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https://www.readbyqxmd.com/read/27920936/steroid-resistant-tolosa-hunt-syndrome-with-a-de-novo-intracavernous-aneurysm-a-case-report
#1
Hiroshi Takasuna, Rie Sasaki, Makoto Shiraishi, Masatomo Doi, Daisuke Wakui, Hidemichi Ito, Kotaro Oshio, Yuichiro Tanaka
BACKGROUND: We report a case of steroid-resistant Tolosa-Hunt syndrome (THS) with recurrent bilateral painful ophthalmoplegia, accompanied with sphenoid sinusitis, pituitary abscess, and an aneurysm arising from the cavernous portion of the internal carotid artery. CASE DESCRIPTION: A 53-year-old woman suffered severe left painful ophthalmoplegia. A magnetic resonance image (MRI) revealed thickness of the left cavernous sinus (CS). Steroid was administrated under the diagnosis of THS, and the symptom transiently diminished...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27920872/anterior-and-posterior-suprasellar-extensions-of-a-symmetrical-trilobed-nonfunctional-giant-pituitary-adenoma-in-the-sagittal-plane-a-case-report-and-review-of-literature
#2
Rushabh M Vakharia, Roman Kremen, Ajit Vakharia, Obed Adarkwah, Gordon Anderson
INTRODUCTION: To the best of our knowledge, the presence of a trilobed nonfunctional giant pituitary adenoma has never been described before in the literature. These tumors present unique diagnostic and therapeutic challenges. Tumors of this etiology can be managed with pharmacologic treatment or aggressive surgical intervention. The following case illustrates an unique visual presentation of a giant pituitary adenoma. CASE PRESENTATION: We report the case of a 40-year-old Hispanic man who presented with new onset seizures...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27910710/management-of-a-pregnant-woman-with-thyrotropinoma-a-case-report-and-review-of-the-literature
#3
Carolina M Perdomo, Jorge A Árabe, Miguel Á Idoate, Juan C Galofré
INTRODUCTION: Pituitary disorders during pregnancy are uncommon. The approach should include a close follow-up in order to reduce maternal and fetal risks associated with physiological changes during pregnancy or treatment side effects. MATERIALS AND METHODS: We report a 21-year-old woman with a thyroid-stimulating hormone-secreting pituitary macroadenoma and positive antithyroid antibodies. She was initially treated using transsphenoidal pituitary surgery. The patient relapsed 17-month post-surgery...
December 2, 2016: Gynecological Endocrinology
https://www.readbyqxmd.com/read/27903117/risk-factors-associated-with-the-surgical-management-of-craniopharyngiomas-in-pediatric-patients-analysis-of-1961-patients-from-a-national-registry-database
#4
Joshua Bakhsheshian, Diana L Jin, Ki-Eun Chang, Ben A Strickland, Dan A Donoho, Steven Cen, William J Mack, Frank Attenello, Eisha A Christian, Gabriel Zada
OBJECTIVE Patient demographic characteristics, hospital volume, and admission status have been shown to impact surgical outcomes of sellar region tumors in adults; however, the data available following the resection of craniopharyngiomas in the pediatric population remain limited. The authors sought to identify potential risk factors associated with outcomes following surgical management of pediatric craniopharyngiomas. METHODS The Nationwide Inpatient Sample database and Kids' Inpatient Database were analyzed to include admissions for pediatric patients (≤ 18 years) who underwent a transcranial or transsphenoidal craniotomy for resection of a craniopharyngioma...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27903115/aggressive-surgery-based-on-an-anatomical-subclassification-of-craniopharyngiomas
#5
Hiroki Morisako, Takeo Goto, Hiroyuki Goto, Christian Aisse Bohoun, Samantha Tamrakar, Kenji Ohata
OBJECTIVE Craniopharyngiomas remain a particularly formidable challenge in the neurosurgical field. Because these lesions involve the hypothalamus and ophthalmological systems, their resection is associated with either higher rates of mortality and recurrence or a lower rate of radical resection. The authors report the outcomes of aggressive surgeries based on an anatomical subclassification of craniopharyngiomas. METHODS Clinical and ophthalmological examinations, imaging studies, endocrinological studies, neuropsychological function, and surgical complications in all patients who had undergone microsurgical resection for craniopharyngioma at Osaka City University hospital between January 2000 and December 2014 were retrospectively reviewed through the medical records...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27903019/osteochondroma-presenting-as-a-calcified-mass-in-the-sellar-region-and-review-of-the-literature
#6
Kazuya Sekiguchi, Satoshi Tsutsumi, Sho Arai, Senshu Nonaka, Takamoto Suzuki, Hisato Ishii, Hiroshi Izumi, Yukimasa Yasumoto
Objective Osteochondroma (OC) is the most common benign bone neoplasm. It infrequently occurs in the cranial cavity as a calcified lesion and very rarely presents in the sellar region. The present study summarizes the knowledge about OCs of the sellar region. Methods We searched the literature search for the clinical appearance of OCs and other calcified pathologies occurring in the sellar region. Results A total of 21 English-language articles published from 1961 to 2015 documented cases of calcified lesions in the sellar region including cerebral aneurysm, chondroid chordoma, chondroma, craniopharyngioma, OC, odontome, osteoma, pituitary adenoma, pituitary stone, Rathke cleft cyst, retinoblastoma, schwannoma, and xanthogranuloma...
November 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27900232/vanishing-pituitary-macroadenoma-a-case-report
#7
Emily P Sieg, Hayk Stepanyan, Russell Payne, Tao Ouyang, Brad E Zacharia
Pituitary macroadenomas are the most common suprasellar lesions in adults and are typically managed surgically through transsphenoidal resection when symptomatic. Due to their close proximity to the optic chiasm, pituitary macroadenomas often present with signs of bitemporal hemianopsia. Alternatively, these tumors can cause mass effect, thus presenting with signs of elevated intracranial pressure or can present with signs and symptoms of endocrine dysfunction. Here, we discuss a 55-year-old male diagnosed with a non-functioning pituitary macroadenoma (NFPA) based on cranial imaging, ophthalmologic exam, and endocrine evaluation...
October 20, 2016: Curēus
https://www.readbyqxmd.com/read/27885957/visual-pathway-impairment-by-pituitary-adenomas-quantitative-diagnostics-by-diffusion-tensor-imaging
#8
Ylva Lilja, Oscar Gustafsson, Maria Ljungberg, Göran Starck, Bertil Lindblom, Thomas Skoglund, Henrik Bergquist, Karl-Erik Jakobsson, Daniel Nilsson
OBJECTIVE Despite ample experience in surgical treatment of pituitary adenomas, little is known about objective indices that may reveal risk of visual impairment caused by tumor growth that leads to compression of the anterior visual pathways. This study aimed to explore diffusion tensor imaging (DTI) as a means for objective assessment of injury to the anterior visual pathways caused by pituitary adenomas. METHODS Twenty-three patients with pituitary adenomas, scheduled for transsphenoidal tumor resection, and 20 healthy control subjects were included in the study...
November 25, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27875509/osseous-repair-in-minimally-invasive-reconstruction-of-anterior-skull-base-defects
#9
Vijay R Ramakrishnan, Adam M Terella, Seerat Poonia, Alexander G Chiu, James N Palmer
Management of anterior skull base defects is an area of continued innovation for skull base surgeons. Various grafting materials have been advocated for the repair of skull base defects depending on needs, availability, harvest site morbidity, and surgeon preference. Spontaneous bony closure of small skull defects is known to occur in animal models without bone grafts, but this phenomenon has been unexplored in the human skull base. The objective of this study was to evaluate osseous skull base closure in patients undergoing endoscopic repair of skull base defects...
November 21, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27872697/co-occurrence-of-pituitary-adenoma-with-suprasellar-and-olfactory-groove-meningiomas
#10
Kai-Zheong Lim, Tony Goldschlager, Ronil V Chandra, Jonathan Hall, Brent Uren, Michael Pullar
INTRODUCTION: The co-existence of pituitary adenoma and meningioma is extremely rare. It is even rarer in patients with no previous known risk factors for either tumour. Here, we present a case of synchronous non-functioning pituitary adenoma with suprasellar and olfactory groove meningiomas in a patient without previous irradiation. METHODS: The tumours were diagnosed on MRI in the 65-year-old patient who presented with patchy visual deficits. The decision was made to undergo surgery for resection of the suprasellar meningioma and the pituitary adenoma, leaving the small olfactory groove meningioma intact...
October 2016: Basic and Clinical Neuroscience
https://www.readbyqxmd.com/read/27857875/dual-endoscopic-endonasal-transsphenoidal-and-precaruncular-transorbital-approaches-for-clipping-of-the-cavernous-carotid-artery-a-cadaveric-simulation
#11
Jeremy Ciporen, Brandon Lucke-Wold, Aclan Dogan, Justin S Cetas, William E Cameron
Background Endoscopic skull base approaches are being used to address complicated neurovascular pathology. These approaches are safest when proximal vascular control of the cavernous carotid artery (CavCA) can be obtained. Methods We present a cadaver-based anatomic simulation study showing the feasibility of clip placement for the CavCA as it courses through the cavernous sinus. The arterial vessels were injected with red microfil (Flow Tech, Carver, Massachusetts) to enhance visibility. The endoscope was directed through a precaruncular transorbital approach and instrumentation was managed through an endonasal transsphenoidal approach...
December 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27857874/minimizing-septectomy-for-endoscopic-transsphenoidal-approaches-to-the-sellar-and-suprasellar-regions-a-cadaveric-morphometric-study
#12
Hermes G Garcia, Marc Otten, Marc Pyfer, Saurabh J Singhal, Alfred Marc Iloreta, Varun R Kshettry, Christopher J Farrell, Gurston Nyquist, Marc Rosen, James J Evans
The purpose of this study was to evaluate the effect of posterior septectomy size on surgical exposure and surgical freedom during the endoscopic transsphenoidal approach to the sella and parasellar region. Dissections were performed on 10 embalmed cadaver heads. Dissections started with wide bilateral sphenoidotomies, lateralization of middle turbinates, and a 5-mm posterior septectomy. The posterior septectomy was increased in 5-mm increments to a maximum of 35 mm, followed by bilateral middle turbinectomies...
December 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27857869/endoscopic-transmaxillary-transposition-of-temporalis-flap-for-recurrent-cerebrospinal-fluid-leak-closure
#13
Regi Thomas, Shabari Girishan, Ari George Chacko
Objective To describe the technique of endoscopic transmaxillary temporalis muscle flap transposition for the repair of a persistent postoperative sphenoidal cerebrospinal fluid leak. Design The repair of a recurrent cerebrospinal fluid leak for a patient who had undergone endoscopic transsphenoidal excision of an invasive silent corticotroph Hardy C and Knosp Grade IV pituitary adenoma was undertaken. The patient had completed postoperative radiotherapy for the residual tumor and presented with cerebrospinal fluid leak, 1 year later...
December 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27855233/a-macroprolactinoma-becoming-resistant-to-cabergoline-and-developing-atypical-pathology
#14
Emilia Sbardella, George Farah, Ahmed Fathelrahman, Simon Cudlip, Olaf Ansorge, Niki Karavitaki, Ashley B Grossman
: Pituitary adenomas are a common intracranial neoplasm, usually demonstrating a benign phenotype. They can be classified according to pathological, radiological or clinical behaviour as typical, atypical or carcinomas, invasive or noninvasive, and aggressive or nonaggressive. Prolactinomas account for 40-60% of all pituitary adenomas, with dopamine agonists representing the first-line treatment and surgery/radiotherapy reserved for drug intolerance/resistance or in neuro-ophthalmological emergencies...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27855229/late-presentation-of-acromegaly-in-medically-controlled-prolactinoma-patients
#15
Ekaterina Manuylova, Laura M Calvi, Catherine Hastings, G Edward Vates, Mahlon D Johnson, William T Cave, Ismat Shafiq
: Co-secretion of growth hormone (GH) and prolactin (PRL) from a single pituitary adenoma is common. In fact, up to 25% of patients with acromegaly may have PRL co-secretion. The prevalence of acromegaly among patients with a newly diagnosed prolactinoma is unknown. Given the possibility of mixed GH and PRL co-secretion, the current recommendation is to obtain an insulin-like growth factor-1 (IGF-1) in patients with prolactinoma at the initial diagnosis. Long-term follow-up of IGF-1 is not routinely done...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27847570/parasellar-extension-grades-and-surgical-extent-in-endoscopic-endonasal-transsphenoidal-surgery-for-pituitary-adenomas-a-single-surgeon-s-consecutive-series-with-the-aspects-of-reliability-and-clinical-validity
#16
Sang-Hyo Lee, Jae-Sung Park, Song Lee, Sung-Won Kim, Yong-Kil Hong
OBJECTIVE: The inter-rater reliability of the modified Knosp's classification was measured before the analysis. The clinical validity of the parasellar extension grading system was evaluated by investigating the extents of resection and complication rates among the grades in the endoscopic endonasal transsphenoidal surgery (EETS) for pituitary adenomas. METHODS: From November 2008 to August 2015, of the 286 patients who underwent EETS by the senior author, 208 were pituitary adenoma cases (146 non-functioning pituitary adenomas, 10 adrenocorticotropic hormone-secreting adenomas, 31 growth hormone-secreting adenomas, 17 prolactin-secreting adenomas, and 4 thyroid-stimulating hormone-secreting adenomas; 23 microadenomas, 174 macroadenomas, and 11 giant adenomas)...
November 2016: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/27846864/one-and-a-half-nostril-endoscopic-transsphenoidal-approach-for-pituitary-adenomas-a-technical-report
#17
Guodao Wen, Chao Tang, Chunyu Zhong, Junyang Li, Zixiang Cong, Yuan Zhou, Kaidong Liu, Yong Zhang, Mamatemin Tohti, Chiyuan Ma
BACKGROUND: Binostril endoscopic transsphenoidal approach (BETA) provides sufficient manipulation space and wide endoscopic vision, although it increases the trauma of nose. Mononostril endoscopic transsphenoidal approach (META) has minimal trauma of nose, at the expense of space within the operation. We describe a one-and-a-half nostril endoscopic transsphenoidal approach (OETA) that combines the advantages of BETA and META. METHODS: We introduced OETA for pituitary adenomas with a detailed technical description...
November 15, 2016: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27828691/long-term-complete-remission-of-crooke-s-corticotropinoma-after-temozolomide-treatment
#18
Maria Kurowska, Jerzy S Tarach, Joanna Malicka, Grzegorz Zieliński, Maria Maksymowicz, Piotr Denew
INTRODUCTION: Crooke's corticotropinomas are the unique cause of Cushing's disease. The majority of them are aggressive macroadenomas, refractory to conventional therapy, with a high recurrence rate. The aim of the study was the presentation, in relation to data from the literature, of a case of a patient with ACTH-dependent Cushing's syndrome caused by recurrent Crooke's cells corticotropinoma, who achieved 33-month complete remission after treatment with temozolomide (TMZ). CASE REPORT: A 54-year-old man was diagnosed with Cushing's disease five years earlier on the basis of a typical clinical picture and hormonal tests...
2016: Endokrynologia Polska
https://www.readbyqxmd.com/read/27824399/p27-cdkn1b-translational-regulators-in-pituitary-tumorigenesis
#19
C S Martins, R C Camargo, F P Saggioro, L Neder, H R Machado, A C Moreira, M de Castro
In pituitary tumors, P27(CDKN1B) is underexpressed. We aimed to clarify whether translational regulation underlies this phenomenon. This study evaluated the expression of P27/CDKN1B, its targets (CCNE1, CDK2) and translational regulators (DKC1, RPS13, miR221, miR222) and screened for DKC1 variants in sporadic pituitary adenomas. Samples were obtained during transsphenoidal surgery from 48 patients with pituitary adenomas: 10 ACTH-, 17 GH-secreting, and 21 nonfunctioning (NFPA). The control group comprised 7 normal pituitaries (NP) obtained during autopsies...
December 2016: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/27812603/transsphenoidal-pituitary-surgery-by-microscopic-or-endoscopic-approach-the-still-unsolved-question-of-superiority
#20
EDITORIAL
Eduardo de Arnaldo S Vellutini
No abstract text is available yet for this article.
October 2016: Archives of Endocrinology and Metabolism
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