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Macroadenoma

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https://www.readbyqxmd.com/read/28528397/perioperative-hypothalamic-pituitary-adrenal-function-in-patients-with-silent-corticotroph-adenomas
#1
Abdelle F Cheres, Nadine ElAsmar, Aman Rajpal, Warren R Selman, Baha M Arafah
BACKGROUND: Silent corticotroph adenomas (SCAs) are characterized by strong ACTH immunostaining without clinical manifestations of hypercortisolism. Patients with SCAs often present with mechanical symptoms related to tumor growth. This study investigates the hypothalamic pituitary adrenal axis (HPA) characteristics after adenomectomy in patients with SCAs. METHODS: Biochemical parameters of HPA function were monitored frequently after surgical resection of non-functioning macroadenomas...
May 20, 2017: Pituitary
https://www.readbyqxmd.com/read/28527171/lymphocytic-hypophysitis-mimicking-pituitary-macroadenoma
#2
Tarun Kumar Ralot, Jitesh Aggarwal, Raghavendra Haniadka, Kushal Gehlot, Nikhil Dongre, Swapnil Patil
Lymphocytic hypophysitis is an inflammatory /autoimmune disorder that primarily involves the pituitary gland and the pituitary stalk. The common clinical presentations include headache, nausea, vomiting, fatigue, features of hypopituitarism and diabetes insipidus as well as diplopia, orbital pain and bitemporal hemianopia. We report a case of lymphocytic hypophysitis which presented as hemichorea. Neuroimaging showed a mass in the sella tursica region which, on histopathological examination was suggestive of lymphocytic hypophysitis...
April 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28516968/preliminary-experience-with-4k-ultra-high-definition-endoscope-analysis-of-pros-and-cons-in-skull-base-surgery
#3
M Rigante, G La Rocca, L Lauretti, G Q D'Alessandris, A Mangiola, C Anile, A Olivi, G Paludetti
During the last two decades endoscopic skull base surgery observed a continuous technical and technological development 3D endoscopy and ultra High Definition (HD) endoscopy have provided great advances in terms of visualisation and spatial resolution. Ultra-high definition (UHD) 4K systems, recently introduced in the clinical practice, will shape next steps forward especially in skull base surgery field. Patients were operated on through transnasal transsphenoidal endoscopic approaches performed using Olympus NBI 4K UHD endoscope with a 4 mm 0° Ultra Telescope, 300 W xenon lamp (CLV-S400) predisposed for narrow band imaging (NBI) technology connected through a camera head to a high-quality control unit (OTV-S400 - VISERA 4K UHD) (Olympus Corporation, Tokyo, Japan)...
June 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28503387/rubinstein-taybi-syndrome-associated-with-pituitary-macroadenoma-a-case-report
#4
Yasamin Olyaei, J Manuel Sarmiento, Serguei I Bannykh, Doniel Drazin, Robert T Naruse, Wesley King
Rubinstein-Taybi Syndrome (RSTS) is an autosomal dominant disorder that is classically characterized by prenatal and postnatal growth restriction, microcephaly, dysmorphic craniofacial features, broad thumbs and toes, and intellectual disability. We describe the first reported case of a pituitary macroadenoma associated with RSTS. A 39-year-old Caucasian female with a past medical history of RSTS diagnosed at age two was found to have a gadolinium-enhancing pituitary mass on magnetic resonance imaging (MRI) of the brain three years ago during workup for migraine-like headaches...
April 11, 2017: Curēus
https://www.readbyqxmd.com/read/28500926/different-patterns-of-gelatinolytic-activity-in-pituitary-macro-and-microadenomas
#5
Daniel Babula, Joanna Kocot, Anna Horecka, Marcin Baran, Jacek Kurzepa
OBJECTIVE: Gelatinases, Matrix MetalloProteinase(MMP)-2 and MMP-9, belong to zinc-dependent endopeptidases involved in several physiological and pathological processes including inflammation and tumor development. Because the information about the involvement of gelatinases in pituitary adenoma (PA) development are scant, our objective was the analysis of MMP-2 and MMP-9 activity in serum and tumor tissue of PA patients. PATIENTS AND METHODS: Twenty one patients with PA (macroadenoma n=18, microadenoma n=3), qualified to the endoscopic resection of tumors were enrolled...
May 4, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28495945/role-of-high-resolution-dynamic-contrast-enhanced-mri-with-golden-angle-radial-sparse-parallel-reconstruction-to-identify-the-normal-pituitary-gland-in-patients-with-macroadenomas
#6
R Sen, C Sen, J Pack, K T Block, J G Golfinos, V Prabhu, F Boada, O Gonen, D Kondziolka, G Fatterpekar
BACKGROUND AND PURPOSE: Preoperative localization of the pituitary gland with imaging in patients with macroadenomas has been inadequately explored. The pituitary gland enhancing more avidly than a macroadenoma has been described in the literature. Taking advantage of this differential enhancement pattern, our aim was to evaluate the role of high-resolution dynamic MR imaging with golden-angle radial sparse parallel reconstruction in localizing the pituitary gland in patients undergoing trans-sphenoidal resection of a macroadenoma...
May 11, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28493439/very-late-presentation-of-a-disorder-of-sex-development
#7
J M Martins, M Fraga, J Miguens, F Tortosa, B Marques, A D Sousa
Disorders of sex development generally present in the neonatal period with ambiguity of external genitalia. We report a very old male patient presenting at 75 years because of panhypopituitarism and a large nonsecreting pituitary macroadenoma secondary to long-standing primary hypogonadism due to 46,XX sex reversal disorder now first diagnosed. Sex development disorders may go unrecognised for the entire life span, despite infertility and long-standing primary gonadic failure may lead to uncommon complications...
May 11, 2017: Andrologia
https://www.readbyqxmd.com/read/28490347/gh-secreting-pituitary-macroadenoma-acromegaly-associated-with-progressive-dental-malocclusion-and-refractory-cpap-treatment
#8
Jaume Miranda-Rius, Lluís Brunet-LLobet, Eduard Lahor-Soler, David de Dios-Miranda, Josep Anton Giménez-Rubio
BACKGROUND: A link between progressive dental malocclusion, the use of a continuous positive airway pressure mask and GH-secreting pituitary macroadenoma (acromegaly) has not been previously reported. The present clinicopathological analysis stresses that tooth malposition should not be seen exclusively as a local process. CASE PRESENTATION: A 62-year-old caucasian man with no relevant medical history reported difficulty chewing food and perceived voice alteration during his annual periodontal check-up...
May 10, 2017: Head & Face Medicine
https://www.readbyqxmd.com/read/28483363/aip-mutations-and-gigantism
#9
Liliya Rostomyan, Iulia Potorac, Pablo Beckers, Adrian F Daly, Albert Beckers
AIP mutations are rare in sporadic acromegaly but they are seen at a higher frequency among certain specific populations of pituitary adenoma patients (pituitary gigantism cases, familial isolated pituitary adenoma (FIPA) kindreds, and patients with macroadenomas who are diagnosed ≤30 years). AIP mutations are most prevalent in patients with pituitary gigantism (29% of this group were found to have mutations in AIP gene). These data support targeted genetic screening for AIP mutations/deletions in these groups of pituitary adenoma patients...
May 5, 2017: Annales D'endocrinologie
https://www.readbyqxmd.com/read/28469923/macroprolactinoma-appearing-after-resolution-of-hydrocephalus
#10
Oscar D Bruno, Ricardo Fernández Pisani, Gabriel Isaac, Armando Basso
SUMMARY: The role of mechanical forces influencing the growth of a pituitary adenoma is poorly understood. In this paper we report the case of a young man with hyperprolactinaemia and an empty sella secondary to hydrocephalia, who developed a macroprolactinoma following the relief of high intraventricular pressure. LEARNING POINTS: The volume of a pituitary tumour may be influenced not only by molecular but also by local mechanical factors.Intratumoural pressure, resistance of the sellar diaphragm and intracranial liquid pressure may play a role in the final size of a pituitary adenoma...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28467632/younger-age-a-risk-factor-for-regrowth-and-recurrence-of-non-functioning-pituitary-macroadenomas-results-from-a-single-australian-centre
#11
A K Watts, A Easwaran, P McNeill, Y Y Wang, W J Inder, C Caputo
OBJECTIVE: The natural history of non-functioning pituitary macroadenomas (NFPMA) after surgical resection is variable, with guidelines unable to define the duration of radiological follow up. In this first Australian series, we identify risk factors for regrowth/recurrence of NFPMA to assist with guiding recommendations for long-term follow-up. DESIGN: Retrospective analysis of all radiotherapy naïve cases with NFPMA resected between 1995 - 2013. PATIENTS: One hundred and twenty-three cases had both ≥ 2 post-operative scans and ≥ 12 months follow up...
May 3, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28465267/outcome-of-endoscopic-transsphenoidal-surgery-for-acromegaly
#12
Jung Hee Kim, Kyu Yeon Hur, Jung Hyun Lee, Ji Hyun Lee, Young-Bem Se, Hey In Kim, Seung Hoon Lee, Do-Hyun Nam, Seong Yeon Kim, Kwang-Won Kim, Doo-Sik Kong, Yong Hwy Kim
OBJECTIVE: Endoscopic transsphenoidal surgery has recently been introduced in pituitary surgery. We investigated outcomes and complications of endoscopic surgery in two referral centers in Korea. METHODS: We enrolled 134 patients with acromegaly (microadenomas, n=15; macroadenomas, n=119) who underwent endoscopic transsphenoidal surgery at Seoul National University Hospital (n=74) and Samsung Medical center (n=60) between Jan 2009 and Mar 2016. Remission was defined as having a normal IGF-1 and a suppressed GH less than 1 ng/mL during an oral glucose tolerance test...
April 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28447589/neuroretinal-evaluation-using-optical-coherence-tomography-in-patients-affected-by-pituitary-tumors
#13
Yasar Altun, Ayse Sevgi Karadag, Seyho Cem Yucetas, Sadullah Saglam, A Z A Tak, Ilhan Cag, Yusuf Ehi
AIM: To investigate the thickness of the retinal nerve fiber layer (RNFL), the ganglion cell layer (GCL), inner plexiform layer (IPL), and choroid thickness (CT) in patients with pituitary tumours, microadenoma and macroadenoma, using spectral optical coherence tomography (OCT). METHODS: Thirty six patients who had micro and macroadenoma, and 34 healthy participants (control group) were included in the study. Spectral OCT was used to measure the RNFL, GCL, IPL, and CT values for all patients...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28389053/non-functioning-pituitary-adenoma-underwent-surgery-a-multicenter-retrospective-study-over-the-last-four-decades-1977-2015
#14
Pedro Iglesias, Karina Arcano, Vanessa Triviño, Paula García-Sancho, Juan José Díez, Fernando Cordido, Carles Villabona
OBJECTIVE: To assess clinical features, diagnostic procedures, therapies and outcomes in patients with clinically non-functioning pituitary adenomas (NFPAs) surgically treated over the last four decades. DESIGN AND METHODS: A multicenter retrospective study in NFPA patients periodically followed up in specialized neuroendocrinology units who underwent surgery in the period 1977-2015 was performed. RESULTS: A total of 131 patients were studied [66 women (50...
April 4, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28382019/transcriptome-analysis-showed-a-differential-signature-between-invasive-and-non-invasive-corticotrophinomas
#15
Leonardo Jose Tadeu de Araújo, Antonio Marcondes Lerario, Margaret de Castro, Clarissa Silva Martins, Marcello Delano Bronstein, Marcio Carlos Machado, Ericka Barbosa Trarbach, Maria Candida Barisson Villares Fragoso
ACTH-dependent hypercortisolism caused by a pituitary adenoma [Cushing's disease (CD)] is the most common cause of endogenous Cushing's syndrome. CD is often associated with several morbidities, including hypertension, diabetes, osteoporosis/bone fractures, secondary infections, and increased cardiovascular mortality. While the majority (≈80%) of the corticotrophinomas visible on pituitary magnetic resonance imaging are microadenomas (MICs, <10 mm of diameter), some tumors are macroadenomas (MACs, ≥10 mm) with increased growth potential and invasiveness, exceptionally exhibiting malignant demeanor...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28368500/long-term-endocrine-outcomes-following-endoscopic-endonasal-transsphenoidal-surgery-for-acromegaly-and-associated-prognostic-factors
#16
Harish Babu, Alicia Ortega, Miriam Nuno, Aaron Dehghan, Aaron Schweitzer, H Vivien Bonert, John D Carmichael, Odelia Cooper, Shlomo Melmed, Adam N Mamelak
BACKGROUND: Long-term remission rates from endoscopic transsphenoidal surgery for acromegaly and their relationship to prognostic indicators of disease aggressiveness are not well documented. OBJECTIVE: To investigate long-term remission rates in patients with acromegaly after endoscopic transsphenoidal surgery, and correlate this with molecular and radiographic markers of disease aggressiveness. METHODS: We identified all patients undergoing endoscopic transsphenoidal surgery for acromegaly from 2005 to 2013 at Cedars-Sinai Pituitary Center...
March 29, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28326242/nasal-lobular-capillary-hemangioma-as-a-complication-after-an-endoscopic-transsphenoidal-gonadotrophin-producing-pituitary-adenoma-resection
#17
Dalila Forte, Amets Sagarribay Irañeta, Anabela Nabais, António Figueiredo, Manuela Mafra, Victor Gonçalves
Background Lobular capillary hemangioma is a rare benign tumor, most frequently located in the head or neck region, the nasal cavity being uncommonly affected. Its etiopathogenesis is not fully established, although traumatic and hormonal factors have been implied. Case Description A 50-year-old female patient underwent an uneventful endoscopic transsphenoidal removal of a pituitary cystic macroadenoma at our institution. Nasal packing was used in postoperative hemostasis. Histopathology was compatible with a gonadotrophin-producing adenoma...
January 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/28323955/rapid-onset-of-diabetic-ketoacidosis-after-sglt2-inhibition-in-a-patient-with-unrecognized-acromegaly
#18
Marino Quarella, Daniel Walser, Michael Brändle, Jean-Yves Fournier, Stefan Bilz
Context: Diabetic ketoacidosis has been described as a rare complication of acromegaly and may be observed in 1% of affected patients. The well-described direct lipolytic effect of growth hormone results in increased availability of free fatty acids (FFAs) for hepatic ketogenesis and is an important pathogenic event. More recently, ketoacidosis has been identified as an important complication of sodium-glucose-transport-protein 2 inhibitors (SGLT2i). Increased pancreatic glucagon secretion, impaired renal ketone body clearance, and an increase in FFA concentrations secondary to decreased insulin concentrations are likely precipitating factors...
May 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28321384/operative-strategies-to-minimize-complications-following-resection-of-pituitary-macroadenomas
#19
Jayesh P Thawani, Ashwin G Ramayya, Jared M Pisapia, Kalil G Abdullah, John Y-K Lee, M Sean Grady
Introduction We sought to identify factors associated with increased length of stay (LOS) and morbidity in patients undergoing resection of pituitary macroadenomas. Methods We reviewed records of 203 consecutive patients who underwent endoscopic endonasal resection of a pituitary macroadenoma (mean age = 55.7 [16-88]) years, volume = 11.3 (1.0-134.3) cm(3). Complete resection was possible in 60/29.6% patients. Mean follow-up was 575 days. Multivariate logistic regression was performed using MATLAB...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28301972/efficacy-of-transsphenoidal-surgery-in-achieving-biochemical-cure-of-growth-hormone-secreting-pituitary-adenomas-among-patients-with-cavernous-sinus-invasion-a-systematic-review-and-meta-analysis
#20
REVIEW
Vanessa Briceno, Hasan A Zaidi, Joanne A Doucette, Kaho B Onomichi, Amer Alreshidi, Rania A Mekary, Timothy R Smith
OBJECTIVES: Growth hormone-secreting pituitary adenomas in adults can result in severe craniofacial disfigurement and potentially fatal medical complications. Surgical resection leading to remission of the disease is dependent on complete surgical resection of the tumor. Lesions that invade the cavernous sinus may not be safely accessible via an endonasal transsphenoidal surgery (TSS), and the rates of biochemical remission of patients with residual disease vary widely in the literature...
May 2017: Neurological Research
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