scholarly journals Post-operative volumes following endoscopic surgery for non-functioning pituitary macroadenomas are predictive of further intervention, but not endocrine outcomes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
K. Seejore ◽  
S. A. Alavi ◽  
S. M. Pearson ◽  
J. M. W. Robins ◽  
B. Alromhain ◽  
...  
Keyword(s):  
Tumour Volume ◽  
Tumour Resection ◽  
Pituitary Hormone ◽  
Residual Tumour ◽  
Repeat Surgery ◽  
Recurrent Tumour ◽  
Tertiary Centre ◽  
Before And After ◽  
Treatment Naïve ◽  
Pituitary Macroadenomas

Abstract Background Transsphenoidal surgery (TSS) remains the treatment of choice for non-functioning pituitary macroadenomas (NFPMA). The value of measuring tumour volumes before and after surgery, and its influence on endocrine outcomes and further treatment of the residual or recurrent tumour are unknown. Methods Data from patients who underwent endoscopic TSS for a NFPMA (2009–2018) in a UK tertiary centre were analysed for pre- and post-operative endocrine and surgical outcomes. Results Of 173 patients with NFPMA, 159 (61% male) were treatment naïve. At presentation, 76.2% (77/101) had ≥1 pituitary axis deficit. Older age (p = 0.002) was an independent predictor for multiple hormonal deficiencies. Preoperative tumour volume did not correlate with degree of hypopituitarism. Postoperative tumour volume and extent of tumour resection were not predictive of new onset hypopituitarism. Hormonal recovery was observed in 16 patients (20.8%) with impaired pituitary function, with the greatest recovery in the hypothalamic-pituitary-adrenal axis (21.2%, 7/33). A larger residual tumour volume was predictive of adjuvant radiotherapy (3.40 vs. 1.24 cm3, p = 0.005) and likelihood for repeat surgery (5.40 vs. 1.67cm3, p = 0.004). Conclusion Pre- and post-operative NFPMA volumes fail to predict the number of pituitary hormone deficits, however, greater post-operative residual volumes increase the likelihood of further intervention to control tumour growth.

Morphologic Change in Computed Tomography of Aldosterone-Producing Adenoma after Radiofrequency Ablation

2014 ◽  
Vol 65 (1) ◽  
pp. 86-90 ◽  
Author(s):  
Ryan K.L. Lee ◽  
Shirley Y.W. Liu ◽  
Cina S.L. Tong ◽  
Paul S.F. Lee ◽  
Enders K.W. Ng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiofrequency Ablation ◽  
Tumour Size ◽  
Tumour Volume ◽  
Morphologic Change ◽  
Residual Tumour ◽  
Ct Guided ◽  
Contrast Enhanced ◽  
Before And After ◽  
Aldosterone Producing Adenoma

Objective To evaluate the morphologic changes of aldosterone-producing adenoma (APA) on computed tomography (CT) before and after radiofrequency ablation (RFA) and to assess the factors that are important in determining successful complete ablation of these tumours. Method Between August 2004 and August 2011, 24 consecutive patients with APA undergoing CT-guided percutaneous RFA were identified from our prospective database. The pre-RFA and post-RFA CT appearances of these APAs that showed positive biochemical response were reviewed retrospectively for their 3-dimensional size, tumour volume, and CT attenuation in terms of Hounsfield units (HU). A comparison of these parameters before and after RFA was performed. Results In this study, there were 23 APAs in these 24 patients that showed biochemical cure of primary aldosteronism after RFA. When comparing post-RFA to pre-RFA CTs, there was no significant change in tumour size (14.5 mm vs 14.6 mm: P = .83) and tumour volume (1.55 cm3 vs 1.59 cm3; P = .41) after RFA. In nonenhanced CT images, there was no significant reduction in HU from pre-RFA to post-RFA measurements (4.4 HU vs 7.9 HU; P = .52). In contrast-enhanced CTs, there was a significant drop in HU after RFA (from 48.3 HU to 14.7 HU; P = .03). None of the included cases showed a focal region of contrast enhancement to suggest residual tumour. Conclusion A change in tumour size, tumour volume, and HU in nonenhanced CT were unreliable in defining radiologic treatment success. Only changes in HU in contrast-enhanced CT was useful in confirming a positive treatment response after RFA for APA.

scholarly journals Influence of type and volume of surgical resection on postoperative period in patients with gliomas

2008 ◽  
Vol 7 (5-1) ◽  
pp. 231-235
Author(s):  
B. V. Martynov ◽  
V. Ye. Parfenov ◽  
D. V. Svistov ◽  
G. Ye. Trufanov ◽  
V. A. Fokin ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Surgical Resection ◽  
Neurological Deficit ◽  
Open Surgery ◽  
Tumor Resection ◽  
Neurological Status ◽  
Tumor Location ◽  
Tumour Resection ◽  
Before And After ◽  
Location Type

283 patients with gliomas were included in this study. Age, sex, neurological status and Karnovsky performance were analyzed before and after surgery, also tumor location, type and volume of surgical resection, postoperative complications were considered. Volume of tumor resection did not depend on glioma localization, excluding deep located tumors, in which case stereotactic cryotomy was performed (p < 0,01). In cases of stereotactic cryotomy postoperative neurological deficit worsening was noted in 12,5%, in patients with open biopsy and partial resection — 10,9%, and in case of total or subtotal tumor resection in 7,0% (p > 0,05). Partial gliom resection often related with postoperative complications and neurological deficit worsening then open surgery total tumour resection. Stereotactic cryotomy does not lead to bigger postoperative complications frequency in comparisons with open surgery.

scholarly journals Morphological changes in the trabecular meshwork and Schlemm’s canal after treatment with topical intraocular pressure-lowering agents

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ji-Hye Park ◽  
Hyun Woo Chung ◽  
Eun Gyu Yoon ◽  
Min Jung Ji ◽  
Chungkwon Yoo ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Trabecular Meshwork ◽  
Morphological Changes ◽  
Open Angle Glaucoma ◽  
Anterior Segment ◽  
Schlemm’S Canal ◽  
Schlemm's Canal ◽  
Before And After ◽  
Treatment Naïve ◽  
Aqueous Outflow

AbstractGlaucoma treatment is usually initiated with topical medication that lowers the intraocular pressure (IOP) by reducing the aqueous production, enhancing the aqueous outflow, or both. However, the effect of topical IOP-lowering medications on the microstructures of the aqueous outflow pathway are relatively unknown. In this retrospective, observational study, 56 treatment-naïve patients with primary open-angle glaucoma were enrolled. Images of the nasal and temporal corneoscleral limbus were obtained using anterior segment optical coherence tomography (AS-OCT). The conjunctival vessels and iris anatomy were used as landmarks to select the same limbal area scan, and the trabecular meshwork (TM) width, TM thickness, and Schlemm’s canal (SC) area were measured before and after using the IOP-lowering agents for 3 months. Among the 56 patients enrolled, 33 patients used prostaglandin (PG) analogues, and 23 patients used dorzolamide/timolol fixed combination (DTFC). After 3 months of DTFC usage, the TM width, TM thickness, and SC area did not show significant changes in either the nasal or temporal sectors. Conversely, after prostaglandin analog usage, the TM thickness significantly increased, and the SC area significantly decreased (all P < 0.01). These findings warrant a deeper investigation into their relationship to aqueous outflow through the conventional and unconventional outflow pathways after treatment with PG analogues.

Neoadjuvant therapy in gynaecological malignancies: What pathologists need to know

2019 ◽  
Vol 72 (2) ◽  
pp. 102-111 ◽  
Author(s):  
Aoife J McCarthy ◽  
Marjan Rouzbahman ◽  
Sakinah A Thiryayi ◽  
William B Chapman ◽  
Blaise A Clarke
Keyword(s):  
Tumour Volume ◽  
Serous Carcinoma ◽  
Pathology Report ◽  
Pathological Stage ◽  
Comprehensive Overview ◽  
Response To Chemotherapy ◽  
Before And After ◽  
Gynaecological Malignancies ◽  
Carcinoma Of The Ovary ◽  
Interval Cytoreduction

In recent times, there has been a growing tendency to treat advanced gynaecological malignancies with neoadjuvant chemotherapy (NACT), with the goal of reducing tumour volume and enhancing operability resulting in optimal cytoreduction. This approach is used in particular for patients with advanced high-grade serous carcinoma of the ovary, fallopian tube or peritoneum. Pathology plays a crucial role in the management of these patients, both before and after NACT. Prior to initiation of NACT, a biopsy should be performed, usually of the omental cake, to confirm that a malignancy is present, to identify the site of origin of the tumour and to type and grade the tumour. Histopathologists must be aware of the resultant morphological effects of NACT when examining specimens following interval cytoreduction surgery. Tumour typing and grading, and even the identification of residual neoplasia, are particular challenges. Immunohistochemistry, when used judiciously, can be a useful adjunct in certain scenarios. A pathological assessment of the response to chemotherapy, and the pathological stage should be provided in the pathology report, as these may inform prognosis and subsequent management. We present a comprehensive overview of the relevant clinical and pathological aspects pertaining to NACT for gynaecological malignancies for the practicing surgical pathologist.

scholarly journals Chordoid Glioma as a Differential Diagnosis of Anterior Third Ventricle Tumours: A Rare Case Report and Five-Year Follow-Up

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Kristin Suetens ◽  
Jeroen Swinnen ◽  
Linde Stessens ◽  
Sofie Van Cauter ◽  
Geert Gelin
Keyword(s):  
Anterior Part ◽  
Third Ventricle ◽  
Tumour Resection ◽  
Low Grade ◽  
Residual Tumour ◽  
Rare Case Report ◽  
Tumour Entity ◽  
Chordoid Glioma ◽  
Third Ventricle Tumours

Chordoid glioma is a rare and relatively recently defined tumour entity. Worldwide there have only been around 90 cases described until now. A chordoid glioma comprises a low-grade suprasellar neuroepithelial neoplasm originating in the anterior part of the third ventricle, with consistent radiological features on MRI. This lesion should be considered as a differential of third ventricle tumours. The patient described in this paper is quite unique in the sense that despite only partial tumour resection was obtained, the residual tumour was not progressive during several years of follow-up. Preoperative recognition of this disease entity is crucial to modify the treatment approach and improve patient outcome.

scholarly journals Open adrenalectomy for medium sized adrenocortical tumour: How I do it?

2015 ◽  
Vol 9 (5-6) ◽  
pp. 291 ◽  
Author(s):  
Wael M. Sameh ◽  
Ahmed Fouad Kotb
Keyword(s):  
Adrenocortical Carcinoma ◽  
Tumour Volume ◽  
Lateral Approach ◽  
Easy Access ◽  
Surgical Removal ◽  
Residual Tumour ◽  
Respiratory Problems ◽  
Adrenal Masses ◽  
The Mean ◽  
Adrenocortical Tumour

Introduction: The aim of our work was to report our experience in managing cases with medium-sized adrenocortical carcinoma by the high retroperitoneal extra pleural approach.Methods: During the past 2 years, 10 patients with suspected adrenocortical carcinoma were managed by our technique: the high supra 10th rib, retroperitoneal extra pleural approach. We included cases with 5 to 10 cm adrenal masses, suspected as adrenocortical carcinoma.Results: The mean patient age was 38 years (range: 26–44), the median tumour volume was 7 cm (range: 5–8). Of the 10 patients, 7 were female. Of the patients, 6 had right- and 4 had left-sided tumours. Intraoperatively, all cases had proper surgical removal, with no apparent residual tumour tissue. No single patient required a chest tube or developed respiratory problems. There were no major vascular injuries during surgery. We did not compare our findings to the standard lateral or subcostal approaches, as in our institution we adopt this high lateral approach for medium-sized tumours, while managing larger tumours with transperitoneal subcostal approach and smaller tumours laparoscopically.Conclusion: The high supra 10th lateral retroperitoneal, extra pleural approach is a safe, doable technique, allowing easy access to medium-sized suprarenal tumours and its vasculature, for cases suspected to be adrenocortical carcinoma.

632 Surgical considerations in residual tumour resection following chemotherapy for advanced testicular cancer

2004 ◽  
Vol 3 (2) ◽  
pp. 161 ◽  
Author(s):  
A. Heidenreich ◽  
M. Seger ◽  
A.J. Schrader ◽  
R. Hofmann ◽  
U. Engelmann ◽  
...  
Keyword(s):  
Testicular Cancer ◽  
Tumour Resection ◽  
Residual Tumour ◽  
Advanced Testicular Cancer

MR-appearance of the pituitary gland before and after resection of pituitary macroadenomas

1994 ◽  
Vol 49 (8) ◽  
pp. 524-530 ◽  
Author(s):  
E. Steiner ◽  
G. Math ◽  
E. Knosp ◽  
G. Mostbeck ◽  
J. Kramer ◽  
...  
Keyword(s):  
Pituitary Gland ◽  
Before And After ◽  
Pituitary Macroadenomas

scholarly journals Spinal versus General Anaesthesia in Postoperative Pain Management during Transurethral Procedures

ISRN Urology ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Stavros I. Tyritzis ◽  
Konstantinos G. Stravodimos ◽  
Ioanna Vasileiou ◽  
Georgia Fotopoulou ◽  
Georgios Koritsiadis ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
General Anaesthesia ◽  
Analogue Scale ◽  
Bladder Tumour ◽  
Analgesic Efficacy ◽  
Postoperative Pain Management ◽  
Tumour Volume ◽  
Tumour Resection ◽  
Transurethral Prostatectomy ◽  
Vas Score

We compared the analgesic efficacy of spinal and general anaesthesia following transurethral procedures. 97 and 47 patients underwent transurethral bladder tumour resection (TUR-B) and transurethral prostatectomy (TUR-P), respectively. Postoperative pain was recorded using an 11-point visual analogue scale (VAS). VAS score was greatest at discharge from recovery room for general anaesthesia (). The pattern changed significantly at 8 h and 12 h for general anaesthesia's efficacy ( and resp.). A higher VAS score was observed in pT2 patients. Patients with resected tumour volume >10  exhibited a VAS score >3 at 8 h and 24 h (, resp.). Multifocality of bladder tumours induced more pain overall. It seems that spinal anaesthesia is more effective during the first 2 postoperative hours, while general prevails at later stages and at larger traumatic surfaces. Finally, we incidentally found that tumour stage plays a significant role in postoperative pain, a point that requires further verification.

Sign in / Sign up

Export Citation Format

Share Document