotropin-secreting pituitary adenoma (TSHoma) are limited. Herein, we present a rare case of octreotide-insensitive TSHoma responding to bromocriptine therapy. PATIENT CONCERNS: A 45-year-old Chinese man was admitted to Peking Union Medical College Hospital with marked clinical manifestations of hyperthyroidism. DIAGNOSES: Thyroid function tests demonstrated elevated concentrations of free thyroid hormones in the presence of normal thyrotropin...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28875120/rater-reliability-of-the-hardy-classification-for-pituitary-adenomas-in-the-magnetic-resonance-imaging-era
#6
Michael A Mooney, Douglas A Hardesty, John P Sheehy, C Roger Bird, Kristina Chapple, William L White, Andrew S Little
Objectives  The Hardy classification is used to classify pituitary tumors for clinical and research purposes. The scale was developed using lateral skull radiographs and encephalograms, and its reliability has not been evaluated in the magnetic resonance imaging (MRI) era. Design  Fifty preoperative MRI scans of biopsy-proven pituitary adenomas using the sellar invasion and suprasellar extension components of the Hardy scale were reviewed. Setting  This study was a cohort study set at a single institution...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28869375/treatment-strategies-for-craniopharyngiomas
#7
Malte Ottenhausen, Kavelin Rumalla, Emanuele LA Corte, Andrew Alalade, Prakash Nair, Jonathan Forbes, Atef Ben Nsir, Theodore H Schwartz
Craniopharyniomas arise from the sellar region and are particularly challenging because of their close proximity to critical neurovascular structures, including cranial nerves, brainstem, internal carotid arteries, posterior cerebral arteries, hypothalamus, and the pituitary gland. The tumors are benign on histology but can cause serious symptoms by compression of surrounding vital structures. While radical surgery and gross total resection (GTR) remains the first line treatment, choosing the optimal surgical approach is critical for the minimization of complications and post-operative morbidity...
September 4, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28868192/giant-cavernous-carotid-aneurysm-causing-pituitary-dysfunction-pituitary-function-recovery-with-high-flow-bypass
#8
Hideaki Ono, Tomohiro Inoue, Naoto Kunii, Takeo Tanishima, Akira Tamura, Isamu Saito, Nobuhito Saito
BACKGROUND: Giant internal carotid artery (ICA) aneurysms extending into the sellar region, mimicking pituitary tumors, and causing pituitary dysfunction are relatively rare. Open surgery or endovascular treatment can treat these aneurysms, but achieving recovery of endocrine function is difficult. CASE DESCRIPTION: A 56-year-old man presented with giant aneurysm of the ICA causing pituitary impairment, leading to disturbance of consciousness due to hyponatremia...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28859453/comparison-of-complications-trends-and-costs-in-endoscopic-vs-microscopic-pituitary-surgery-analysis-from-a-us-health-claims-database
#9
Anthony O Asemota, Masaru Ishii, Henry Brem, Gary L Gallia
BACKGROUND: Microsurgical and endoscopic techniques are commonly utilized surgical approaches to pituitary pathologies. There are limited data comparing these 2 procedures. OBJECTIVE: To evaluate postoperative complications, associated costs, and national and regional trends of microscopic and endoscopic techniques in the United States employing a nationwide database. METHODS: The Truven MarketScan database 2010 to 2014 was queried and Current Procedural Terminology codes identified patients that underwent microscopic and/or endoscopic transsphenoidal pituitary surgery...
September 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28832172/-metastatic-pituitary-disorders
#10
V Novák, L Hrabálek, M Hampl, J Hoza, Z Fryšák, M Vaverka
BACKGROUND: Pituitary metastases are a rare complication of generalized cancer. Metastases to the pituitary gland occur in only 1% of patients operated on for sellar tumor. The most common presenting symptom in patients with pituitary metastases is diabetes insipidus, whereas this is rare in those with pituitary adenoma. MATERIAL AND METHODS: This publication presents the cases of two patients with pituitary metastases and a systematic review of the literature. English-language publications related to pituitary metastases and published from 1957 to 2016 were identified using the PubMed database...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/28821944/the-2017-world-health-organization-classification-of-tumors-of-the-pituitary-gland-a-summary
#11
REVIEW
M Beatriz S Lopes
The 4th edition of the World Health Organization (WHO) classification of endocrine tumors has been recently released. In this new edition, major changes are recommended in several areas of the classification of tumors of the anterior pituitary gland (adenophypophysis). The scope of the present manuscript is to summarize these recommended changes, emphasizing a few significant topics. These changes include the following: (1) a novel approach for classifying pituitary neuroendocrine tumors according to pituitary adenohypophyseal cell lineages; (2) changes to the histological grading of pituitary neuroendocrine tumors with the elimination of the term "atypical adenoma;" and (3) introduction of new entities like the pituitary blastoma and re-definition of old entities like the null-cell adenoma...
August 18, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28815312/trilateral-retinoblastoma-a-systematic-review-of-211-cases
#12
REVIEW
Ryuya Yamanaka, Azusa Hayano, Yasuo Takashima
We conducted a systematic review of 72 studies to characterize trilateral retinoblastomas. Kaplan-Meier analysis was used to estimate survival, and statistical significance was assessed by using a log-rank test. We analyzed 211 cases of trilateral retinoblastomas. The average age of onset of retinoblastoma was 0.79 ± 1.38 years, and the average latency period between the onset of retinoblastomas and trilateral retinoblastomas was 1.49 ± 1.76 years. The brain tumors were found before the retinoblastoma diagnosis in 6 cases (3...
August 16, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28807344/pituicytoma-review-of-commonalities-and-distinguishing-features-among-ttf-1-positive-tumors-of-the-central-nervous-system
#13
REVIEW
Siba El Hussein, Cristina Vincentelli
Pituicytoma is a rare low-grade glial neoplasm that originates in the distribution of the neurohypophysis, including the posterior pituitary lobe and infundibular stalk. The tumor cells resemble pituicytes, which are specialized glial cells of the neurohypophysis. Pituicytoma can be misdiagnosed pre-operatively as a pituitary adenoma due to overlapping clinical and neuroimaging features between these two entities. Pituicytoma can also mimic other neoplasms of the sellar and parasellar regions microscopically - meningioma, schwannoma and pilocytic astrocytoma - and shares immunohistochemical expression of TTF-1 with spindle cell oncocytoma and granular cell tumor of the sellar region, suggesting a common histogenesis...
August 2017: Annals of Diagnostic Pathology
https://www.readbyqxmd.com/read/28766057/overview-of-the-2017-who-classification-of-pituitary-tumors
#14
REVIEW
Ozgur Mete, M Beatriz Lopes
This review focuses on discussing the main changes on the upcoming fourth edition of the WHO Classification of Tumors of the Pituitary Gland emphasizing histopathological and molecular genetics aspects of pituitary neuroendocrine (i.e., pituitary adenomas) and some of the non-neuroendocrine tumors involving the pituitary gland. Instead of a formal review, we introduced the highlights of the new WHO classification by answering select questions relevant to practising pathologists. The revised classification of pituitary adenomas, in addition to hormone immunohistochemistry, recognizes the role of other immunohistochemical markers including but not limited to pituitary transcription factors...
August 1, 2017: Endocrine Pathology
https://www.readbyqxmd.com/read/28754639/bevacizumab-for-radiation-associated-visual-decline-among-aggressive-residual-recurrent-suprasellar-tumors-more-than-a-mere-anti-neoplastic-effect
#15
Pinaki Dutta, Sivashanmugam Dhandapani, Narendra Kumar, Prakamya Gupta, Chirag Ahuja, K K Mukherjee
BACKGROUND: Angiogenesis and vascular endothelial growth factor (VEGF) are recently being implicated in animal and clinical models of radiation-induced optic nerve-retinal and brain necrosis. Though there are isolated case reports of anti-VEGF therapy (Bevacizumab) as a treatment modality in the management of radiation induced brain necrosis, there is paucity of data defining its role in radiation induced optic nerve damage. PATIENTS AND METHOD: patients with sellar suprasellar tumor who received intensity modulated or Gamma Knife radiotherapy and developed radiation induced optic neuritis refractory to three weeks of glucocorticoid therapy who were given bevacizumab 5mg/Kg intra venously as initial dose followed by 10mg/Kg subsequent doses...
July 25, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28745610/clinically-non-functioning-pituitary-adenomas-pathogenic-diagnostic-and-therapeutic-aspects
#16
Moises Mercado, Virgilio Melgar, Latife Salame, Dalia Cuenca
Clinically non-functioning pituitary adenomas (NFPAs) are among the most common tumors in the sellar region. These lesions do not cause a hormonal hypersecretion syndrome, and are therefore found incidentally (particularly microadenomas) or diagnosed based on compressive symptoms such as headache and visual field defects, as well as clinical signs of pituitary hormone deficiencies. Immunohistochemically, more than 45% of these adenomas stain for gonadotropins or their subunits and are therefore called gonadotropinomas, while 30% of them show no immunostaining for any hormone and are known as null cell adenomas...
August 2017: Endocrinología, diabetes y nutrición
https://www.readbyqxmd.com/read/28738798/efficacy-of-sellar-opening-in-the-pituitary-adenoma-resection-of-transsphenoidal-surgery-influences-the-degree-of-tumor-resection
#17
Shousen Wang, Yong Qin, Deyong Xiao, Liangfeng Wei
BACKGROUND: Endonasal transsphenoidal microsurgery is often adopted in the resection of pituitary adenoma, and has showed satisfactory treatment and minor injuries. It is important to accurately localize sellar floor and properly incise the bone and dura matter. METHODS: Fifty-one patients with pituitary adenoma undergoing endonasal transsphenoidal microsurgery were included in the present study. To identify the scope of sellar floor opening, CT scan of the paranasal sinus and MRI scan of the pituitary gland were performed for each subject...
July 24, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28719461/serotonin-atrx-and-daxx-expression-in-pituitary-adenomas-markers-in-the-differential-diagnosis-of-neuroendocrine-tumors-of-the-sellar-region
#18
Olivera Casar-Borota, Johan Botling, Dan Granberg, Jerker Stigare, Johan Wikström, Henning Bünsow Boldt, Bjarne Winther Kristensen, Fredrik Pontén, Jacqueline Trouillas
Differential diagnosis based on morphology and immunohistochemistry between a clinically nonfunctioning pituitary neuroendocrine tumor (NET)/pituitary adenoma and a primary or secondary NET of nonpituitary origin in the sellar region may be difficult. Serotonin, a frequently expressed marker in the NETs, has not been systematically evaluated in pituitary NETs. Although mutations in ATRX or DAXX have been reported in a significant proportion of pancreatic NETs, the mutational status of ATRX and DAXX and their possible pathogenetic role in pituitary NETs are unknown...
September 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28684370/a-primary-pigmented-choroid-plexus-papilloma-located-within-the-sella-turcica-case-report-and-literature-review
#19
Xuan Gong, Chao Liu, Longbo Zhang, Zhenyan Li, Christopher M Bartley, Zhixiong Liu
BACKGROUND: Choroid plexus papillomas (CPPs) are rare benign tumors, and the pigmented subtype is observed even more rarely. CASE DESCRIPTION: We present the case of a 43-year-old woman with complaints of headache and progressive left monocular visual deterioration, whose initial plain computed tomography CT scan showed an ovate high-density tumor located within the insellar region. Magnetic resonance imaging revealed a homogeneously contrast-enhancing tumor extending from the sella turcica to the suprasellar cistern...
September 2017: World Neurosurgery
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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