scholarly journals Case of a Giant Prolactinoma Measuring Greater Than 10 CM in a Post-Menopausal Woman

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A575-A575
Author(s):  
Nasvin Imamudeen ◽  
Aiman Zafar ◽  
Shankar Bettadahalli
Keyword(s):  
Medical Therapy ◽  
Prolactin Level ◽  
Night Vision ◽  
Serum Prolactin ◽  
Menopausal Woman ◽  
Female Ratio ◽  
Presenting Symptoms ◽  
The Right ◽  
The Brain

Abstract Prolactinomas are the most common type of pituitary adenomas. Macroprolactinoma is the name used for tumors when their size exceeds 1 cm and giant prolactinomas are those that exceeds 4 cm. Females are more commonly reported to have microprolactinomas with female-to-male ratio of 20:1, on the contrary macroprolactinomas are usually diagnosed in men aged 20-50 years with a reported male-to-female ratio of 9:1. We are presenting the case of a 63-year-old female with history of cataracts and hypertension who presented with complaints of progressive decrease in vision in both of her eyes (right greater than left) for several months and declining night vision without headache. Her only other symptoms were tiredness and cold intolerance. A detailed visual exam led to the findings of bitemporal hemianopsia and possible right optic neuropathy. Her neurological exam otherwise was intact. Subsequently contrast magnetic resonance imaging (MRI) of the brain showed a large sellar and suprasellar mass measuring greater than 10 cm x 6 cm in size invading right cavernous sinus, surrounding vessels and compressing optic chiasm with extension into the right temporal lobe, left frontal lobe and subfalcine shift to the right. Laboratory studies indicated elevated prolactin level of 4932 ng/mL (2.8 - 29.2 ng/mL) consistent with prolactinoma. Pituitary hormone function testing revealed suppressed gonadotropins, subnormal ACTH stimulation test and central hypothyroidism. She was started on medical therapy with cabergoline. At one month follow-up, serum prolactin level significantly decreased to 136.2 ng/mL but the size of the mass did not significantly decrease on follow up brain MRI. Patient currently wants to try medical management alone. Conclusion: Macroprolactinomas measuring >4 cm are rare, accounting for only 1–5% of all prolactinomas and are more commonly seen in men, however they can be seen in postmenopausal women as well. Headaches and visual field disturbances are common presenting symptoms due to compressive effect and warrant further investigation with MRI of the brain. Medical therapy alone can sometimes suffice and surgery is a second line option as it confers morbidity risks.

scholarly journals RONC-26. A CASE OF RADIATION NECROSIS OF THE CEREBELLUM 16 YEARS AFTER CHEMORADIOTHERAPY FOR MEDULLOBLASTOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii460-iii460
Author(s):  
Mayuko Miyata ◽  
Masahiro Nonaka ◽  
Akio Asai
Keyword(s):  
Radiation Necrosis ◽  
Tumor Resection ◽  
Pathological Examination ◽  
Secondary Cancer ◽  
Brain Necrosis ◽  
Cerebellar Medulloblastoma ◽  
Cerebellar Peduncle ◽  
The Right ◽  
The Brain

Abstract BACKGROUND If new lesions are observed during follow-up of the malignant tumor after treatment, it is difficult to distinguish whether the tumor is a recurrent lesion, secondary cancer, or radiation necrosis of the brain. We have encountered a patient with symptomatic radiation necrosis of the cerebellum 16 years after treatment of medulloblastoma. CASE PRESENTATION: A 24-year-old man who had received a tumor resection and chemoradiotherapy for cerebellar medulloblastoma at the age of 8 presented with dizziness. For the past 16 years, there was no recurrence of the tumor. He subsequently underwent MRI scan, and T1-Gd image showed enhanced lesion in the right cerebellar peduncle. Cerebrospinal fluid cytology analysis was negative for tumor. We suspected tumor reccurence or secondary cancer, and performed lesion biopsy. The result of the pathological examination was radiation necrosis of the cerebellum. DISCUSSION: The interval of radiation necrosis of the brain and radiotherapy can vary from months to more than 10 years. So, whenever a new lesion is identified, radiation brain necrosis must be envisioned. According to guidelines in Japan, there is no absolute examination for discriminating tumor recurrence from radiation brain necrosis and diagnosis by biopsy may be required. CONCLUSION We experienced a case of symptomatic radiation necrosis of the cerebellum 16 years after treatment. In patients showing new lesion after long periods of time, the possibility of radiation necrosis to be considered.

scholarly journals SENTUHAN KASIH IBU, UPAYA STIMULASI TUMBUH KEMBANG ANAK DENGAN PIJAT BAYI PADA ANAK USIA 0-3 TAHUN DI DESA SELEBUNG KETANGGA, KECAMATAN KERUAK KABUPATEN LOMBOK TIMUR

2020 ◽  
Vol 4 (1) ◽  
pp. 356
Author(s):  
Catur Esty Pamungkas ◽  
Aulia Amini ◽  
Cyntiya Rahmawati
Keyword(s):  
Community Service ◽  
Motor Development ◽  
Blood Circulation ◽  
Infant Massage ◽  
Post Test ◽  
Good Productivity ◽  
The Right ◽  
The Brain ◽  
Stimulation Of

ABSTRAKBayi dapat tumbuh dan berkembang dengan baik jika kebutuhan dasarnya terpenuhi, yaitu  asah, asih dan asuh. Kebutuhan asah adalah kebutuhan akan stimulasi dini. Pemberian stimulasi dini yang sesuai akan memungkinkan terbentuknya etika, kepribadian yang baik, kecerdasan, kemandirian, keterampilan dan produktivitas yang baik. Efektifitas pijat bayi memberikan manfaat pada perkembangan motorik sangat baik pada anak usia 8-28 hari dibandingkan dengan anak yang tidak diberikan stimulasi pijat bayi (Rizki, 2017). Melalui pemijatan peredaran darah akan lancar, Salah satu zat penting yang dibawa adalah oksigen. Terpenuhinya oksigen diotak secara cukup membuat konsentrasi dan kesiagaan bayi semakin baik(Sembiring, 2017). Solusi permasalahan yang ditawarkan yaitu “Sentuhan Kasih Ibu” Upaya Stimulasi Tumbuh Kembang anak dengan Pijat Bayi yang dilakukan Pada Anak Usia 0-3 Tahun di Desa Selebung Ketangga di Kecamatan Keruak Kabupaten Lombok Timur. Tujuan pengabdian ini memberikan informasi bagi masyarakat terutama orang tua mengenai manfaat setiap langkah dari pijat bayi. Tim PKMS akan memberikan pelatihan langsung kepada ibu yang akan dipraktikkan oleh narasumber yang berpengalaman, memiliki bidang ilmu yang sesuai dan telah mendapatkan pelatihan pijat bayi sebelumnya, sehingga setiap informasi diberikan oleh orang yang tepat. Setelah diberikan pelatihan pijat bayi tersebut, diharapkan ibu dapat mempraktikan sendiri pijat bayi di rumah.Jumlah responden yang mengikuti kegiatan ini sebanyak 32 balita. Hasil pengadian didapatkan terbanyak responden 12-24 sebanyak 19 balita (59,4%). Hasil pre test didapatkan 23 responden memiliki pengetahuan kurang dan post test sebagian besar pengetahuan cukup sebanyak 18 responden. Hasil follow up kemampuan pijat bayi didapatkan 24 reponden mampu melakukan pijat bayi dengan benar. Kata kunci: stimulasi tumbuh kembang; bayi; pijat bayi. ABSTRACTBabies can grow and develop well if their basic needs, which are teasers, love and foster. The need for sharpening is the need for early stimulation. Providing first inspiration appropriate will enable the formation of ethics, a good personality, intelligence, independence, skills and good productivity. The effectiveness of baby massage provides benefits to motor development is very good in children aged 8-28 days compared with children who do not give stimulation of baby massage (Rizki, 2017). Through massage, the blood circulation will be smooth. One of them the essential substance carried is oxygen. Fulfilment of oxygen in the brain is sufficient to make the baby's concentration and alertness are getting better (Sembiring, 2017). The solution to the problem offered is the "Touch of Mother's Love" Efforts to Stimulate Child Development with Infant Massage which was carried out on children aged 0-3 years in Selebung Ketangga Village in Keruak District East Lombok Regency. The purpose of this service is to provide information for the community, especially parents, regarding the benefits of every step of baby massage. The Stimulus Community Service Team (PKMS) will provide training directly to the mother who will be practised by experienced speakers who have fields science according to the training and baby massage before, so every information given by the right person. After being given the baby massage training, it is hoped that the mother can practicing baby massage at home on their own. The number of respondents who participated in this activity was 32 toddler. The results obtained were the most respondents 12-24 as many as 19 toddlers (59.4%). Pre results test found 23 respondents have less knowledge and most of the post-test sufficient knowledge of 18 respondents. The follow-up results of the infant massage ability were obtained 24 respondents are able to massage the baby properly. Keywords: growth and development stimulation; baby; baby massage.

scholarly journals Gastrointestinal and Extra-Gastrointestinal Stromal Tumours: A Clinicopathological and Immunohistochemical (c-KIT) Study

2020 ◽  
Author(s):  
Parasappa Joteppa Yaranal ◽  
N Prasanna ◽  
Anantharao Shankar Anand
Keyword(s):  
Gastrointestinal Stromal Tumour ◽  
Female Ratio ◽  
Medical College ◽  
Presenting Symptoms ◽  
Pain Abdomen ◽  
Bleeding Per Rectum ◽  
Malignant Gists ◽  
Histopathological Studies ◽  
The Right ◽  
Cells Of Cajal

Introduction: Gastrointestinal Stromal Tumour (GIST) is one of the most common mesenchymal tumours of GIT. They have been proved to be arising from the smooth muscle pacemaker interstitial cells of Cajal, these cells are involved in gut motility and peristaltic movements. They can also rarely arise outside the Gastrointestinal Tract (GIT) from retroperitoneum, mesentery and omentum called as Extragastrointestinal Stromal Tumor (EGIST). Single best defining feature of GIST is positivity for Cytoplasmic Tyrosine Kinase (c-KIT). Aim: The aim of the study was to analyse clinicopathological features and c-KIT expression in both gastrointestinal and EGISTs. Materials and Methods: This was a retrospective observational (cohort) study; over a period of two years from January 2018 to December 2019, done at Navodaya Medical College and Hospital, Raichur, Karnataka, which comprised of 12 cases of GIST. All the cases were a resected specimens and thorough evaluation of clinical, imaging and histopathological studies were done and forwarded for immunohistochemistry for c-KIT expression. Results: Age of cases ranged from 04-70 years, mean age being 50.6 years and male to female ratio 2:1. Presenting symptoms of most of GIST were pain abdomen, diarrhea and few with vomiting whereas, rectosigmoid GISTs (2 cases and one with metastasis to liver) were associated with pain abdomen, bleeding per rectum and constipation. One case of retroperitoneal (extraintestinal) GIST was asymptomatic and other presented with pain in the right hip due to secondaries and one benign gastric serosal GIST was associated with gastric adenocarcinoma. The CT scan in two of malignant GISTs, confirmed metastasis and c-KIT study was negative in these 2 malignant GISTs. Conclusion: This study reaffirms importance of CD117 in diagnosis of GIST and EGIST, however, the negativity of CD117 does not rule out GIST, which requires thorough clinico-radiological and pathological correlation.

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.

Early and late outcomes of surgical repair of double-chambered right ventricle: a single-centre experience

2020 ◽  
Vol 30 (3) ◽  
pp. 409-412
Author(s):  
Murat Surucu ◽  
İlkay Erdoğan ◽  
Birgül Varan ◽  
Murat Özkan ◽  
N. Kürşad Tokel ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Right Ventricle ◽  
Septal Defect ◽  
Surgical Intervention ◽  
Systolic Pressure ◽  
Presenting Symptoms ◽  
Long Term Follow Up ◽  
The Right

AbstractObjective:Double-chambered right ventricle is characterised by division of the outlet portion of the right ventricle by hypertrophy of the septoparietal trabeculations into two parts. We aim to report our experiences regarding the presenting symptoms of double-chambered right ventricle, long-term prognosis, including the recurrence rate and incidence of arrhythmias after surgery.Methods:We retrospectively investigated 89 consecutive patients who were diagnosed to have double-chambered right ventricle and underwent a surgical intervention from 1995 to 2016. The data obtained by echocardiography, cardiac catheterisation, and surgical findings as well as post-operative follow-up, surgical approaches, post-operative morbidity, mortality, and cardiac events were evaluated.Results:Median age at the time of diagnosis was 2 months and mean age at the time of operation was 5.3 years. Concomitant cardiac anomalies were as follows: perimembranous ventricular septal defect (78 patients), atrial septal defect (9 patients), discrete subaortic membrane (32 patients), right aortic arch (3 patients), aortic valve prolapse and/or mild aortic regurgitation (14 patients), and left superior caval vein (2 patients). The mean follow-up period was 4.86 ± 4.6 years. In these patients, mean systolic pressure gradient in the right ventricle by echocardiography before, immediately, and long-term after surgical intervention was 66.3, 11.8, and 10.4 mmHg, respectively. There were no deaths during the long-term follow-up period. Surgical reinterventions were performed for residual ventricular septal defect (2), residual pulmonary stenosis (1), and severe tricuspid insufficiency (1).Conclusion:The surgical outcomes and prognosis of double-chambered right ventricle are favourable, recurrence and fatal arrhythmias are unlikely in long-term follow-up.

Convexity Meningioma Presenting as Postpartum Eclampsia

2003 ◽  
Vol 33 (1) ◽  
pp. 53-54 ◽  
Author(s):  
Bello B Shehu ◽  
Nasiru J Ismail
Keyword(s):  
Early Diagnosis ◽  
The Body ◽  
History Of ◽  
Neurological Features ◽  
The Right ◽  
The Brain ◽  
Tomography Scan ◽  
Progressive Weakness ◽  
In Pregnancy

A 37-year-old woman, Para 5+0 presented with a 1 year history of recurrent convulsions and progressive weakness of the right side of the body. She had been treated for postpartum eclampsia in her last delivery but symptoms recurred 3 months later. Evaluation including computerized tomography scan of the brain suggested a parieto-temporal meningioma, which was completely excised at craniotomy. Histology confirmed this to be a meningioma. The patient was well at 8 months of follow up. The growth of meningiomas may increase during pregnancy due to presence of receptors for progestational hormones in the tumour and the meningioma may become symptomatic in pregnancy, presenting as eclampsia. Close follow up of patients with eclampsia is necessary to identify neurological features that may lead to a diagnosis of meningioma. Early diagnosis is essential if a good outcome is to be ensured.

scholarly journals Marked Hyperprolactinemia Caused by Carotid Aneurysm

1997 ◽  
Vol 24 (1) ◽  
pp. 64-66 ◽  
Author(s):  
Susan R. Kahn ◽  
Richard Leblanc ◽  
Abbas F. Sadiko ◽  
I. George Fantus
Keyword(s):  
Prolactin Level ◽  
Artery Aneurysm ◽  
Cranial Computed Tomography ◽  
Serum Prolactin ◽  
Left Internal Carotid Artery ◽  
Carotid Artery Aneurysm ◽  
Pituitary Dysfunction ◽  
Internal Carotid Artery Aneurysm ◽  
Aneurysm Repair

ABSTRACT:Background:Pituitary dysfunction caused by intracranial aneurysms is rare. We report a patient with the unique feature of hyperprolactinemia to a degree previously seen only with prolactinsecreting tumours.Method:Case report.Result:A 42-year-old woman had a galactorrhea, left-sided headache, reduced vision in the left eye and a left temporal hemianopsia. Serum prolactin was elevated (365 μg/L). Cranial computed tomography (CT) revealed a suprasellar mass, which carotid angiography showed to be a left internal carotid artery aneurysm. At craniotomy, this aneurysm and a smaller one of the ophthalmic artery were repaired, and the patient's vision returned to normal. The prolactin level fell to normal. Follow-up CT showed no evidence of pituitary adenoma or hypothalamic lesion.Conclusions:Carotid aneurysm can cause reversible pituitary dysfunction. A prolactin level >300 μg/L is not a reliable cut-off for distinguishing prolactin-secreting adenomas from other causes of elevated prolactin. A co-existing prolactinoma was felt to be ruled out by both a normal CT scan and normal prolactin levels following aneurysm repair. Patients with marked hyperprolactinemia should be considered for angiography or MRI to rule out carotid aneurysm, since the consequences of pituitary exploration in this setting are potentially grave.

scholarly journals Clinical features and outcomes of adrenal schwannoma: a study of 13 cases from a single center

2021 ◽  
Author(s):  
Henghai Huang ◽  
Qijian Ding ◽  
XiaoCao Lin ◽  
DeLin Li ◽  
Jingjing Zeng ◽  
...  
Keyword(s):  
Operative Management ◽  
Pathological Examination ◽  
Computed Tomography Imaging ◽  
Tertiary Referral Hospital ◽  
Female Ratio ◽  
Tomography Imaging ◽  
Male Female Ratio ◽  
The Mean ◽  
The Right

Background: Adrenal schwannomas (AS) are extremely rare neoplasms. This study shares our experience regarding the diagnosis and operative management of AS. Methods: Clinical details, radiologic, laboratory, and pathologic findings as well as follow-up data were analyzed retrospectively for 13 AS patients who accepted surgery at a tertiary referral hospital in China between January 1, 1996, and December 31, 2017. Results: The mean age of the patients at diagnosis was 44.7 ± 13.7 years (range 19–62 years; male: female ratio, 1:1.16), of whom 7 patients had unilateral AS on the right side, and the remaining 6 on the left side. None of the cases were hormonally active. None of the 13 cases were diagnosed as AS by computed tomography imaging before the operation. Among the patients, 10 were asymptomatic. The mean preoperative size was 7.1 ± 3.2 cm (range 1.6–12.6 cm). All patients underwent surgery, with open adrenalectomy in 5 patients and laparoscopy in 8 patients. The mean tumor size on pathologic examination was 6.8 ± 3.0 cm (range 3.0–11.7 cm). The surgical specimens were confirmed by pathological examination. During a median follow-up of 60.8 ± 17.7 months, no patients showed recurrence or metastasis. Conclusion: The preoperative diagnosis of AS remains difficult despite the advances in imaging examinations. After complete resection, the prognosis of AS is excellent.

Cerebral contrast staining mimicking parenchymal haemorrhage in a stroke patient

2020 ◽  
Vol 13 (12) ◽  
pp. e236400
Author(s):  
Elvin Yuan Ting Lim ◽  
Saravana Kumar Swaminathan
Keyword(s):  
Ct Scan ◽  
Middle Cerebral Artery ◽  
Signs And Symptoms ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Iodinated Contrast ◽  
Acute Infarct ◽  
The Right ◽  
The Brain

A 75-year-old female patient presented with signs and symptoms of a right hemispheric syndrome. A CT scan of the brain with angiogram showed an acute infarct in the right middle cerebral artery (MCA) territory secondary to thromb-occlusion of the M1 segment of the right MCA. A follow-up CT scan 2 weeks later showed a large hyperdense region in the infarcted area. With the aid of a dual-energy CT scan, this was eventually shown to be due to contrast staining from an earlier administration of iodinated contrast on the same day, rather than frank haemorrhagic conversion of the recent right MCA infarct.

Rupture of lenticulostriate artery aneurysms

2014 ◽  
Vol 120 (2) ◽  
pp. 426-433 ◽  
Author(s):  
Olivier Heck ◽  
René Anxionnat ◽  
Jean-Christophe Lacour ◽  
Anne-Laure Derelle ◽  
Xavier Ducrocq ◽  
...  
Keyword(s):  
Therapeutic Strategy ◽  
First Line ◽  
Ischemic Event ◽  
Bilateral Case ◽  
History Of ◽  
Lenticulostriate Artery ◽  
The Right ◽  
The Brain ◽  
Deep Location

The authors report on 3 rare cases of ruptured lenticulostriate artery (LSA) aneurysms that were heralded by deep cerebral hematomas. The hematomas were unilateral in 2 cases and bilateral in 1; in the bilateral case, only a single LSA aneurysm could be identified on the right side of the brain. Because of their small size (≤ 2 mm), fusiform aspect, and deep location within the brain, all of the aneurysms were treated conservatively. There was no hemorrhage recurrence, and follow-up angiography demonstrated spontaneous thrombosis in 2 of the 3 cases. The clinical course was favorable in 2 of the 3 patients. The course in the patient with the bilateral hematoma was marked by an ischemic event after the initial episode, resulting in an aggravation of deficits. The cause of this second event was uncertain. Because our knowledge about the natural history of LSA aneurysms is incomplete, there is no consensus concerning a therapeutic strategy. The authors' experience in 3 reported cases leads them to think that a conservative approach involving close angiographic monitoring may be proposed as first-line treatment. If the monitored aneurysm then persists or grows in size, its occlusion should be considered. Nonetheless, other studies are needed to further strengthen the legitimacy of this strategy.

Sign in / Sign up

Export Citation Format

Share Document