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Macroadenoma

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https://www.readbyqxmd.com/read/28938458/corticotroph-pituitary-carcinoma-in-a-patient-with-lynch-syndrome-ls-and-pituitary-tumors-in-a-nationwide-ls-cohort
#1
Daniel Bengtsson, Patrick Joost, Christos Aravidis, Marie Askmalm Stenmark, Ann-Sofie Backman, Beatrice Melin, Jenny von Salomé, Theofanis Zagoras, Samuel Gebre-Medhin, Pia Burman
Context: Lynch syndrome is a cancer predisposing syndrome caused by germline mutations in genes involved in DNA mismatch repair (MMR). Patients are at high risk for several types of cancer, but pituitary tumors have not previously been reported. Case: A 51-year old man with LS (MSH2 mutation) and a history of colon carcinoma presented with severe Cushing's disease and a locally aggressive pituitary tumor. The tumor harbored a mutation consistent with the patient's germline mutation, and displayed defect MMR function...
August 18, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28919625/van-wyk-and-grumbach-syndrome-an-unusual-presentation-of-hypothyroism
#2
P K Chanda, M Kamrul-Hasan, M Abu-Bakar, M Rahman, M A Kader, M A Hossain, N I Siddiqui
An 18 years-old-girl presented one and half years back with the complaints of short stature, retarded growth, and menorrhagia with sudden severe lower abdominal pain; was diagnosed as bilateral ovarian cysts and underwent bilateral ovarian cystectomy. Later on she was incidentally diagnosed as a case of hypothyroidism when she had been experiencing slowly enlarging left lower abdominal mass with dull ache for the 5 month and then was transferred to the department of Endocrinology for further evaluation. Detailed work up revealed her short stature with obesity, delayed bone age and other features of hypothyroidism which was confirmed by thyroid function testing...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28919622/incidence-of-diabetes-insipidus-in-postoperative-period-among-the-patients-undergoing-pituitary-tumour-surgery
#3
M L Kadir, M T Islam, M M Hossain, S Sultana, R Nasrin, M M Hossain
Post operative complications after pituitary tumour surgery vary according to procedure. There are several surgical procedures being done such as transcranial, transsphenoidal microsurgical and transsphenoidal endoscopic approaches. One of the commonest complications is diabetes insipidus (DI). Our main objective was to find out the incidence of diabetes insipidus in post operative period among patients undergoing surgical intervention for pituitary tumour in our institute. The presence of diabetes insipidus in the postoperative period was established by measuring serum Na+ concentration, hourly urine output and urinary specific gravity to find out the incidence of diabetes insipidus in postoperative period in relation to age, gender, tumour diameter, function of tumour (i...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28918446/favorable-surgical-outcomes-of-aldosterone-producing-adenoma-based-on-lateralization-by-ct-imaging-and-hypokalemia-a-non-avs-based-strategy
#4
Hai Li, Jianbin Liu, Xiujuan Feng, Liehua Liu, Guohong Wei, Xiaopei Cao, Yanbing Li
PURPOSE: To test the efficacy of a strategy based on CT imaging and clinical characteristics on lateralizing origin of excess aldosterone secretion in primary aldosteronism. PATIENTS AND METHODS: Consecutive patients with diagnosed primary hyperaldosteronism from June 2006 to July 2012 in our center underwent adrenal surgeries without pre-operational adrenal venous sampling (AVS) if all the three criteria were met: (1) round- or oval-shaped occupational lesion of low density after contrast enhancement with diameter >1 cm on CT scan was located in one adrenal gland; (2) unequivocally normal contralateral adrenal gland; (3) serum potassium level lower than 3...
September 16, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28913667/microsurgical-versus-endoscopic-transsphenoidal-resection-for-acromegaly-a-systematic-review-of-outcomes-and-complications
#5
REVIEW
Ching-Jen Chen, Natasha Ironside, I Jonathan Pomeraniec, Srinivas Chivukula, Thomas J Buell, Dale Ding, Davis G Taylor, Robert F Dallapiazza, Cheng-Chia Lee, Marvin Bergsneider
PURPOSE: The aim of this systematic review is to evaluate the long-term endocrine outcomes and postoperative complications following endoscopic vs. microscopic transsphenoidal resection (TSR) for the treatment of acromegaly. METHODS: A literature review was performed, and studies with at least five patients who underwent TSR for acromegaly, reporting biochemical remission criteria and long-term remission outcomes were included. Data extracted from each study included surgical technique, perioperative complications, biochemical remission criteria, and long-term remission outcomes...
September 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28912338/duration-of-post-operative-hypocortisolism-predicts-sustained-remission-after-pituitary-surgery-for-cushing-s-disease
#6
Prachi Ashok Kumar Bansal, Anurag Ranjan Lila, Manjunath Goroshi, Swati Jadhav, Nilesh Keshavrao Lomte, Kunal Thakkar, Atul Goel, Abhidha Shah, Shilpa S Sankhe, Naina Goel, Neelam Jaguste, Tushar Ramkrishna Bandgar, Nalini Shah
PURPOSE: Transsphenoidal surgery(TSS) is the primary treatment modality for Cushing's disease(CD). However, the predictors of post-operative remission and recurrence remain debatable. Thus, we studied the post-operative remission and long term recurrence rates, as well as their respective predictive factors. METHODS: Retrospective analysis of case records of 230 CDpatients who underwent primary microscopic TSS at our tertiary care referral center between 1987-2015was undertaken...
September 14, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28912278/pituitary-macroadenoma-and-visual-impairment-postoperative-outcome-prediction-with-contrast-enhanced-fiesta
#7
S Hisanaga, S Kakeda, J Yamamoto, K Watanabe, J Moriya, T Nagata, Y Fujino, H Kondo, S Nishizawa, Y Korogi
BACKGROUND AND PURPOSE: Contrast-enhanced FIESTA can depict anterior optic pathways in patients with large suprasellar tumors. We assessed whether the degree of kink in the optic nerve at the optic canal orifice on contrast-enhanced FIESTA correlates with the postoperative improvement of visual impairment in patients with pituitary macroadenoma. MATERIALS AND METHODS: Thirty-one patients with pituitary macroadenoma who underwent preoperative MR imaging and an operation were evaluated...
September 14, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28900805/mgmt-and-msh6-immunoexpression-for-functioning-pituitary-macroadenomas
#8
Alexander S G Micko, Adelheid Wöhrer, Romana Höftberger, Greisa Vila, Christine Marosi, Engelbert Knosp, Stefan Wolfsberger
PURPOSE: Knowledge of biological behavior is crucial for clinical management of functioning pituitary macroadenomas. For recurrent cases unresponsive to standard treatment, temozolomide (TMZ) has been used as a therapeutic alternative. MGMT (O6-methyl-guanine-DNA methyltransferase) and MSH6 (mutS homolog 6) immunoexpression have been linked to the response to TMZ treatment and MGMT immunoexpression has been additionally linked to early recurrence of non-functioning pituitary adenomas...
September 12, 2017: Pituitary
https://www.readbyqxmd.com/read/28887283/endoscopic-transsphenoidal-approach-for-acromegaly-remission-rates-in-401-patients-2010-consensus-criteria
#9
Ihsan Anik, Burak Cabuk, Aykut Gokbel, Alev Selek, Berrin Cetinarslan, Yonca Anik, Savas Ceylan
BACKGROUND: Transsphenoidal surgery is the first choice treatment for acromegaly. Postoperative remission is an important predictor of outcome. Various factors have been described as markers of remission preoperative mean growth hormone (GH) and insulin-like growth factor-1 levels, cavernous sinus invasion, tumor size, extra pseudocapsule resection, and experience of the surgeon. MATERIALS AND METHODS: A total of 401 patients underwent 432 endoscopic transsphenoidal surgeries between August1997 and June 2016 at Pituitary Research Centre of Kocaeli University...
September 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28882600/lesson-to-be-remembered-from-a-skull-base-tumor
#10
C Briet, F Bernard, P Rodien
The natural history of giant prolactinomas is not known. While it is commonly accepted that the enlargement of microadenoma is rare and more limited than macroadenoma, it is so far uncommon that macroadenoma progress to giant adenoma. Thus, spontaneous enlargement of adenomas is poorly documented. We report the unusual history of undiagnosed microprolactinoma, revealed 12years later at the stage of a giant adenoma presenting as a skull base tumor. This unique observation provides information on the natural history of giant adenomas and arguments for particular attention to microadenomas with signs of invasion...
September 4, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28874187/prolonged-preoperative-treatment-of-acromegaly-with-somatostatin-analogs-may-improve-surgical-outcome-in-patients-with-invasive-pituitary-macroadenoma-knosp-grades-1-3-a-retrospective-cohort-study-conducted-at-a-single-center
#11
Lian Duan, Huijuan Zhu, Bing Xing, Feng Gu
BACKGROUND: This study aimed to investigate preoperative somatostatin analogs (SSAs) treatment on the surgical outcome in patients with acromegaly. METHODS: An analysis of 358 patients with acromegaly was conducted. The preoperative medical therapy group (81 patients) received SSA treatment for at least 3 months prior to surgery, while the primary surgery group (277 patients) underwent transsphenoidal surgery directly. Follow-up duration was ≥3 months. Tumor invasion was evaluated by magnetic resonance imaging (MRI) and classified according to the Knosp grading system...
September 6, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28871708/pituitary-hyperplasia-mimicking-macroadenoma-associated-with-primary-hypothyroidism-in-a-patient-with-selective-l-thyroxine-malabsorption
#12
Andrea Sansone, Massimiliano Sansone, Walter Vena, Radha Tedone, Francesco Romanelli
We present the case of a 29-year-old woman who developed a severe hypothyroidism induced by a thyroxine malabsorption and a secondary pituitary hyperplasia. We performed thyroxine absorption tests to diagnose the malabsorption and to evaluate the best therapeutic intervention. Once assessed a correct therapy lowering TSH, we observed the regression of pituitary mass confirming our diagnosis of secondary pituitary hyperplasia. We suggest to evaluate any possible reason for thyroxine malabsorption and to consider the hypothesis of pituitary hyperplasia in the presence of pituitary mass together with overt hypothyroidism...
August 5, 2017: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28862548/reoperation-for-growth-hormone-secreting-pituitary-adenomas-report-on-an-endonasal-endoscopic-series-with-a-systematic-review-and-meta-analysis-of-the-literature
#13
João Paulo Almeida, Armando S Ruiz-Treviño, Buqing Liang, Sacit B Omay, Sathwik R Shetty, Yu-Ning Chen, Vijay K Anand, Kartikey Grover, Paul Christos, Theodore H Schwartz
OBJECTIVE Surgery is generally the first-line therapy for acromegaly. For patients with residual or recurrent tumors, several treatment options exist, including repeat surgery, medical therapy, and radiation. Reoperation for recurrent acromegaly has been associated with poor results, with hormonal control usually achieved in fewer than 50% of cases. Extended endonasal endoscopic approaches (EEAs) may potentially improve the results of reoperation for acromegaly by providing increased visibility and maneuverability in parasellar areas...
September 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28820308/resection-of-pituitary-macroadenomas-via-the-pseudocapsule-along-the-posterior-tumor-margin-a-cohort-study-and-technical-note
#14
Davis G Taylor, John A Jane, Edward H Oldfield
OBJECTIVE Extracapsular resection of pituitary microadenomas improves remission rates, but the application of pseudocapsular techniques for macroadenomas has not been well described. In larger tumors, the extremely thin, compressed normal gland or its complete absence along the tumor's anterior surface limits the application of the traditional pseudocapsular technique that can be used for microadenomas. However, in the authors' experience, the interface between the pseudocapsule at the posterior margin of the adenoma and the compressed normal gland behind it is universally present, providing a surgical dissection plane...
August 18, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28816201/risk-factors-and-the-prognosis-of-sexual-dysfunction-in-male-patients-with-pituitary-adenomas-a-multivariate-analysis
#15
Wen-Jian-Long Zhou, Shun-Chang Ma, Min Zhao, Chang Liu, Xiu-Dong Guan, Zhao-Shi Bao, Gui-Jun Jia, Wang Jia
The impact of sexual dysfunction (SD) is distressing to many male patients with pituitary adenomas which affect both physical and psychological health. The research explored to identify risk factors affecting sexual function and the prognosis of male patients with pituitary adenomas. Two hundred and fifty-four male patients, who aged between 18 and 60 (mean ± s.d.: 44.16 ± 10.14) years and diagnosed with pituitary adenomas, were retrospectively analyzed. One hundred and fifty-nine patients (62.6%) complained of SD prior to surgery...
August 11, 2017: Asian Journal of Andrology
https://www.readbyqxmd.com/read/28806314/limitations-of-current-methodology-for-assessment-of-compression-of-the-optic-chiasm-by-macroadenoma-the-neuroradiologic-perspective
#16
Ari M Blitz, Sachin K Gujar
No abstract text is available yet for this article.
September 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28759937/prevalence-clinical-features-and-natural-history-of-incidental-clinically-non-functioning-pituitary-adenomas
#17
Pedro Iglesias, Karina Arcano, Vanessa Triviño, Paula García-Sancho, Juan José Díez, Carles Villabona, Fernando Cordido
The objective of the study was to assess the prevalence and clinical features of incidentally discovered clinically non-functioning pituitary adenoma (CNFPA) and to analyze its natural history. A multicenter retrospective study in patients diagnosed with incidental CNFPA periodically followed-up in 3 specialized neuroendocrinology units from 1992 to 2015 was performed. Out of a total of 189 CNFPA patients, 57 cases (30.1%; 29 women; age at diagnosis 55.8±16.7 years) were incidental. Most patients (n=55, 96...
July 31, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28721598/a-retrospective-review-of-34-cases-of-pediatric-pituitary-adenoma
#18
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
#19
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
#20
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
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