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Macroadenoma

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https://www.readbyqxmd.com/read/29772978/outcomes-of-the-addition-of-pasireotide-to-traditional-adrenal-directed-treatment-for-dogs-with-pituitary-dependent-hyperadrenocorticism-secondary-to-macroadenoma-9-cases-2013-2015
#1
Maya Lottati, David S Bruyette
OBJECTIVE To evaluate clinical signs, endocrine test results, and pituitary tumor size for dogs with medically managed pituitary-dependent hyperadrenocorticism (PDH) and macroadenoma following 6 months of concurrent treatment with pasireotide. DESIGN Prospective case series. ANIMALS 9 client-owned dogs with PDH and macroadenoma in which PDH had been successfully managed with adrenal-directed treatment (trilostane or mitotane). PROCEDURES Dogs were given pasireotide (0.03 mg/kg [0.014 mg/lb], SC, q 12 h) for 6 months, while adrenal-directed treatment was continued...
June 1, 2018: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29767319/endoscopic-vs-microscopic-transsphenoidal-surgery-for-cushing-s-disease-a-systematic-review-and-meta-analysis
#2
Leonie H A Broersen, Nienke R Biermasz, Wouter R van Furth, Friso de Vries, Marco J T Verstegen, Olaf M Dekkers, Alberto M Pereira
PURPOSE: Systematic review and meta-analysis comparing endoscopic and microscopic transsphenoidal surgery for Cushing's disease regarding surgical outcomes (remission, recurrence, and mortality) and complication rates. To stratify the results by tumor size. METHODS: Nine electronic databases were searched in February 2017 to identify potentially relevant articles. Cohort studies assessing surgical outcomes or complication rates after endoscopic or microscopic transsphenoidal surgery for Cushing's disease were eligible...
May 16, 2018: Pituitary
https://www.readbyqxmd.com/read/29732160/granular-cell-tumour-of-the-neurohypophysis-an-unusual-cause-of-hypopituitarism
#3
Carlos Tavares Bello, Patricia Cipriano, Vanessa Henriques, João Sequeira Duarte, Conceição Canas Marques
Granular cell tumours (GCT) are rare, slow-growing, benign neoplasms that are usually located in the head and neck. They are more frequent in the female gender and typically have an asymptomatic clinical course, being diagnosed only at autopsy. Symptomatic GCT of the neurohypophysis are exceedingly rare, being less than 70 cases described so far. The authors report on a case of a 28-year-old male that presented to the Endocrinology clinic with clinical and biochemical evidence of hypogonadism. He also reported minor headaches without any major visual symptoms...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29719850/delayed-progressive-intraparenchymal-tension-pneumocephalus-after-craniotomy-for-recurrent-pituitary-macroadenoma-a-case-report
#4
Samer S Hoz, Khatab Baban, Mohamad Sabah, Awfa Aktham, Alexis Rafael Narvaez-Rojas, Luis Rafael Moscote-Salazar
Pneumocephalus is defined as the presence of air in the intracranial cavity. In most cases, its evolution is asymptomatic and benign. Pneumocephalus post-surgery is a frequent complication of cranial surgery. We herein report delayed tension pneumocephalus after craniotomy for pituitary macroadenoma. A 73-year-old man with recurrent pituitary macroadenoma underwent subtotal resection via subfrontal approach. The postoperative course was uneventful and the patients regained his normal daily living activities...
April 2018: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29712721/comparative-population-based-analysis-of-pituitary-incidentalomas-vs-clinically-manifesting-sellar-masses
#5
Nadine Marie Vaninetti, David B Clarke, Deborah A Zwicker, Churn-Ern Yip, Barna Tugwell, Steve Doucette, Chris Theriault, Khaled Aldahmani, Syed Ali Imran
PURPOSE: Sellar masses may present either with clinical manifestations of mass effect/hormonal dysfunction (CMSM) or incidentally on imaging (PI). This novel population-based study compares these two entities. METHODS: Retrospective analysis of all patients within a provincial pituitary registry between January 2006 and June 2014. RESULTS: 903 patients were included (681 CMSM, 222 PI). CMSM mainly presented with secondary hormone deficiencies (SHD) or stalk compression (29...
April 30, 2018: Endocrine Connections
https://www.readbyqxmd.com/read/29694638/a-review-of-cushing-s-disease-treatment-by-the-department-of-neuroendocrinology-of-the-brazilian-society-of-endocrinology-and-metabolism
#6
Márcio Carlos Machado, Maria Candida Barisson Vilares Fragoso, Ayrton Custódio Moreira, César Luiz Boguszewski, Leonardo Vieira Neto, Luciana A Naves, Lucio Vilar, Luiz Antônio de Araújo, Nina Rosa Castro Musolino, Paulo Augusto C Miranda, Mauro A Czepielewski, Monica R Gadelha, Marcello Delano Bronstein, Antônio Ribeiro-Oliveira
The treatment objectives for a patient with Cushing's disease (CD) are remission of hypercortisolism, adequate management of co-morbidities, restoration of the hypothalamic-pituitary-adrenal axis, preservation of fertility and pituitary function, and improvement of visual defects in cases of macroadenomas with suprasellar extension. Transsphenoidal pituitary surgery is the main treatment option for the majority of cases, even in macroadenomas with low probability of remission. In cases of surgical failure, another subsequent pituitary surgery might be indicated in cases with persistent tumor imaging at post surgical magnetic resonance imaging (MRI) and/or pathology analysis of adrenocorticotropic hormone-positive (ACTH+) positive pituitary adenoma in the first procedure...
February 2018: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29685009/sudden-onset-unilateral-ptosis-induced-by-pituitary-macroadenoma-with-false-positive-jolly-and-neostigmine-tests
#7
G X Shen, K J Wu, Z Chen, Y F Gao, G X Nan
The development of ptosis as a consequence of pituitary tumor is an exceptionally rare occurrence. Here, we describe the case of sudden-onset unilateral ptosis induced by pituitary macroadenoma. The condition was characterized by false-positive Jolly and neostigmine tests. These findings mimic oculomotor nerve palsy and make the correct diagnostics rather challenging. The case points to the fact that patients with acquired ptosis need detailed neuroophthalmological examination.
March 2018: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29665752/histopathologic-findings-in-canine-pituitary-glands
#8
Margaret A Miller, David S Bruyette, J Catharine Scott-Moncrieff, Tina Jo Owen, José A Ramos-Vara, Hsin-Yi Weng, Andrea L Vanderpool, Annie V Chen, Linda G Martin, Deidre M DuSold, Sina Jahan
To optimize the histologic evaluation of hypophysectomy specimens, sections of 207 canine pituitary glands (196 postmortem, 11 hypophysectomy specimens) were reviewed. Adenohypophyseal proliferation was the most common (n = 79) lesion. Proliferative lesions were sparsely to densely granulated; the granules were usually basophilic to chromophobic and periodic acid-Schiff-positive. Adenohypophyseal proliferation was classified as hyperplasia (n = 40) if ≤2 mm diameter with intact reticulin network, as microadenoma (n = 22) for 1-5 mm homogeneous nodules with lost reticulin network, or as macroadenoma (n = 17) for larger tumors...
January 1, 2018: Veterinary Pathology
https://www.readbyqxmd.com/read/29660734/interpretation-of-serum-gonadotropin-levels-in-hyperprolactinemia
#9
Ali Abbara, Sophie A Clarke, Alexander Nesbitt, Sabreen Ali, Alexander N Comninos, Emma Hatfield, Niamh Martin, Amir Sam, Karim Meeran, Waljit S Dhillo
<br>Background/Aims: Hyperprolactinemia is a common cause of amenorrhea due to hypogonadotropic hypogonadism. Prolactin is hypothesized to impede the reproductive axis through an inhibitory action at the hypothalamus. However, limited data exists to aid the interpretation of serum gonadotropins in the context of hyperprolactinemia. METHODS: Serum gonadotropin values were reviewed in 243 patients with elevated serum monomeric prolactin due to discrete etiologies at a tertiary reproductive endocrine centre between 2012 and 2015...
April 16, 2018: Neuroendocrinology
https://www.readbyqxmd.com/read/29626274/predictors-of-surgical-outcome-and-early-criteria-of-remission-in-acromegaly
#10
Ximene Antunes, Nina Ventura, Gustavo Bittencourt Camilo, Luiz Eduardo Wildemberg, Andre Guasti, Paulo José M Pereira, Aline Helen Silva Camacho, Leila Chimelli, Paulo Niemeyer, Mônica R Gadelha, Leandro Kasuki
BACKGROUND: Transsphenoidal surgery (TSS) is the cornerstone of acromegaly treatment, however there are no robust predictors of surgical outcome and remission can only be defined three months after surgery. PURPOSE: To analyze if biochemical, demographical, radiological, and immunohistochemical characteristics are predictors of surgical remission and investigate if immediate postoperative GH and IGF-I levels can help defining remission earlier. METHODS: Consecutive acromegaly patients submitted to TSS between 2013-2016 were evaluated...
April 6, 2018: Endocrine
https://www.readbyqxmd.com/read/29618021/persistence-of-diabetes-and-hypertension-after-multimodal-treatment-of-acromegaly
#11
Baldomero González, Guadalupe Vargas, Ana Laura Espinosa de Los Monteros, Victoria Mendoza, Moisés Mercado
Context: Diabetes and hypertension are frequent comorbidities of acromegaly. Objective: To analyze the course of diabetes and hypertension at diagnosis and after multimodal therapy in a large cohort of patients with acromegaly. Design and setting: Retrospective study, at a tertiary care center. Patients and methods: 522 patients with acromegaly treated according to a pre-established protocol. Main outcome measures: Prevalence of diabetes and hypertension and its relationship with biochemical indices of acromegalic control...
March 30, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29588906/complications-of-extended-endoscopic-endonasal-surgery-in-elderly-patients
#12
Tyler J Kenning, Carlos D Pinheiro-Neto
Extended endoscopic endonasal procedures are not unique among surgical interventions in carrying increased risk in the elderly population. There are, however, components of the procedure, namely high-flow cerebrospinal fluid leaks, that do result in the potential for increased perioperative morbidity for these patients. We present the case of a 77-year-old male with a large invasive pituitary macroadenoma resected through a transplanum-transtuberculum-transsellar endonasal approach. A gross total resection was obtained with resolution of the patient's preoperative ophthalmologic deficits...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588904/endoscopic-endonasal-approach-for-complex-macroadenoma-with-suprasellar-and-retrochiasmatic-extension
#13
Edinson Najera, Carl H Snyderman, Juan C Fernandez-Miranda
In this video, we describe the technical nuances of an endoscopic endonasal approach (EEA) for a complex macroadenoma with suprasellar and retrochiasmatic extension. The patient is a 51-year-old male with several years' history of progressive visual loss. Neuro-ophthalmology assessment revealed a profound visual loss with homonymous hemianopsia and left optic nerve atrophy. His pituitary hormonal profile was normal. The options for surgical approach included transcranial, endoscopic endonasal, or a combination of both...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29581739/investigating-the-application-of-diving-endoscopic-technique-in-determining-the-extent-of-pituitary-adenoma-resection-via-the-trans-nasal-sphenoidal-approach
#14
Hai-Bin Gao, Li-Qing Wang, Jian-Yun Zhou, Wei Sun
The aim of the present study was to investigate the advantages and disadvantages of the diving endoscopic technique in pituitary adenoma surgery, and the application value in determining the extent of tumor resection. A total of 37 patients with pituitary adenoma initially underwent tumor resection under an endoscope-assisted microscope via standard trans-nasal-sphenoidal approach, and tumor cavity structure was observed by applying the diving endoscopic technique. Surgery was subsequently performed again under a microscope or endoscope...
April 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29580720/endonasal-endoscopic-surgery-in-pituitary-adenomas-surgical-results-in-a-series-of-86-consecutive-patients
#15
R López-García, J Abarca-Olivas, I Monjas-Cánovas, A M Picó Alfonso, P Moreno-López, J R Gras-Albert
INTRODUCTION: The endoscopic endonasal approach has become the gold standard for the surgical treatment of pituitary adenomas. OBJECTIVES: The aim of this study is to present the results obtained in our hospital in purely endoscopic surgery of pituitary adenomas. METHODS: From February 2011 to August 2016, we conducted a prospective study on a series of 86 patients with pituitary adenoma, all of whom underwent surgery with a purely endoscopic endonasal approach...
March 23, 2018: Neurocirugía
https://www.readbyqxmd.com/read/29570007/superiority-of-constructive-interference-in-steady-state-mri-sequencing-over-t1-weighted-mri-sequencing-for-evaluating-cavernous-sinus-invasion-by-pituitary-macroadenomas
#16
Min Lang, Danilo Silva, Lu Dai, Varun R Kshettry, Troy D Woodard, Raj Sindwani, Pablo F Recinos
OBJECTIVE Preoperatively determining the extent of parasellar invasion of pituitary macroadenomas is useful for surgical planning and patient counseling. Here, the authors compared constructive interference in steady state (CISS), a T2-weighted gradient-echo MRI sequence, to volume-interpolated breath-hold examination (VIBE), a T1-weighted gradient-echo MRI sequence, for evaluation of cavernous sinus invasion (CSI) by pituitary macroadenomas. METHODS VIBE and CISS images of 98 patients with pituitary macroadenoma were retrospectively analyzed and graded using the modified Knosp classification...
March 23, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29532430/complete-evaluation-of-pituitary-tumours-in-a-single-tertiary-care-institution
#17
Dimitrios Askitis, Damianos Tsitlakidis, Nicolle Müller, Albrecht Waschke, Gunter Wolf, Ulrich Alfons Müller, Christof Kloos
INTRODUCTION: We retrospectively evaluated all patients with pituitary tumours treated in our department from 1/1/1997 to 01/11/2014. PATIENTS AND METHODS: Two hundred and fifteen patients (124 females, 91 males, mean age 50.9 years) were treated because of pituitary tumours. All patients underwent basal hormonal analysis and when required dynamic testing in order to check for hormonal activity. Pituitary masses were divided into groups concerning their hormonal status and were further classified according to gender, age at diagnosis, tumour size, and the development of postoperative pituitary insufficiency when neurosurgical intervention was conducted...
May 2018: Endocrine
https://www.readbyqxmd.com/read/29520496/endoscopic-transnasal-surgery-of-clival-lesions-our-experience
#18
Daniele Marchioni, Angelo Musumeci, Cristoforo Fabbris, Stefano De Rossi, Davide Soloperto
BACKGROUND: The clivus is a region characterized by complex anatomy, with vascular and neural structures that are located in close proximity. Different pathologies can affect this area, and traditional surgical approaches were open approaches. Recently, the endoscopic transnasal technique has been introduced, and currently represents a good alternative for the surgical management of these lesions. This is a preliminary report on patients treated endoscopically for clival lesions by the authors' Skull Base Team...
May 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29505532/case-report-of-a-pituitary-thyrotropin-secreting-macroadenoma-with-hashimoto-thyroiditis-and-infertility
#19
Jiaqi Li, Jianwei Li, Shu Jiang, Ruichao Yu, Yerong Yu
RATIONALE: Thyrotropin-secreting adenoma (TSHoma) is rare, diagnosis and treatment are often delayed if the condition coexists with Hashimoto thyroiditis. The enlarged pituitary adenoma may eventually induce panhypopituitarism, infertility, or the compression of optic nerves and optic chiasma. PATIENT CONCERNS: This patient was a 36-year-old man who had been referred to the pituitary disease multidisciplinary team (MDT) of the West China Hospital, due to infertility...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29482118/extended-endoscopic-endonasal-approach-to-the-ventral-skull-base-lesions
#20
Murat Kutlay, Abdullah Durmaz, İlker Özer, Cahit Kural, Çağlar Temiz, Serdar Kaya, İlker Solmaz, Mehmet Daneyemez, Yusuf Izci
OBJECTIVE: With the use of multiple endoscopic endonasal surgical corridors, extended endoscopic endonasal approaches (EEEAs) are now being used to treat a wide range of ventral skull base lesions. Our aim was to present our experience with EEEAs to the ventral skull base lesions. PATIENTS AND METHODS: The study group consisted of 106 patients (57 men and 49 women) who underwent surgery for skull base lesions using EEEAs from 2010 to 2017. The EEEA was most commonly used for giant pituitary macroadenomas, sinonasal malignancies, cerebrospinal fluid (CSF) leaks, meningiomas, craniopharyngiomas, and fibro-osseous lesions...
April 2018: Clinical Neurology and Neurosurgery
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