Acromegaly: A Rare Manifestation of Bronchial Carcinoid

2002 ◽  
Vol 10 (3) ◽  
pp. 273-276 ◽  
Author(s):  
Anil Bhansali ◽  
S Singh Rana ◽  
Sujit Bhattacharya ◽  
Rajgopal Muralidharan ◽  
Radharaman J Dash ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Growth Hormone ◽  
Magnetic Resonance ◽  
Surgical Resection ◽  
Lung Lesion ◽  
Bronchial Carcinoid ◽  
Growth Hormone Releasing Hormone ◽  
Resonance Imaging ◽  
Rare Manifestation ◽  
Ectopic Production

Bronchial carcinoids usually present with pulmonary symptoms. Neurohumoral manifestations in the form of acromegaly and Cushing's syndrome are rarely encountered. We report a case of bronchial carcinoid with features of acromegaly due to ectopic production of growth hormone-releasing hormone. Surgical resection of the lung lesion resulted in regression of acromegalic features, normalization of growth hormone secretory dynamics, and remarkable diminution of pituitary size seen on magnetic resonance imaging.

Acromegaly Caused by a Growth Hormone-releasing Hormone-secreting Carcinoid Tumor: Case Report

Neurosurgery ◽  
2002 ◽  
Vol 50 (6) ◽  
pp. 1356-1360 ◽  
Author(s):  
Thomas J. Altstadt ◽  
Biagio Azzarelli ◽  
Carl Bevering ◽  
James Edmondson ◽  
Paul B. Nelson
Keyword(s):  
Magnetic Resonance Imaging ◽  
Growth Hormone ◽  
Case Report ◽  
Magnetic Resonance ◽  
Carcinoid Tumor ◽  
Hormone Level ◽  
Growth Hormone Releasing Hormone ◽  
Resonance Imaging ◽  
Releasing Hormone ◽  
Pituitary Hyperplasia

Abstract OBJECTIVE AND IMPORTANCE We describe a patient with acromegaly and pituitary hyperplasia secondary to a growth hormone-releasing hormone-secreting gastrointestinal carcinoid tumor. This case report illustrates the importance of including this rare clinical syndrome in the differential diagnosis of acromegaly for patients with suspected or known neuroendocrine tumors. CLINICAL PRESENTATION A 19-year-old, Asian-American, male patient with a 2-year history of a nonresectable, metastatic, intestinal carcinoid tumor presented with complaints of headaches, arthralgias, sweats, and changing features. The examination revealed a young subject with acromegalic features, without visual field deficits. Magnetic resonance imaging revealed a diffuse sellar mass that extended suprasellarly to compress the optic chiasm. Endocrinological studies demonstrated a growth hormone level of more than 100 ng/ml and an inappropriately elevated growth hormone-releasing hormone level. INTERVENTION The patient underwent transsphenoidal resection of the pituitary mass for diagnostic and decompressive purposes. The pathological examination revealed pituitary hyperplasia, without evidence of an adenoma. Therapy with long-acting repeatable octreotide (Sandostatin LAR; Novartis AG, Basel, Switzerland) was initiated postoperatively, to further control the acromegaly and carcinoid tumor. The soft-tissue swelling resolved, and the patient remained free of headaches, arthralgias, and sweats at the 6-month follow-up examination. CONCLUSION Ectopic acromegaly is a rare syndrome that must be recognized by neurosurgeons because its treatment differs from that of classic pituitary acromegaly. We describe a patient for whom this syndrome was documented with magnetic resonance imaging, endocrinological testing, and pathological examinations.

scholarly journals A243 A RETROSPECTIVE REVIEW OF THE RADIOGRAPHIC DIAGNOSIS AND SURGICAL RESECTION RATES OF PANCREATIC SEROUS CYSTS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 300-301
Author(s):  
M Monachese ◽  
S Li ◽  
M Salim ◽  
L Guimaraes ◽  
P D James
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Surgical Resection ◽  
Predictive Value ◽  
Resected Specimen ◽  
Cystic Lesions ◽  
Resonance Imaging ◽  
Guided Biopsy ◽  
Magnetic Resonance Imaging Mri

Abstract Background Pancreatic cystic lesions are increasingly identified in persons undergoing abdominal imaging. Serous cystic neoplasms (SCNs) have a very low risk of malignant transformation. Resection of SCNs is not recommended in the absence of related symptoms. The accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) to identify SCNs is not known and may impact clinical care. Aims To evaluate the accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) for the diagnosis of SCN. To see how this can impact the decision to resect suspected SCNs. Methods Retrospective cohort study of patients from the University Health Network with suspected SCNs from 2017–2020 who underwent either a CT or MRI of the abdomen. Reports noting pancreatic cystic lesions were identified and reviewed. Only cases with suspected SCNs were included. Clinical (age, sex, symptoms, treatment) and radiographic (type of imaging, reported cyst characteristics) data was collected. Pathology was reviewed for all cases where the cysts was biopsied or resected during follow-up. The gold standard for the diagnosis for SCN was pathology of resected specimen or EUS-guided biopsy cytopathology showing no evidence of a mucinous lesion, CEA level below 10ug per L and amylase level below 50 U/L. Results 163 patients were included in the study. 99 (61%) were female and 98 (60%) underwent CT scan. EUS-guided biopsy was performed in 24 (15%) of patients and 8 (5%) had surgical resection. Multidisciplinary review was performed in 6 of the 8 cases that went to surgery. Of the resected specimens, 5 (63%) were SCN, 1 was a mucinous cystic lesion, 1 was a neuroendocrine tumor and 1 was a carcinoma. Two patients underwent EUS evaluation prior to surgical resection. In one case SCN was resected when EUS reported an undetermined cyst type. Reasons for surgical resection were: the diagnosis of serous cyst was not definitive (n=5), symptoms (n=2), and high-risk mucinous cystic neoplasm identified on EUS (n=1). Of 30 patients with pathology available, 15 (50%) were confirmed to have a SCN. CT and MRI had a sensitivity, specificity, positive predictive value and negative predictive value of 93%, 25%, 52% and 80%, respectively. Conclusions Surgical resection for SCN lesions is driven by diagnostic uncertainty after cross-sectional imaging. Multidisciplinary review and EUS evaluation may improve diagnostic accuracy and should be considered prior to surgical resection of possible SCN lesions. Funding Agencies None

scholarly journals ASSESSMENT OF GROWTH HORMONE PITUITARY RESERVE AND MAGNETIC RESONANCE IMAGING FINDINGS IN SHORT CHILDREN

1993 ◽  
Vol 33 ◽  
pp. S31-S31
Author(s):  
A Dammacco ◽  
S Pesce ◽  
A Acquafredda ◽  
A Lorusso ◽  
C F Andreula ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Growth Hormone ◽  
Magnetic Resonance ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Short Children

Can Intraoperative Magnetic Resonance Imaging Be Helpful in the Surgical Resection of Parasellar Meningiomas? A Case Series

2019 ◽  
Vol 132 ◽  
pp. e577-e584
Author(s):  
Mario Giordano ◽  
Massimo Gallieni ◽  
Hussam Metwali ◽  
Rudolf Fahlbusch ◽  
Madjid Samii ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Surgical Resection ◽  
Case Series ◽  
Resonance Imaging ◽  
Intraoperative Magnetic Resonance Imaging

scholarly journals Extrapontine Myelinolysis following Extreme Hypernatremia and Hyperosmolarity

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Jan-Niclas Schwade ◽  
Lior Haftel ◽  
Lars Rühe ◽  
Matthias Endmann
Keyword(s):  
Magnetic Resonance Imaging ◽  
Growth Hormone ◽  
Magnetic Resonance ◽  
Growth Hormone Deficiency ◽  
Medical History ◽  
Hormone Deficiency ◽  
Resonance Imaging ◽  
Cranial Magnetic Resonance Imaging ◽  
Extrapontine Myelinolysis ◽  
Therapeutic Implications

We present a case of a nearly 3-year-old girl who was admitted to hospital due to severe hypernatremia (196 mmol/l). Her medical history included central hypothyreosis and growth hormone deficiency. Rehydration and normalization of sodium was achieved according to guidelines. On the fourth day of hospitalization, the patient developed tremor, ataxia, and rigor. Cranial magnetic resonance imaging (cMRI) was performed and (mis)interpreted for meningoencephalitis, with corresponding diagnostic and therapeutic implications. The patient had extrapontine myelinolysis. The child recovered completely after hospitalization for nearly 2 weeks.

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