Pituitary infundibular epidermoid cyst: a rare cause of hypopituitarism

2021 ◽  
Vol 14 (3) ◽  
pp. e241065
Author(s):  
Sajjad Ahmad ◽  
Ashutosh Surya ◽  
Caroline Hayhurst ◽  
Stephen Davies
Keyword(s):  
Weight Loss ◽  
Epidermoid Cyst ◽  
Cystic Lesion ◽  
Visual Fields ◽  
Adrenal Crisis ◽  
Rapid Enlargement ◽  
History Of ◽  
Low Cortisol ◽  
Suprasellar Extension

A 53-year-old man presented with 6 months history of weight loss associated with nausea, fatigue, dizziness and headache. On arrival he was in adrenal crisis. Biochemistry revealed anterior hypopituitarism with low cortisol, thyroxine, testosterone and a slightly raised prolactin. He was commenced on steroids, thyroxine and testosterone. MRI pituitary gland was reported to have a 9.4 mm microadenoma. Cabergoline was started for a possible microprolactinoma. Follow-up MRI showed increase in the size of complex cystic lesion causing chiasmal compression raising a possibility of craniopharyngioma. Visual fields assessment was normal. In view of the rapid enlargement, to protect vision and obtain a tissue diagnosis he underwent endoscopic trans-sphenoidal surgery. A cystic lesion was noted intraoperatively originating from pituitary stalk with intrasellar and suprasellar extension. It was filled with white caseous material and fluid. Histology revealed epidermoid cyst. His headache resolved postoperatively.

scholarly journals Disseminated Tuberculosis Causing Addison’s Disease in an Adult Diabetic Patient

2016 ◽  
Vol 33 (1) ◽  
pp. 44-47
Author(s):  
Nazmul Kabir Qureshi ◽  
Zafar Ahmed Latif
Keyword(s):  
Weight Loss ◽  
Past History ◽  
Gastrointestinal Symptoms ◽  
Adrenal Crisis ◽  
Endocrine Glands ◽  
Acth Stimulation Test ◽  
Acth Stimulation ◽  
The Face ◽  
History Of ◽  
Low Cortisol

Tuberculosis may affect many of the endocrine glands including the hypothalamus, pituitary, thyroid with adrenal gland being the commonest. We describe a patient presented with recurrent spontaneous hypoglycemia, hypotension, fever, weight loss and cough. Along with this clinical picture, high ACTH in the face of low cortisol was compatible with diagnosis of Addison’s disease. Rapid ACTH stimulation test affirmed the diagnosis. Disseminated TB affecting adrenal glands was supported by CXR, USG, CT Abdomen and FNAC. Adrenal Crisis was led by add-on bacterial pneumonia. Patient made good recovery with treatment for adrenal crisis and subsequently with standard antitubercular regimen and steroid replacement therapy. Tuberculosis, although uncommon but potentially devastating cause of adrenal failure, merits consideration when fever, weight loss, gastrointestinal symptoms, hyponatremia, hyperkalemia are observed in patients with features of active tuberculosis or past history of tuberculosisJ Bangladesh Coll Phys Surg 2015; 33(1): 44-47

A rare case of Dirofilaria repens infection

2013 ◽  
Vol 127 (6) ◽  
pp. 607-609 ◽  
Author(s):  
C C Chan ◽  
M S Kermanshahi ◽  
B Mathew ◽  
R J England
Keyword(s):  
Weight Loss ◽  
Case Report ◽  
Rare Case ◽  
Cystic Lesion ◽  
Neck Region ◽  
Dirofilaria Repens ◽  
Ultrasound Scan ◽  
Neck Swelling ◽  
History Of

AbstractObjective:This paper reports a case of Dirofilaria repens infection in a patient who presented with an anterolateral neck swelling. Dirofilaria repens infection of the neck region is rare even in countries where dirofilarial infestation is endemic. The diagnosis is made by identifying the worm in surgical or pathological specimens.Case report:A 47-year-old man presented with an 8-week history of non-tender, right-sided, lower anterolateral neck swelling and weight loss. An ultrasound scan showed a cystic lesion containing a living worm. The cyst was excised and the patient showed full recovery at follow up.Conclusion:To our knowledge, there has been no previous report of an anterolateral neck swelling secondary to Dirofilaria repens infection in Europe. Our case is unusual because of the rarity of Dirofilaria repens presenting as a neck swelling.

scholarly journals Beyond Sector Retinitis Pigmentosa: Expanding the Phenotype and Natural History of the Rhodopsin Gene Codon 106 Mutation (Gly-to-Arg) in Autosomal Dominant Retinitis Pigmentosa

Genes ◽  
2021 ◽  
Vol 12 (12) ◽  
pp. 1853
Author(s):  
Brian G. Ballios ◽  
Emily M. Place ◽  
Luis Martinez-Velazquez ◽  
Eric A. Pierce ◽  
Jason I. Comander ◽  
...  
Keyword(s):  
Retinitis Pigmentosa ◽  
Autosomal Dominant ◽  
Peripheral Vision ◽  
Visual Fields ◽  
Macular Disease ◽  
History Of ◽  
Intrafamilial Variability ◽  
Long Term Prognosis

Sector and pericentral are two rare, regional forms of retinitis pigmentosa (RP). While usually defined as stable or only very slowly progressing, the available literature to support this claim is limited. Additionally, few studies have analyzed the spectrum of disease within a particular genotype. We identified all cases (9 patients) with an autosomal dominant Rhodopsin variant previously associated with sector RP (RHO c.316G > A, p.Gly106Arg) at our institution. Clinical histories were reviewed, and testing included visual fields, multimodal imaging, and electroretinography. Patients demonstrated a broad phenotypic spectrum that spanned regional phenotypes from sector-like to pericentral RP, as well as generalized disease. We also present evidence of significant intrafamilial variability in regional phenotypes. Finally, we present the longest-reported follow-up for a patient with RHO-associated sector-like RP, showing progression from sectoral to pericentral disease over three decades. In the absence of comorbid macular disease, the long-term prognosis for central visual acuity is good. However, we found that significant progression of RHO p.Gly106Arg disease can occur over protracted periods, with impact on peripheral vision. Longitudinal widefield imaging and periodic ERG reassessment are likely to aid in monitoring disease progression.

scholarly journals SUN-939 Case Report: Malignant Pheochromocytoma

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jose Viana Lima ◽  
Rosa Paula Mello Biscolla ◽  
Maria Izabel Chiamolera ◽  
Marco Antonio Conde Oliveira
Keyword(s):  
Weight Loss ◽  
Case Report ◽  
Chromogranin A ◽  
Scoring Systems ◽  
Lytic Lesion ◽  
Sdhb Mutation ◽  
Adrenal Pheochromocytoma ◽  
History Of ◽  
Abdominal Lesion

Abstract Introduction: The concept of malignancy for pheochromocytoma is complex and the best definition is the presence of metastases, according to WHO. Anatomopathological scoring systems are not effective in predicting metastases. Malignancy should be considered when tumors larger than 8cm (> 80g), paragangliomas (especially retroperitoneal), dopamine / methoxythyramine increase, Ki67> 6% and SDHB mutation. At 5 years, survival ranges from 50-69%. Metastases may appear 20-40 years after initial treatment of pheochromocytoma. We describe a case that metastasis was identified 33 years after pheochromocytoma excision Case report: A 57-year-old female patient with a postoperative history of 33 years of right adrenal pheochromocytoma was discharged from the endocrinologist after 10 years of follow-up. At diagnosis 33 years ago, she had symptoms of hypertension with paroxysms and weight loss that disappeared after tumor removal. 2 years investigating weight loss with general practitioner without another celebratory. On physical examination, orthostatic hypotension was highlighted. Plasma methanephrine 0.8 nmol / L (VR <0.5) and plasma normetanephrine 1.8 nmol / L (VR <0.9), chromogranin A 5.7 nmol / L (VR <3 nmol / L) and clonidine test with 36.6% suppression of metanephrines, suggesting tumor recurrence. MRI localized recurrence of the adrenals and MIBG scintigraphy with I131 that showed, respectively, in the topography next to the paracaval and retroportal right diaphragmatic crura, isointense T1 and slightly hyperintense T2 at 1.8 cm and radiopharmaceutical hypercaptation in right adrenal topography. Genetic panel by NGS did not identify germline mutation in 22 pheochromocytoma-related genes. FDG PETCT was consistent with MRI and MIBG images. Gallium PETCT68 DOTATOC detected the lesions already described, in addition to a lytic lesion in the left femoral intertrochanteric medulla. Anatomopathological approached abdominal lesion confirming pheochromocytoma metastasis in lymph node conglomerate. Currently has a negative methanephrine plasma, however chromogranin A 142 ng / mL (VR <93), and was chosen by the observant approach. Conclusion: The case of the patient illustrates that pheochromocytoma should be followed indefinitely, as metastases may appear many years later and may present different aggressiveness potentials.

Case 11.9

2014 ◽  
pp. 545-545
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Weight Loss ◽  
Cystic Lesion ◽  
Thin Wall ◽  
P 75 ◽  
History Of

75-year-old woman with a 6-month history of anorexia and weight loss Axial fat-suppressed 2D SSFP images (Figure 11.9.1) demonstrate a cystic lesion in the left adnexa with a thin wall and no internal features. Axial IP T1-weighted 2D SPGR image (Figure ...

scholarly journals Gender Differences in Factors Associated with Clinically Meaningful Weight Loss among Adults Who Were Overweight or Obese: A Population-Based Cohort Study

Obesity Facts ◽  
2020 ◽  
pp. 1-13
Author(s):  
Ji-Bin Li ◽  
Zhi-Yu Qiu ◽  
Zhen Liu ◽  
Qian Zhou ◽  
Li-Fen Feng ◽  
...  
Keyword(s):  
Physical Activity ◽  
Gender Differences ◽  
Weight Loss ◽  
Chronic Diseases ◽  
Study Entry ◽  
Factors Associated ◽  
History Of ◽  
Males And Females ◽  
The Impact

<b><i>Objectives:</i></b> The impact of heterogeneity on gender difference for achieving clinically meaningful weight loss (cmWL) remains unclear. Here, we explored the potential gender differences in factors associated with cmWL. <b><i>Methods:</i></b> A total of 60,668 participants with body mass index (BMI) ≥25 kg/m<sup>2</sup> at study entry and available BMI values at follow-up were included in this study. cmWL was defined as a weight loss of ≥5% from the study entry to follow-up. The associations of social-demographic factors, personal history of chronic diseases, lifestyle behaviors, and history of BMI with cmWL were evaluated using logistic regression models. <b><i>Results:</i></b> During a median follow-up of 9.13 years, 26.6% of the participants had a cmWL (30.8% for females vs. 23.1% in males; <i>p</i> &#x3c; 0.001). Participants with older age, obesity at study entry, being more physical activity compared to 10 years ago, being relapsed smokers or consistent current smokers, having a history of chronic diseases (i.e., diabetes, osteoporosis, and stroke), cancer diagnosis during the study period, and more than 10-year follow-up were more likely to achieve cmWL in both males and females (all <i>p</i> &#x3c; 0.05). The new smoking quitters and participants with less active in physical activity compared to 10 years ago were less likely to achieve cmWL in both males and females (all <i>p</i> &#x3c; 0.05). Specifically, males with a history of emphysema were more likely to reach cmWL, and for females, those being overweight at 20 years old and current drinkers were more likely to reach cmWL (<i>p</i> &#x3c; 0.05). Sensitivity analyses demonstrated similar results. <b><i>Conclusion:</i></b> Age, BMI status, physical activity, smoking status, family income, and health status were independent factors in males and females for weight management. However, further well-designed prospective studies are warranted to confirm our findings.

Laryngeal oncocytic cystadenoma mimicking a combined laryngomucocele

2020 ◽  
Vol 13 (10) ◽  
pp. e236866
Author(s):  
Pedro Salvador ◽  
Francisco Moreira da Silva ◽  
Rui Fonseca
Keyword(s):  
Vocal Fold ◽  
Cystic Lesion ◽  
Histopathological Examination ◽  
Neck Swelling ◽  
Vocal Cords ◽  
Thyrohyoid Membrane ◽  
History Of ◽  
Benign Tumours ◽  
False Vocal

Laryngeal oncocytic cystadenomas are rare benign tumours lined by oncocytic epithelium and arising from the salivary glands; they usually present as a supraglottic mass. Oncocytic changes are very uncommon in the larynx and occur mainly in ventricles and false vocal cords, where seromucinous glands predominate. The authors present the case of a 62-year-old woman who reported a 6-month history of hoarseness associated with a soft and non-compressible upper left side neck swelling. Transnasal fiberoptic laryngoscopy revealed a left submucosal supraglottic mass involving the false vocal fold and the vallecula, partially obstructing the airway. CT scan showed a homogeneous isodense cystic lesion centred at the left laryngeal ventricle, with extension through the thyrohyoid membrane. The patient was successfully managed by a lateral thyrotomy approach. Histopathological examination of the specimen revealed a papillary oncocytic cystadenoma and excluded malignancy. There was no evidence of recurrence after 9 months of follow-up.

scholarly journals Prevalence, Clinical Features, and Natural History of Incidental Clinically Non-Functioning Pituitary Adenomas

2017 ◽  
Vol 49 (09) ◽  
pp. 654-659 ◽  
Author(s):  
Pedro Iglesias ◽  
Karina Arcano ◽  
Vanessa Triviño ◽  
Paula García-Sancho ◽  
Juan Díez ◽  
...  
Keyword(s):  
Natural History ◽  
Clinical Features ◽  
Tumor Size ◽  
Tumor Diameter ◽  
Unusual Event ◽  
Maximum Tumor Diameter ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Suprasellar Extension

AbstractThe 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, 96.5%) were diagnosed by magnetic resonance imaging (MRI). A sum of 71.9% (n=41) were macroadenomas; 2 of them (3.5%) were giant adenomas (≥4 cm). Patients with macroadenomas were older than those with microadenomas (59.5±16.7 vs. 46.4±18.1 years, p=0.007). Macroadenomas were more common in men (85.7% vs. 58.6%, p=0.023). Twenty-eight patients (49.1%) showed suprasellar extension; of these, 19 were accompanied by chiasmatic compression. Hypopituitarism was present in 14 (24.6%) patients; which was partial in 13 patients (22.8%) and complete in one patient (1.8%). The gonadal axis was the most frequently affected (n=13, 22.8%). Twenty four patients (42.1%) underwent surgery. Of the non-operated patients, 26 patients could be evaluated morphologically after a median follow-up of 15.5 months (interquartile range, 5.7–32.7 months). No significant changes were found in the maximum tumor diameter at the end of follow-up (1.2±0.6 vs 1.2±0.7 cm). The majority of CNFPAs evaluated (n=23, 88.5%) did not show any changes in size. In 2 cases (7.7%) tumor size decreased, and in one patient (3.8%) increased. In our series of CNFPA patients, approximately one-third were incidental. These tumors were diagnosed by MRI preferably from the 5th decade of life without sex predilection. Most of them were macroadenomas, more commonly diagnosed in men and at an older age, compared to microadenomas. The suprasellar extension with chiasmatic compression and hypopituitarism were frequent at diagnosis. Most of the non-operated incidental CNFPAs remain with stable tumor size over time, growth being an unusual event.

scholarly journals HOW TO MANAGE SUDDEN IVC DECOMPRESSION IN CASE OF A LARGE RETROPERITONEAL MYELOLIPOMA.

2021 ◽  
pp. 12-14
Author(s):  
Nina M. Shah ◽  
Priyanka Warde ◽  
Hiral C. Chauhan
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Cesarean Section ◽  
Past History ◽  
Incidental Finding ◽  
Large Mass ◽  
Normal Vaginal Delivery ◽  
Suprarenal Mass ◽  
History Of

31 year female patient presented to surgical OPD to take consult about incidental finding of large mass originating th from liver in routine antennal checkup at 5 month of pregnancy. We have done ultrasound which is suggestive of suprarenal mass patient was kept under regular follow up and checked for any increase in size of mass but there is no changes in mass .patient deliver baby with normal vaginal delivery ,after postpartum 7 months patient came back with right sided abdominal lump. No complaint of abdominal pain ,vomiting ,headache ,palpitation ,diarrhea ,constipation ,fever ,generalized weakness and weight loss. Past history of cesarean section before 8 years .

scholarly journals Time to death and its predictors among adult with drug-resistance tuberculosis patients, in Eastern and East-Central Ethiopia, 2012-2018: A retrospective cohort study

2019 ◽  
Author(s):  
Tsige Gebre ◽  
Mulatu Ayana Hordofa ◽  
Molla Yigzaw Birhanu ◽  
Melkamu Siferih ◽  
Cheru Tesema Leshargie
Keyword(s):  
Weight Loss ◽  
Survival Time ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
East Central ◽  
Tuberculosis Patients ◽  
Resistant Tuberculosis ◽  
History Of ◽  
Extra Pulmonary

Abstract Background Drug-resistant tuberculosis (DRTB) is becoming a global public health problem in developing country including Ethiopia. It poses a greater challenge to the tuberculosis control program. Tuberculosis drugs namely; rifampicin and isoniazid, were the two most effective anti-tuberculosis drugs for which the agent become resistant. Understanding the survival time and the predictors of DRTB patients would be helpful to policy-makers and health practitioners in Ethiopia. However, there is a limited previous study on the aspect. Therefore, this study aimed to estimate the survival time and predictors of adult DRTB patients, in Eastern and East-Central Ethiopia.Methods A retrospective follow-up study was conducted in the Eastern and East-Central part of Ethiopia among adult drug resistance-tuberculosis patients from 1st September 2012 to 30th August 2017. The checklist was used to retrieve information among a total of 362 drug-resistant tuberculosis patients. Kaplan Meier curve method was used to estimate the median survival time with its interquartile range and risks. Multivariable Cox proportional regression modelling was used to investigating predictors of survival time. Hazard ratio with 95% CI was used to report the findings of regression modelling.Result A total of 362 participants were followed for 132,801 person day observation. During the follow-up period, there were 55 deaths with the overall incidence rate of 4 participants per 10,000-person day observation (95%CI: 3.18, 5.39). DRTB related death was higher among patients who had weight loss (AHRa: 9.0, 95%CI:2, 20.5), pulmonary with extra-pulmonary DRTB (AHR:10, 95% CI:3.3, 16), HIV co-infection (AHR:4, 95%CI:2.1,7.5) and comorbidity (AHR:4.40, 95% CI:1.7, 11), patients with BMI<18.5 (AHR:0.22, 95% CI:0.076, 0.63) were less likely to die of MDR-TB. BMI<18.5 patients with a history of relapse (AHR: 4.2, 95% CI: 1.9, 9) and after the failure of re-treatment (AHR: 6.3, 95%CI: 2.6, 13) were predictors of DRTB death.Conclusion To summarize, the survival time of patients with drug-resistant tuberculosis was low. DRTB related death was higher among patients with weight loss, people with extra-pulmonary, HIV co-infection, comorbidity, and history of relapse.

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