Primary pituitary abscess: case report and suggested management algorithm

Author(s):  
Maria João Machado ◽  
Rui Ramos ◽  
Hugo Pereira ◽  
Mariana Marques Barbosa ◽  
Cristiano Antunes ◽  
...  
Author(s):  
Marie-Laure Legris ◽  
Victor Gabriele ◽  
Aline Host ◽  
Chérif Akladios ◽  
Olivier Garbin ◽  
...  

Author(s):  
Brent D. Bauman ◽  
Maria Evasovich ◽  
Amanda Louiselle ◽  
Eugene Zheng ◽  
Kevin Goodwin ◽  
...  

AbstractBackground:Hyperparathyroidism (HPT) is a rare disease in the pediatric population, and optimal management may be unclear if it is due to an occult parathyroid adenoma. We present a case report of a pediatric patient with an occult, ectopic, supernumerary, parathyroid adenoma.Case presentation:A 13-year-old female who initially presented with anxiety was diagnosed with HPT. Preoperative imaging and bilateral neck exploration with four-gland biopsy were negative for any parathyroid adenoma. Postoperative MRI identified a thymic mass. She subsequently underwent video-assisted thoracoscopic thymectomy with resection of an intrathymic parathyroid adenoma.Conclusions:The diagnosis of pediatric HPT is increasing. Supernumerary or occult parathyroid adenomas are rare and add complexity to presurgical planning and management. Our case represents the rare occurrence of a pediatric ectopic supernumerary occult parathyroid adenoma treated with a two-stage approach utilizing multiple imaging studies. We provide a review of the pathology and propose an algorithmic approach to manage these complex patients.


1996 ◽  
Vol 18 (6) ◽  
pp. 495-498 ◽  
Author(s):  
Masanori Kabuto ◽  
Toshihiko Kubota ◽  
Hidenori Kobayashi ◽  
Hiroaki Takeuchi ◽  
Tetsuya Kubota ◽  
...  

2021 ◽  
Vol 3 (1) ◽  
pp. 22-25
Author(s):  
Adekunle Olowu ◽  
Adel Abbas Alzehairy

Adrenal cysts are rare lesions that could be epithelial, endothelial, parasitic or haemorrhagic[1], as well as pseudocysts. Haemorrhagic adrenal cysts are extremely rare and are often asymptomatic, so diagnosis can be really challenging. This can prove really difficult for primary care physicians who are often the frontline clinicians these patients tend to present to. They are usually benign lesions and do not often cause mortality if detected early and prompt surgery is done, as was the case with the patient in our case report[4]. When they do become symptomatic, they can present with different systemic symptoms as documented in literature, including in our case report[2,4]. Diagnosis is usually through Ultrasound and CT Scan and management is largely laparoscopic or open excision depending on the size of the lesion, surgical expertise and local protocol. Most patients make full recovery and mortality is extremely low [3]. The aim of this review is to provide a broader overview of the subject, highlight salient points in several studies relating to haemorrhagic cysts, provide an up to date follow up information on the index patient in our case report and to explore possible areas for future study [4,6]. This review also includes a suggested management algorithm and intends to emphasize the fact that patients who present in primary, urgent or emergency care settings with persistent non-specific symptoms should be investigated for rare diseases.


Neurosurgery ◽  
2010 ◽  
Vol 67 (6) ◽  
pp. E1831-E1844 ◽  
Author(s):  
Justin M Brown ◽  
Andrew Yee ◽  
Renee A Ivens ◽  
William Dribben ◽  
Susan E Mackinnon

Abstract BACKGROUND: Approximately 5% of cervical decompression cases are complicated by postoperative weakness. Parsonage-Turner syndrome (PTS) or neuralgic amyotrophy is known to be precipitated by surgery and unrelated to technical or structural issues. Our practice has seen a number of cases of PTS after cervical decompression surgery. In this case report, we discuss a series of such patients, highlighting the commonalities with the more frequently diagnosed C5 palsy. We conclude with our management algorithm. CLINICAL PRESENTATION: Six patients with post-cervical decompression PTS were referred to our institution during a 32-month period. All patients were examined physically, radiographically, and electromyographically and were followed for up to 2 years or until symptoms resolved. Conservative management was the rule, and surgical intervention, including nerve releases and nerve reconstruction, was undertaken in select circumstances. In the majority of patients (4 of 6 patients), pain management and physical therapy alone were used and achieved eventual resolution of pain and recovery of motor strength. The other 2 patients required adjunctive surgical procedures to maximize their outcomes. CONCLUSION: PTS accounts for a subset of patients experiencing postoperative weakness after cervical decompression operations. Although it is at times difficult to arrive at this diagnosis, an understanding of the history of PTS, among other causes of postoperative weakness, allows a structured approach to these patients. An evidence-based approach to management helps provide the best outcome for a given patient.


2014 ◽  
Author(s):  
Dashty Husein ◽  
Kendrin Staels ◽  
Frank Dewaele ◽  
Dominique Ballaux ◽  
Guy T'Sjoen

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
David B. Carroll ◽  
Conrad Myler ◽  
Natthapol Songdej ◽  
Khaled Sedeek ◽  
Dmitri Bezinover

Factor XIII (FXIII) deficiency is a rare coagulation defect that can be associated with significant bleeding. A 28-year-old pregnant woman, with a history of hemorrhagic stroke secondary to severe congenital FXIII deficiency, presented in active labor requesting an epidural. Factor XIII levels had been monitored throughout her pregnancy and treated with intermittent factor XIII infusions to maintain factor levels above 30% of normal. After careful multidisciplinary peripartum evaluation and FXIII replacement, neuraxial analgesia was performed without complication. Neuraxial analgesia can be performed without complication in patients with FXIII deficiency if FXIII levels are carefully managed and no other coagulopathy exists.


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