scholarly journals TSH-secreting pituitary adenoma in combination with primary hypothyroidism in the outcome of Hashimoto’s disease: diagnostic difficulties

2018 ◽  
Vol 14 (3) ◽  
pp. 162-168
Author(s):  
Arina V. Tkachuk ◽  
Tatiana A. Grebennikova ◽  
Anastasiya M. Lapshina ◽  
Victoria P. Vladimirova ◽  
Zhanna E. Belaya ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Adenomas ◽  
Immunohistochemical Analysis ◽  
Primary Hypothyroidism ◽  
Hashimoto’S Disease ◽  
Transsphenoidal Adenomectomy ◽  
Autonomously Functioning Thyroid Nodules ◽  
Diagnostic Difficulties ◽  
Hashimoto's Disease ◽  
The Brain

Despite the fact that pituitary adenomas are among the most frequent brain tumours, TSH-secreting pituitary adenomas (thyrotropinomas) are less than 1% of all adenomas. Due to the increase in the free fractions of thyroid hormones at normal or elevated TSH levels, the majority of patients with these pituitary adenomas have a long anamnesis of thyrotoxicosis which requires a differential diagnosis with thyroid pathology (Graves’ disease, toxic adenoma, autonomously functioning thyroid nodules). The diagnosis of the thyrotropinoma is quite challenging for clinicians. This article describes the case of a combination of the thyrotropinoma with primary hypothyroidism as a result of the Hashimoto’s disease. A feature of this article is the absence of a typical clinical picture of thyrotoxicosis in combination with an evaluated level of TSH on the background of constantly increasing substitution therapy for primary hypothyroidism. The picture of space-occupying lesion according to MRI of the brain allowed to suspect hormone-active pituitary adenoma (macroadenoma). As a result of surgical treatment (endonasal transsphenoidal adenomectomy), the level of TSH and free thyroid hormone levels were normalized in the postoperative period. The diagnosis of TSH-secreting pituitary adenoma was confirmed by histological and immunohistochemical analysis of postoperative material.

scholarly journals Association of Ki-67 Labelling Index and IL-17A with Pituitary Adenoma

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Brigita Glebauskiene ◽  
Rasa Liutkeviciene ◽  
Alvita Vilkeviciute ◽  
Inga Gudinaviciene ◽  
Aurelija Rocyte ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Adenomas ◽  
Immunohistochemical Analysis ◽  
Serum Levels ◽  
Labelling Index ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Ki 67 ◽  
Tissue Samples ◽  
Median Serum

The aim of the present study was to determine if the Ki-67 labelling index reflects invasiveness of pituitary adenoma and to evaluate IL-17A concentration in blood serum of pituitary adenoma patients. The study was conducted in the Hospital of Lithuanian University of Health Sciences. All pituitary adenomas were analysed based on magnetic resonance imaging findings. The suprasellar extension and sphenoid sinus invasion by pituitary adenoma were classified according to Hardy classification modified by Wilson. Knosp classification system was used to quantify the invasion of the cavernous sinus. The Ki-67 labelling index was obtained by immunohistochemical analysis with the monoclonal antibody, and serum levels of IL-17A were determined by enzyme-linked immunosorbent assay (ELISA). Sixty-nine PA tissue samples were investigated. Serum levels of IL–17A were determined in 60 patients with PA and 64 control subjects. Analysis revealed statistically significantly higher Ki-67 labelling index in invasive compared to noninvasive pituitary adenomas. Median serum IL-17A level was higher in the pituitary adenoma patients than in the control group. Conclusion. IL-17A might be a significant marker for patients with pituitary adenoma and Ki-67 labelling index in case of invasive pituitary adenomas.

scholarly journals Homoeopathic Treatment of Pituitary Adenoma: A Case Report

2020 ◽  
Vol 7 (2) ◽  
pp. 109-128
Author(s):  
Nur-E-Alam Rasel ◽  
Md. Sofiqul Alam ◽  
Md. Mostafizur Rahman Siddique ◽  
Narottam Debnath ◽  
Md. Jahangir Alam ◽  
...  
Keyword(s):  
Case Report ◽  
Pituitary Adenoma ◽  
Pituitary Adenomas ◽  
Combined Therapy ◽  
Optic Chiasm ◽  
Individual Case ◽  
The Body ◽  
Near Future ◽  
The Brain

Most pituitary adenomas are slow-growing and benign, which means they are not cancer and do not spread to other parts of the body. They generally have a slow but severe impact on vision due to compression of the optic nerves, optic chiasm, and cavernous sinus.  However, as they grow big they can put pressure on nearby structures, such as the nerves that connect the eyes to the brain and cause symptoms. Pituitary adenomas are the third most common intracranial tumor and arise from the pituitary gland. An individual case is presented in this paper with radiological evidence (MRI) of a large lobulated intrasellar mass (3.0 cm transversely, 3.5 cm craniocaudally and 2 cm anteroposteriorly) with supra-sellar extension is causing elevation of the floor of the 3rd ventricle of the brain. Pituitary macroadenoma and hemorrhagic foei, pituitary apoplexy, and pituitary adenomas were founded by different CT scan and MRI reports in different laboratories. The patient was treated with constitutional homoeopathic medicines – Natrum muriticum-m/1, 16 doses up to Natrum muriticum-m/20, 16 doses each from 26/04/2014 to 07/08/2017. Before treatment imaging was done several times from 6/04/2011 to 12/01/2012showed complete resolution of the pituitary adenoma and during treatment3 follow-up imaging was done on 25/07/2015 and 06/08/2017. This case report reviews the clinical presentation, homoeopathic management, and treatment of the major classification of pituitary adenomas and call attention to the need for repertorization in individualized homoeopathic prescription. It is hoped that if this type of clinical research continues in the future, homeopathy will have a breakthrough result and it’s symptomatic medical treatment will play a beneficial role in the near future from the deadly evils of various types of chemotherapy, radiotherapy, or combined therapy.

scholarly journals Hypothyroidism conversion to hyperthyroidism: it’s never too late

2018 ◽  
Vol 2018 ◽  
Author(s):  
Ehtasham Ahmad ◽  
Kashif Hafeez ◽  
Muhammad Fahad Arshad ◽  
Jimboy Isuga ◽  
Apostolos Vrettos
Keyword(s):  
Time Lapse ◽  
Primary Hypothyroidism ◽  
Initial Diagnosis ◽  
Thyroid Peroxidase ◽  
Graves Disease ◽  
Time Interval ◽  
List Type ◽  
Hashimoto’S Disease ◽  
Hashimoto's Disease ◽  
High Index Of Suspicion

Summary Primary hypothyroidism is a common endocrine condition, most commonly caused by autoimmune thyroiditis (Hashimoto’s disease) while Graves’ disease is the most common cause of hyperthyroidism. Hypothyroidism is usually a permanent condition in most patients requiring lifelong levothyroxine treatment. Transformation from Hashimoto’s disease to Graves’ disease is considered rare but recently been increasingly recognised. We describe a case of a 61-year-old lady who was diagnosed with hypothyroidism approximately three decades ago and treated with levothyroxine replacement therapy. Approximately 27 years after the initial diagnosis of hypothyroidism, she started to become biochemically and clinically hyperthyroid. This was initially managed with gradual reduction in the dose of levothyroxine, followed by complete cessation of the medication, but she remained hyperthyroid, ultimately requiring anti-thyroid treatment with Carbimazole. This case highlights that there should be a high index of suspicion for a possible conversion of hypothyroidism to hyperthyroidism, even many years after the initial diagnosis of hypothyroidism. To our knowledge, this case illustrates the longest reported time interval between the diagnosis of hypothyroidism until the conversion to hyperthyroidism. Learning points: Occurrence of Graves’ disease after primary hypothyroidism is uncommon but possible. In this case, there was a time-lapse of almost 28 years and therefore this entity may not be as rare as previously thought. Diagnosis requires careful clinical and biochemical assessment. Otherwise, the case can be easily confused for over-replacement of levothyroxine. We suggest measuring both anti-thyroid peroxidase (TPO) antibodies and TSH receptor antibodies (TRAB) in suspected cases. The underlying aetiology for the conversion is not exactly known but probably involves autoimmune switch by an external stimulus in genetically susceptible individuals.

scholarly journals MON-299 Risk Factors of Re-Growth of Non-Functional Pituitary Adenomas

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Zamira Yusufovna Khalimova ◽  
Yulduz Mahkhakamovna Urmanova
Keyword(s):  
Risk Factors ◽  
Pituitary Adenoma ◽  
Tumor Growth ◽  
Pituitary Gland ◽  
Pituitary Adenomas ◽  
Small Cell ◽  
Pituitary Macroadenoma ◽  
Large Tumor ◽  
Number Of Patients ◽  
The Brain

Abstract The aim of investigation to determine clinical aggressiveness diagnostic markers in patients with non-functional pituitary adenomas (NFPA) in the formation of gravity neuroendocrine disease symptoms. Material and Methods: We observed in 87 patients (including man - 44 women -43) of which have a verified diagnosis of NFPA after surgery - 31 which were subjected transnasal adenomectomy of the pituitary (TAG). Further analysis was performed on these patients, who were followed from 1 to 3 years. Results. After the analysis of the frequency of remission and relapse NFPA data selectively in patients we studied the correlation between various parameters and the frequency of relapses. NFPA developed the scale of aggressiveness allowed to identify the risk factors of markers on the 3rd degrees, allowing to create a set of measures of tumor growth relapse prevention. According to MRI data of the brain and pituitary gland, in 15 patients an endosellar tumor was found, in 16 - an endo-extrasellar tumor. In an MRI study, the structure of the NFPA had a predominantly soft tissue (n = 16) and cystic (n = 11) structure. In 4 cases (13%), the structure of the NFPA was represented by a hemorrhagic component, and in 2 (6.4%) of them, both cystic and hemorrhagic components were present. In 18 patients, microadenoma was revealed, in 12 - pituitary macroadenoma and in 1 - a giant pituitary adenoma. The developed scale of aggression markers of NFPA allowed identifying factors by 3 degrees, which allows developing a complex of measures for the prevention of tumor growth recurrence. Conclusions. 1) According to our data, the number of patients with large-cell chromophobic pituitary adenoma predominated - 24 (77.5%). In 2nd place were patients with small cell NFPA - 6 cases (19.3%). And only in 1 case was observed (3.2%) a giant malignant pituitary macroadenoma with recurrence of growth and metastasis in the brain of a teenage girl, in which dark-cell pituitary adenoma was histologically determined, 2) According to our preliminary data, the markers of aggressiveness of the course of NFPA are: young patient age, first symptoms of the disease manifest, large tumor size, asymmetry and deformation of the pituitary gland, signs of tumor invasion into adjacent tissues / arteries / cavernous sinus, presence of small cell and / or dark extracellular chromophobic adenomas, STH hypopituitarism, panhypopituitarism.

The assessment of vitamin D3 deficiency in patients with Hashimoto's disease and the relationship between the disease duration and 25OHD3 levels

2018 ◽  
Author(s):  
Katarzyna Lizis-Kolus ◽  
Alicja Hubalewska-Dydejczyk ◽  
Anna Sowa-Staszczak ◽  
Anna Skalniak ◽  
Aldona Kowalska ◽  
...  
Keyword(s):  
Vitamin D3 ◽  
Disease Duration ◽  
Hashimoto’S Disease ◽  
Hashimoto's Disease ◽  
The Relationship ◽  
Vitamin D3 Deficiency

PTTG has a Dual Role of Promotion-Inhibition in the Development of Pituitary Adenomas

2019 ◽  
Vol 26 (11) ◽  
pp. 800-818
Author(s):  
Zujian Xiong ◽  
Xuejun Li ◽  
Qi Yang
Keyword(s):  
Cell Cycle ◽  
Pituitary Adenoma ◽  
Pituitary Adenomas ◽  
Cell Cycle Progression ◽  
Key Factors ◽  
Cycle Progression ◽  
Sister Chromatids ◽  
Regulation Of Cell Cycle ◽  
Late Stages

Pituitary Tumor Transforming Gene (PTTG) of human is known as a checkpoint gene in the middle and late stages of mitosis, and is also a proto-oncogene that promotes cell cycle progression. In the nucleus, PTTG works as securin in controlling the mid-term segregation of sister chromatids. Overexpression of PTTG, entering the nucleus with the help of PBF in pituitary adenomas, participates in the regulation of cell cycle, interferes with DNA repair, induces genetic instability, transactivates FGF-2 and VEGF and promotes angiogenesis and tumor invasion. Simultaneously, overexpression of PTTG induces tumor cell senescence through the DNA damage pathway, making pituitary adenoma possessing the potential self-limiting ability. To elucidate the mechanism of PTTG in the regulation of pituitary adenomas, we focus on both the positive and negative function of PTTG and find out key factors interacted with PTTG in pituitary adenomas. Furthermore, we discuss other possible mechanisms correlate with PTTG in pituitary adenoma initiation and development and the potential value of PTTG in clinical treatment.

scholarly journals Successful pregnancy after operation in an infertile woman caused by luteinizing hormone-secreting pituitary adenoma: case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi Zhang ◽  
Cheng Chen ◽  
Min Lin ◽  
Kan Deng ◽  
Huijuan Zhu ◽  
...  
Keyword(s):  
Case Report ◽  
Pituitary Adenoma ◽  
Literature Review ◽  
Pituitary Adenomas ◽  
Sella Turcica ◽  
Infertile Woman ◽  
Mass Treatment ◽  
Successful Pregnancy ◽  
Case Presentation ◽  
Transsphenoidal Resection

Abstract Background Functional gonadotroph adenomas (FGAs) are rare adenomas that most commonly secrete FSH. However, solitary LH-secreting pituitary adenomas are unusual. Case presentation A 30-year-old woman with elevated LH and normal FSH presented with inability to conceive. An MRI revealed an enlarged sella turcica and an intrasellar mass. Treatment with transsphenoidal resection led to normalization of LH and estradiol, as well as successful pregnancy. And we reviewed 6 cases of LH-secreting pituitary adenomas from 1981 to 2020. Conclusions Our case is unique because of the LH-secreting pituitary adenoma without FSH hypersecretion. This case indicates that pituitary adenoma should be considered when other diseases causing infertility have been excluded.

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