scholarly journals Spontaneous Involution of a Presumably Rathke’s Cleft Cyst in a Patient with Slight Subclinical Hypopituitarism: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Diaa Al Safatli ◽  
Rolf Kalff ◽  
Albrecht Waschke
Keyword(s):  
Spontaneous Regression ◽  
Mass Effect ◽  
Complete Regression ◽  
Central Hypothyroidism ◽  
Sellar Lesions ◽  
Rathke Cleft Cyst ◽  
Asymptomatic Patients ◽  
Spontaneous Involution ◽  
Mri Study

Rathke cleft cyst is described as benign intrasellar cyst. They are mostly small and asymptomatic; they may become large enough to cause symptoms by compression of intrasellar or suprasellar structures. We report on a case of spontaneous regression of a symptomatic RCC with subsequent recovery of preexisting endocrine dysfunction and resolution of headaches. A 60-year-old man complained about headaches. Laboratory investigation revealed a partial hypopituitarism with a slight central hypothyroidism without need for substitution. An MRI study showed a cystic, T2-hyperintense, sellar lesion compatible with a RCC. At one year follow-up, the patient had no complaints and the hormone work-up revealed a regression of the previous slight hypopituitarism. The MRI study showed a complete regression of the cystic lesion and a normal sized and shaped pituitary gland. The spontaneous regression of cystic sellar lesions is rare. The exact mechanism of the possible spontaneous involution of RCC is until now not well understood. However, spontaneous regression is possible and justifies the conservative therapy with regular clinical and radiological follow-up for asymptomatic patients or patients with symptoms not caused by the mass effect of these lesions.

Spontaneous involution of Rathke cleft cysts: is it rare or just underreported?

2010 ◽  
Vol 112 (6) ◽  
pp. 1327-1332 ◽  
Author(s):  
Hassan H. Amhaz ◽  
Roukoz B. Chamoun ◽  
Steven G. Waguespack ◽  
Komal Shah ◽  
Ian E. McCutcheon
Keyword(s):  
Clinical Course ◽  
Mass Effect ◽  
Cystic Lesions ◽  
Conservative Approach ◽  
Sellar Lesions ◽  
Imaging Characteristics ◽  
Asymptomatic Patients ◽  
History Of ◽  
Spontaneous Involution ◽  
Field Disturbance

Rathke cleft cysts (RCCs) are benign cystic lesions of the sella that arise from the remnants of Rathke pouch. Although most are asymptomatic, symptoms can result from mass effect and commonly include headache, endocrinopathy, or visual field disturbance. Although asymptomatic patients undergo conservative treatment, patients with symptoms are typically treated surgically. The authors report 9 patients with symptomatic cystic sellar lesions and imaging characteristics consistent with an RCC; in all cases there was spontaneous involution of the lesions, and in 5 of 7 patients presenting with headache the symptom resolved. Spontaneous involution of an RCC may be more common than the paucity of prior reports would suggest, especially because the natural history of both symptomatic and asymptomatic RCCs is poorly understood. The potential for spontaneous involution, together with the clinical course of the patients reported here, supports a conservative approach for patients with symptomatic RCCs presenting solely with headache.

Spontaneous resolution of invasive cerebral aspergillosis following partial resection in a medically untreated infant

2012 ◽  
Vol 10 (1) ◽  
pp. 71-74 ◽  
Author(s):  
Sumit Thakar ◽  
Yasha T. Chickabasaviah ◽  
Alangar S. Hegde
Keyword(s):  
Emergency Services ◽  
Mass Effect ◽  
Cerebral Hemiatrophy ◽  
Right Cerebral Hemisphere ◽  
History Of ◽  
Subcortical Regions ◽  
The Right ◽  
Mri Study ◽  
The Brain

Invasive craniocerebral aspergillosis, often encountered in an immunocompromised setting, is almost uniformly fatal despite radical surgical and medical management, and is frequently a necropsy finding. The authors report a unique, self-resolving clinical course of this aggressive infection in a 10-month-old infant. The infant was brought to the emergency services in altered sensorium with a 1-week history of left-sided hemiparesis, excessive irritability, and vomiting. An MRI study of the brain revealed multiple, heterogeneously enhancing lesions in the right cerebral hemisphere with mass effect. The largest lesion in the frontotemporal cortical and subcortical regions was decompressed on an emergent basis. Histopathological findings were suggestive of invasive aspergillosis, although there was no evidence of the infection in the lungs or paranasal sinuses. Computed tomography–guided aspiration of the remaining lesions and follow-up antifungal therapy were recommended. The parents, however, requested discharge without further treatment. The child was seen at a follow-up visit 3 years later without having received any antifungal treatment. Imaging showed resolution of the infection and features of Dyke-Davidoff-Masson syndrome (cerebral hemiatrophy). This report of invasive cerebral aspergillosis resolving without medical therapy is the first of its kind. Its clinicoradiological aspects are discussed in light of previously reported cases.

PITUITARY DYSFUNCTION IN PATIENTS WITH INTRACRANIAL GERM CELL TUMORS TREATED WITH RADIOTHERAPY

2020 ◽  
Vol 26 (12) ◽  
pp. 1458-1468
Author(s):  
Boni Xiang ◽  
Xiaoming Zhu ◽  
Min He ◽  
Wei Wu ◽  
Haopeng Pang ◽  
...  
Keyword(s):  
Germ Cell ◽  
Diabetes Insipidus ◽  
Adrenal Insufficiency ◽  
Germ Cell Tumors ◽  
Central Diabetes Insipidus ◽  
Central Hypothyroidism ◽  
Free Survival ◽  
Sellar Lesions ◽  
Intracranial Germ Cell Tumors

Objective: To evaluate the endocrine abnormalities in intracranial germ cell tumors (iGCTs) treated with radio-therapy (RT), and to discuss the effects of RT on pituitary functions. Methods: Seventy-seven patients diagnosed with iGCTs who had received RT and endocrine follow-up in Huashan Hospital between January 2010 and July 2017 were retrospectively analyzed, consisting of 49 germinomas and 28 NGGCTs. The median follow-up period was 50.0 months. Fifty-one patients had radiologically proved suprasellar/sellar lesions. Results: The male to female ratio was 62/15. The median endocrine follow-up period was 19 (4, 42) months. The median age at the last endocrine visit was 18 (16, 20) years old. The 5-year overall and recurrence-free survival were both 98.7%. The overall prevalence of central adrenal insufficiency (CAI), central hypothyroidism (CHT), central hypogonadism (CHG), hyperprolactinemia, and central diabetes insipidus (CDI) was 57.3%, 56%, 56.6%, 35.3%, and 52.1%, respectively, after RT. Patients having suprasellar/sellar lesions showed significantly higher post-therapeutic prevalence of hypopituitarism than those who didn’t. Compared to that before RT, CAI, CHT, and CHG weren’t significantly improved while the levels of prolactin and the prevalence of CDI declined significantly ( P = .03 and .001). The radiation doses to pituitary and hypothalamus between those with and without CAI, CHT, and CHG weren’t significantly different. Conclusion: The prevalence of hypopituitarism was high in iGCTs, especially in those with suprasellar/sellar involvement. The levels of prolactin and the prevalence of CDI declined significantly after RT. The hypopituitarism in iGCTs was mainly induced by tumor effects, and RT showed no additional damage to pituitary functions in our study. Abbreviations: AFP = alpha-fetoprotein; CAI = central adrenal insufficiency; CDI = central diabetes insipidus; CHG = central hypogonadism; CHT = central hypothyroidism; CT = computed tomography; DA = dopamine; GH = growth hormone; βHCG = beta-human chorionic gonadotropin; HPA = hypothalamus-pituitary-adrenal; HPG = hypothalamus-pituitary-gonadal; HPL = hyperprolactinemia; HPT = hypothalamus-pituitary-thyroid; iGCT = intracranial germ cell tumor; IGF-1 = insulin-like growth factor 1; NGGCT = nongerminomatous germ cell tumors; OS = overall survival; PFS = progression-free survival; PRL = hypothalamus-pituitary-prolactin; RT = radiotherapy

Cardiac rhabdomyoma in childhood tuberous sclerosis

1995 ◽  
Vol 5 (2) ◽  
pp. 166-171 ◽  
Author(s):  
Jung Yun Choi ◽  
Eun Jung Bae ◽  
Chung Il Noh ◽  
Yong-Soo Yoon ◽  
Yong Seung Hwang
Keyword(s):  
Tuberous Sclerosis ◽  
Spontaneous Regression ◽  
High Rate ◽  
Cardiac Tumors ◽  
Complete Regression ◽  
Cardiac Rhabdomyoma ◽  
Cross Sectional ◽  
One Year ◽  
Almost All

AbstractWe studied 52 children in order to assess the prevalence, natural history, and electrophysiologic effects of cardiac rhabdomyoma in tuberous sclerosis. Their ages ranged from one day to 12 years (median age 1.33 year). The tumors in the heart were found in 22 patients through cross-sectional echocardiography. The overall prevalence of cardiac rhabdomyoma was 42%. The prevalence of cardiac tumors in patients first seen in infancy was 77%, and that in patients over one year of age was 31%. Those with cardiac tumors diagnosed in infancy had more tumors per person than did the patients diagnosed after infancy, and the tumors were smaller in the patients diagnosed over one year of age. Follow-up cross-sectional echocardiography showed that almost all tumors showed spontaneous regression. Complete regression occurred more commonly in younger patients, and in those with smaller tumors. About 70% of patients with cardiac tumors had either normal findings or infrequent premature contractions on 24hour Holter monitorings. The rest of the patients with cardiac tumors showed either frequent premature contractions, atrioventricular block, or atrial tachycardia, but antiarrhythmic medication was rarely required. Cross-sectional echocardiography, therefore, seems to be the best diagnostic tool for screening cardiac rhabdomyomas in patients with tuberous sclerosis. The tumors may be managed more conservatively in view of their high rate of spontaneous regression and rather rare association with symptomatic arrhythmias.

scholarly journals Rapid Pituitary Apoplexy Regression: What Is the Time Course of Clot Resolution?

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Devon L. Jackson ◽  
Jamie J. Van Gompel
Keyword(s):  
Time Course ◽  
Spontaneous Regression ◽  
Pituitary Apoplexy ◽  
Mass Effect ◽  
Sudden Onset ◽  
Pituitary Mass ◽  
Initial Event ◽  
Original Size ◽  
Visual Complaints

A 29-year-old male patient with a functioning pituitary macroadenoma is discussed. The pituitary mass was detected by MRI after the patient presented with sudden onset of headache, suggestive of an apoplectic event. The headache resolved with analgesic medications. Within a follow-up period of one week, the pituitary mass had spontaneously regressed to nearly half its original size without any therapy. The patient never reported any visual complaints and displayed no signs of hypopituitarism. Elevated prolactin levels were present. Seven weeks after the initial event, the pituitary mass showed continued regression on MRI. Prolactin levels remained elevated. This case provides a unique look at the rapid spontaneous regression of mass effect that may occur following apoplexy of a pituitary adenoma.

Regression of Hepatocellular Carcinoma Spontaneous or Herbal Medicine Related?

2004 ◽  
Vol 32 (04) ◽  
pp. 579-585 ◽  
Author(s):  
Hon Mei Cheng ◽  
Ming Che Tsai
Keyword(s):  
Hepatocellular Carcinoma ◽  
Herbal Medicine ◽  
Spontaneous Regression ◽  
Causes Of Death ◽  
Arterial Embolization ◽  
Complete Regression ◽  
Advanced Hepatocellular Carcinoma ◽  
Traditional Herbal Medicine ◽  
Common Causes

Hepatocellular carcinoma is one of the most common causes of death from cancer in Taiwan. Treatments for this disease include surgical resection, transcatheter arterial embolization, chemoembolization and systemic chemotherapy. Without treatment, the prognosis of hepatocellular carcinoma is poor, and mortality continues to be significant even in patients with small tumors detected during follow-up. For patients in Taiwan with advanced hepatocellular carcinoma, traditional herbal medicine is frequently used. However, neither the overall prevalence of this therapy nor its efficacy has been studied systematically. Spontaneous regression of cancer, although rare, may occur, but the mechanism leading to regression is still far from understood. Here, we report a case of hepatocellular carcinoma with complete regression after taking herbal medicine. We cannot be certain how significant the herbal preparation was in the regression of the hepatocellular carcinoma, but the regression of the tumor provides us a reason and hope for further research.

Spontaneous Regression of Hodgkin Lymphoma: Case Report and Review of the Literature

2018 ◽  
Vol 141 (1) ◽  
pp. 14-18
Author(s):  
Oren Pasvolsky ◽  
Tamar Berger ◽  
Hanna Bernstine ◽  
Lucille  Hayman ◽  
Pia Raanani ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Spontaneous Regression ◽  
Rare Event ◽  
Cervical Lymphadenopathy ◽  
Emission Tomography ◽  
Complete Regression ◽  
Review Of The Literature ◽  
Positron Emission ◽  
To Receive

Spontaneous regression of Hodgkin lymphoma (HL) is a rare event. We describe a 32-year-old woman with spontaneous regression of HL and review the literature. The patient presented with cervical lymphadenopathy and was diagnosed with stage IIA classical HL. The patient refused to receive any treatment for her disease. Positron emission tomography/computed tomography carried out 2 years later showed complete regression of the lymphadenopathy, without pathological uptake of fluorodeoxyglucose. At the last follow-up, 3.5 years after the initial presentation, the patient is with no evidence of disease. During workup for the HL, concomitant papillary thyroid carcinoma was diagnosed, for which the patient refused treatment as well. The thyroid malignancy has remained stable throughout the follow-up.

scholarly journals Prenatal findings and postnatal follow-up of a midline dural sinus malformation

2021 ◽  
Vol 10 (4) ◽  
pp. 205846012110063
Author(s):  
Hana Shabana ◽  
Johannes Leidinger ◽  
Johan Wikström ◽  
Ove Axelsson
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spontaneous Regression ◽  
Rare Condition ◽  
Present Knowledge ◽  
Magnetic Resonance Imaging Examination ◽  
Dural Sinus ◽  
Resonance Imaging ◽  
Prenatal Magnetic Resonance Imaging ◽  
Dural Sinus Malformation

Dural sinus malformation is a rare condition. We describe a prenatally detected case followed by repeated ultrasound scans and a prenatal magnetic resonance imaging examination. A substantial spontaneous regression was observed, which is associated with a favorable outcome. We believe that our observations, including a long postnatal follow-up, will add to the present knowledge of prenatally detected cases, and thus improve management of the pregnancies as well as our possibilities to counsel the parents-to-be.

scholarly journals Carotid artery stenosis – Current evidence and treatment recommendations

2021 ◽  
Vol 5 (1) ◽  
pp. 2514183X2110016
Author(s):  
Mandy D Müller ◽  
Leo H Bonati
Keyword(s):  
Carotid Artery ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Current Evidence ◽  
Asymptomatic Carotid Stenosis ◽  
Asymptomatic Carotid ◽  
Risk Of Death ◽  
Asymptomatic Patients

Background: Carotid artery stenosis is an important cause for stroke. Carotid endarterectomy (CEA) reduces the risk of stroke in patients with symptomatic carotid stenosis and to some extent in patients with asymptomatic carotid stenosis. More than 20 years ago, carotid artery stenting (CAS) emerged as an endovascular treatment alternative to CEA. Objective and Methods: This review summarises the available evidence from randomised clinical trials in patients with symptomatic as well as in patients with asymptomatic carotid stenosis. Results: CAS is associated with a higher risk of death or any stroke between randomisation and 30 days after treatment than CEA (odds ratio (OR) = 1.74, 95% CI 1.3 to 2.33, p < 0.0001). In a pre-defined subgroup analysis, the OR for stroke or death within 30 days after treatment was 1.11 (95% CI 0.74 to 1.64) in patients <70 years old and 2.23 (95% CI 1.61 to 3.08) in patients ≥70 years old, resulting in a significant interaction between patient age and treatment modality (interaction p = 0.007). The combination of death or any stroke up to 30 days after treatment or ipsilateral stroke during follow-up also favoured CEA (OR = 1.51, 95% CI 1.24 to 1.85, p < 0.0001). In asymptomatic patients, there is a non-significant increase in death or stroke occurring within 30 days of treatment with CAS compared to CEA (OR = 1.72, 95% CI 1.00 to 2.97, p = 0.05). The risk of peri-procedural death or stroke or ipsilateral stroke during follow-up did not differ significantly between treatments (OR = 1.27, 95% CI 0.87 to 1.84, p = 0.22). Discussion and Conclusion: In symptomatic patients, randomised evidence has consistently shown CAS to be associated with a higher risk of stroke or death within 30 days of treatment than CEA. This extra risk is mostly attributed to an increase in strokes occurring on the day of the procedure in patients ≥70 years. In asymptomatic patients, there may be a small increase in the risk of stroke or death within 30 days of treatment with CAS compared to CEA, but the currently available evidence is insufficient and further data from ongoing randomised trials are needed.

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