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Endocrinology, pituitary adenoma, diabetes,

Jens Conrad, Ali Ayyad, Christian Wüster, Wael Omran, Matthias M Weber, Moritz A Konerding, Wibke Müller-Forell, Alf Giese, Joachim Oertel
OBJECTIVE Over the past 2 decades, endoscopy has become an integral part of the surgical repertoire for skull base procedures. The present clinical evaluation and cadaver study compare binostril and mononostril endoscopic transnasal approaches and the surgical techniques involved. METHODS Forty patients with pituitary adenomas were treated with either binostril or mononostril endoscopic surgery. Neurosurgical, endocrinological, ophthalmological, and neuroradiological examinations were performed. Ten cadaver specimens were prepared, and surgical aspects of the preparation and neuroradiological examination were documented...
August 2016: Journal of Neurosurgery
Kevan C Herold, Joseph A Majzoub, Shlomo Melmed, Merri Pendergrass, Martin Schlumberger
The inaugural issue of this journal, published in November 2005, included articles on thyroid cancer, type 2 diabetes mellitus, the metabolic syndrome, pituitary adenomas and obesity. 10 years later, we are still publishing articles on these topics (and many others). Although a great deal of progress has been made in our understanding of the pathogenesis, diagnosis and treatment of diseases of the endocrine system over the past 10 years, many challenges still remain. For this Viewpoint, we have asked five of our Advisory Board Members to comment on the progress and challenges from the past 10 years...
November 2015: Nature Reviews. Endocrinology
Rucai Zhan, Guangming Xu, Timothy M Wiebe, Xingang Li
OBJECTIVE: To evaluate the safety and effectiveness of the endoscopic endonasal transsphenoidal approach (EETA) for the management of pituitary adenomas in paediatric patients >10 years of age. METHODS: A retrospective chart review was performed to identify 56 paediatric patients between 10 and 18 years of age who underwent an endonasal endoscopic transsphenoidal approach for the resection of a pituitary adenoma during the last 5 years. The age, sex, symptoms, tumour size, extent of tumour resection, clinical outcome and surgical complications of patients were reviewed...
August 2015: Archives of Disease in Childhood
Yanyang Zhang, Bainan Xu, Jinli Jiang, Shiyu Feng, Bo Bu, Tao Zhou, Xinguang Yu, Dingbiao Zhou
OBJECTIVE: To explore the techniques and efficacies of surgical resection of giant sellar region tumors via anterior interhemispheric approach. METHODS: A series of 110 consecutive cases of giant sellar region tumors undergoing microsurgery through an anterior interhemispheric approach at our hospital were retrospectively analyzed. Their mean age was 35.6 (3-72) years. There were craniopharyngioma (n = 57), pituitary adenoma (n = 33), hypothalamic glioma (n = 5), meningioma (n = 4) and other lesions (n = 11)...
December 23, 2014: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Veronica Preda, Márta Korbonits, Simon Cudlip, Niki Karavitaki, Ashley B Grossman
AIM: To study the prevalence of germline mutations of the aryl-hydrocarbon receptor interacting protein (AIP) gene in a large cohort of patients seen in the Oxford Centre for Diabetes Endocrinology and Metabolism (OCDEM), UK, with apparently sporadic pituitary adenomas, who were either diagnosed or had relevant clinical manifestations by the age of 40 years. PATIENTS: We prospectively investigated all patients who were seen at Oxford University Hospital, OCDEM, and a tertiary referral centre, between 2012 and 2013, and presented with pituitary tumours under the age of 40 years and with no family history: a total of 127 patients were enrolled in the study...
November 2014: European Journal of Endocrinology
Guadalupe Vargas, Baldomero Gonzalez, Gerardo Guinto, Victoria Mendoza, Blas López-Félix, Erick Zepeda, Moisés Mercado
OBJECTIVE: Pituitary apoplexy (PA) is an endocrinologic emergency characterized by headache, visual abnormalities, and hemodynamic instability in the context of hemorragic infarction of a pituitary adenoma. Our goal was to estimate the incidence, precipitating factors, clinical characteristics, and outcome of PA in a cohort of patients with nonfunctioning pituitary macroadenomas (NFPMAs). METHODS: A retrospective, case-control study of 46 patients with PA and 47 controls matched for age, gender, and tumor invasiveness...
December 2014: Endocrine Practice
Caroline Unsinn, Marian Christoph Neidert, Jan-Karl Burkhardt, David Holzmann, Michael Grotzer, Oliver Bozinov
OBJECTIVE: To evaluate clinical outcome in a 10-year consecutive series of children operated for sellar and parasellar tumors with special focus on neuropsychology and endocrinology. PATIENTS AND METHODS: We analyzed 61 children (30 female) under 18 years of age (mean age 9.9, range 1 month-17 years) operated between 2000 and 2010. Medical records were evaluated retrospectively; postoperative histologic diagnoses included 20 craniopharyngiomas, 17 gliomas, 6 pituitary adenomas and 18 rare tumor entities...
August 2014: Clinical Neurology and Neurosurgery
Cheng Huan, Tao Han, Ying Ju, Yuan-Ming Qu
OBJECTIVE: To evaluate the characteristics of pituitary adenomas that produce both prolactin and adrenocorticotropin. METHODS: Between 2002 and 2011, we reviewed the data of 336 patients undergoing transsphenoidal surgery at Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China. Patients were divided into 2 subgroups: patients with mixed prolactin and adrenocorticotropin secreting adenomas, and patients with merely prolactin-secreting adenomas...
March 2014: Saudi Medical Journal
Shunji Yunoue, Hiroshi Tokimura, Atsushi Tominaga, Shingo Fujio, Prasanna Karki, Satoshi Usui, Yasuyuki Kinoshita, Mika Habu, F M Moinuddin, Hirofumi Hirano, Kazunori Arita
To know the clinical characteristics of pituitary adenomas in the elderly patients aged 80 years or older who were surgically treated. From 1995 through 2012, 907 patients underwent surgery for the pituitary adenomas at Kagoshima- and Hiroshima University hospitals in Japan. Ten (1.1%) patients were aged 80 years or older. We retrospectively assessed the clinical characteristics including preoperative comorbidities, manifestations, neuroimaging findings, and endocrinologic features of these ten patients. The subjects included eight males and two females...
April 2014: Neurosurgical Review
Kostas I Lampropoulos, George Samonis, Panagiotis Nomikos
OBJECTIVE: Evaluation of factors influencing the outcome of microsurgical transsphenoidal surgery in patients harbouring pituitary adenomas as well as of the efficacy and safety of this procedure. DESIGN: A total of 184 consecutive patients with pituitary adenomas, undergoing microsurgical transsphenoidal resection of their lesions from March 2004 to June 2011, were prospectively studied. Extent of tumour resection and disease remission were defined according to recently established radiological and hormonal consensus criteria...
April 2013: Hormones: International Journal of Endocrinology and Metabolism
Toshiro Seki, Atsushi Yasuda, Takayuki Yamaoka, Jin Imai, Kazuko Ito, Hideki Ozawa, Masafumi Fukagawa, Chizuko Okamatsu, Naoya Nakamura, Hideki Atsumi, Mitsunori Matsumae, Atsushi Takagi
Lymphocytic hypophysitis (LYH) is a chronic inflammation that primarily affects the pituitary gland. This disorder has recently been classified into lymphocytic adenohypophysitis (LAH), lymphocytic infundibulo-neurohypophysitis (LINH), and lymphocytic infundibulo-panhypophysitis (LIPH) according to the affected area. We report a case of LINH in a 68-year-old woman who presented with diabetes insipidus (DI). In this case, the posterior lobe was affected in both endocrinological assessment and magnetic resonance imaging (MRI) findings...
December 2012: Tokai Journal of Experimental and Clinical Medicine
Ali R Bokhari, Mark A Davies, Terrence Diamond
Endoscopic transsphenoidal surgery for pituitary adenomas has been introduced as an alternative to transsphenoidal microsurgery. This is the first Australian study to evaluate a single surgeon's experience by comparing our results with other series and attempting to identify a learning curve. Retrospective analysis was carried out on 79 consecutively treated patients by fully endoscopic transsphenoidal surgery by a single neurosurgeon over a period spanning from July 1998 to September 2010 at St George Public and Private hospitals...
February 2013: British Journal of Neurosurgery
M Locatelli, G Bertani, G Carrabba, P Rampini, M Zavanone, M Caroli, E Sala, E Ferrante, S M Gaini, A Spada, G Mantovani, A Lania
In western countries, the process of "ageing of the population" is increasingly forcing clinical medicine to find answers for pathologies affecting the elder segments of our community. In this respect, pituitary adenomas often raise difficult questions on surgical indications, since little is known about postoperative morbidity and mortality in elderly patients. The transsphenoidal endonasal approach (TNS), which is considered the gold standard for surgical resection of the majority of functioning and non-functioning pituitary adenomas, is supposed to be a low morbidity and mortality procedure in adult patients...
June 2013: Pituitary
Matteo Zoli, Diego Mazzatenta, Marco Faustini-Fustini, Ernesto Pasquini, Giorgio Frank
OBJECTIVE: To evaluate the clinical and radiographic manifestations of pituitary metastases (PM), discuss the role of surgery, and briefly review the pertinent literature. METHODS: At a single institution between January 1992 and July 2011, 15 patients with PM were surgically treated (all cases were confirmed by histologic analysis). Of patients, 14 complained of visual impairment, 8 complained of headache, 4 complained of ophthalmoplegia, and 11 complained of endocrine disturbances manifesting as diabetes insipidus (7 patients) and anterior hypopituitarism (4 patients)...
February 2013: World Neurosurgery
Xian-Ling Wang, Jing-Tao Dou, Zhao-Hui Lü, Wen-Wen Zhong, Jian-Ming Ba, Du Jin, Ju-Ming Lu, Chang-Yu Pan, Yi-Ming Mu
BACKGROUND: Subclinical apoplexy of pituitary functional adenoma can cause spontaneous remission of hormone hypersecretion. The typical presence of pituitary growth hormone (GH) adenoma is gigantism and/or acromegaly. We investigated the clinical characteristics of patients with spontaneous partial remission of acromegaly or gigantism due to subclinical apoplexy of GH adenoma. METHODS: Six patients with spontaneous remission of acromegaly or gigantism were enrolled...
November 2011: Chinese Medical Journal
Sven Berkmann, Javier Fandino, Beat Müller, Luca Remonda, Hans Landolt
BACKGROUND: Transsphenoidal surgery guided by intraoperative MRI (iMRI) is related to higher rates of tumour resection. The influence of iMRI on endocrinological outcome is still unclear. This study evaluates the endocrinological outcome of iMRI-guided transsphenoidal surgery. METHODS: A series of 60 patients operated by iMRI-guidance for inactive adenomas were matched to a previous series of 32 controls. The following factors were used for matching: gender; age; tumour volume; Hardy's grade; pituitary function; pituitary stalk configuration; stalk effect hyperprolactinemia; arterial hypertension; diabetes mellitus; smoking...
April 2012: Acta Neurochirurgica
Mustafa Berker, Derya Burcu Hazer, Taşkın Yücel, Alper Gürlek, Ayşenur Cila, Mustafa Aldur, Metin Onerci
Endoscopic transsphenoidal surgery is emerging as a minimally invasive and maximally effective procedure for pituitary adenomas. In this report we analyzed the complications in 624 procedures of endonasal transsphenoidal endoscopic surgery in the treatment of 570 patients with pituitary adenomas. The leading author (MB) operated pituitary adenomas via pure endoscopic endonasal transsphenoidal surgery between January 2006 and August 2011 at the Hacettepe University, Department of Neurosurgery in Ankara. Complications were assessed in 624 surgical procedures under five groups; rhinological, CSF leaks, infection, vascular and endocrinologic complications...
September 2012: Pituitary
Osamah J Choudhry, Asad J Choudhry, Elkin A Nunez, Jean Anderson Eloy, William T Couldwell, Ivan S Ciric, James K Liu
Pituitary apoplexy in patients with adrenocorticotropic hormone (ACTH) producing tumors is a rare occurrence. We report four patients with Cushing's disease harboring ACTH-secreting macroadenomas who presented with pituitary apoplexy. We report the endocrinologic and visual outcomes of these patients after emergent transsphenoidal surgery. A retrospective chart review was performed in 4 patients who presented with pituitary apoplexy from hemorrhage into an ACTH-secreting pituitary adenoma. The patient charts were reviewed for clinical presentation, neuroimaging findings, intraoperative surgical findings, pathologic findings, and postoperative endocrinologic and visual outcomes...
September 2012: Pituitary
Mark J Bolland, Ian M Holdaway, Juliet E Berkeley, Sarina Lim, Will J Dransfield, John V Conaglen, Michael S Croxson, Greg D Gamble, Penny J Hunt, Robyn J Toomath
OBJECTIVE: Untreated Cushing's syndrome (CS) is associated with significant morbidity and mortality. However, recent operative series suggest low morbidity and mortality for CS, whereas population-based surveys report elevated mortality rates. We investigated the mortality and morbidity of CS in New Zealand. DESIGN: A nationwide retrospective survey of patients with CS between 1960 and 2005 managed at the four main endocrinology services. PATIENTS: A total of 253 patients with CS were identified, excluding adrenal carcinoma and malignant ectopic CS...
October 2011: Clinical Endocrinology
Gilberto Ka Kit Leung, Hing Yu Law, Kwun Ngai Hung, Yiu Wah Fan, Wai Man Lui
BACKGROUND: While large-to-giant pituitary adenomas (PAs) may be safely removed by experienced surgeons through a single route, the procedure is technically challenging. We present the outcome of a simultaneous combined transcranial and transsphenoidal approach and discuss its applications. METHODS: A retrospective review was conducted on 12 consecutive patients. Surgical complications, visual and endocrinological functions, and tumour control were reviewed. RESULTS: There were four men and eight women, with a mean age of 47...
July 2011: Acta Neurochirurgica
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