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Pituitary macroadenoma

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https://www.readbyqxmd.com/read/28919622/incidence-of-diabetes-insipidus-in-postoperative-period-among-the-patients-undergoing-pituitary-tumour-surgery
#1
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/28912338/duration-of-post-operative-hypocortisolism-predicts-sustained-remission-after-pituitary-surgery-for-cushing-s-disease
#2
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
#3
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
#4
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
#5
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/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
#6
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
#7
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
#8
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
#9
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
#10
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/28759937/prevalence-clinical-features-and-natural-history-of-incidental-clinically-non-functioning-pituitary-adenomas
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/28669359/radiological-growth-patterns-of-prolactinomas-and-nonfunctioning-adenomas
#15
Syed Ali Imran, Jai Shankar, Andrea L O Hebb, Sidney E Croul, David B Clarke
OBJECTIVES: To compare growth patterns of nonfunctioning and prolactin-producing pituitary macroadenomas, and to find whether their specific growth patterns are associated with clinically significant effects on vision. MATERIALS AND METHODS: From our comprehensive provincial neuropituitary registry, we retrospectively identified 35 randomly selected patients each with nonfunctioning adenomas and prolactinomas >10 mm in any dimension. MRI scans were analyzed to determine the superior and inferior growth, volume, and maximum craniocaudal height of the adenomas...
September 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28667391/-tumors-of-the-sellar-region
#16
REVIEW
J M Lieb, F J Ahlhelm
METHODICAL ISSUE: The anatomy of the sellar region is complex and tumors of the sellar region are very variable because they arise from the many different tissue types in the sellar region, ranging from benign to life-threatening. Despite this variety, approximately 80% of sellar region tumors are due to the 5 most common lesions: adenomas, meningiomas, aneurysms, astrocytomas and craniopharyngiomas. STANDARD RADIOLOGICAL METHODS: In addition to clinical and laboratory results, the magnetic resonance imaging (MRI) and computed tomography (CT) results including the exact anatomical position and the proliferation pattern of the lesion are decisive for the diagnosis...
June 30, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28626987/prolactinomas-diagnosed-in-the-postmenopausal-period-clinical-phenotype-and-outcomes
#17
Sandhya Santharam, Metaxia Tampourlou, Wiebke Arlt, John Ayuk, Neil Gittoes, Andrew Toogood, Rachel Webster, Niki Karavitaki
OBJECTIVE: Most prolactinomas in females are diagnosed during the reproductive age, and the majority are microadenomas. Prolactinomas detected in the postmenopausal period are less common with limited published data on their presentation and prognosis. Our objective was to assess the presenting clinical, biochemical and imaging findings, as well as the outcomes of women diagnosed with a prolactinoma in the postmenopausal period. DESIGN AND METHODS: We undertook a retrospective cohort study of women diagnosed with prolactinoma after menopause and followed up in a large UK pituitary centre...
June 19, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28611948/van-wyk-grumbach-syndrome-with-kocher-debr%C3%A3-s%C3%A3-m%C3%A3-laigne-syndrome-case-report-of-a-rare-association
#18
Syed Mohd Razi, Abhinav Kumar Gupta, Deepak Chand Gupta, Manish Gutch, Keshav Kumar Gupta, Syeda Iqra Usman
BACKGROUND: Van Wyk-Grumbach syndrome (VWGS) is a rare presentation of juvenile hypothyroidism which manifests in females as chronic autoimmune hypothyroidism, isosexual pseudoprecocious puberty, and multicystic ovaries. It uniquely presents with short stature and delayed bone age unlike other causes of precocious puberty. Kocher-Debré-Sémélaigne (KDSS) is a rare presentation of juvenile hypothyroidism manifesting as calf muscle pseudohypertrophy, delayed contraction and relaxation of reflexes, and percussion myxedema...
February 2017: European Thyroid Journal
https://www.readbyqxmd.com/read/28603683/cavernous-sinus-involvement-by-pituitary-adenomas-clinical-implications-and-outcomes-of-endoscopic-endonasal-resection
#19
Abdulrazag Ajlan, Achal S Achrol, Abdulrahman Albakr, Abdullah H Feroze, Erick M Westbroek, Peter Hwang, Griffith R Harsh
Background  Parasellar invasion of pituitary adenomas (PAs) into the cavernous sinus (CS) is common. The management of the CS component of PA remains controversial. Objective  The objective of this study was to analyze CS involvement in PA treated with endoscopic endonasal approaches, including incidence, surgical risks, surgical strategies, long-term outcomes, and our treatment algorithm. Methods  We reviewed a series of 176 surgically treated PA with particular attention to CS involvement and whether the CS tumor was approached medial or lateral to the internal carotid artery...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28601571/intrasellar-dermoid-cyst-mimicking-pituitary-apoplexy-a-case-report-and-review-of-the-literature
#20
Yuan-Bo Pan, Zhao-Liang Sun, Dong-Fu Feng
Intrasellar dermoid cysts are extremely unusual lesions, with only four cases reported to date, and have not been previously reported in association with sudden-onset symptoms. Here, we present the case of an intrasellar dermoid cyst with sudden-onset symptoms mimicking pituitary apoplexy in an elderly woman. A 69year-old woman presented with sudden onset of headache, dizziness, and decreased visual acuity. Magnetic resonance imaging of the sellar region showed an intrasellar lesion, which showed mixed hyper- and hypointense signal on T1-weighted and T2-weighted images and enhanced peripherally...
June 7, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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