scholarly journals Synchronous GH- and prolactin-secreting pituitary adenomas

2014 ◽  
Vol 2014 ◽  
Author(s):  
Maryam Rahman ◽  
Ignacio Jusué-Torres ◽  
Abdulrahman Alkabbani ◽  
Roberto Salvatori ◽  
Fausto J Rodríguez ◽  
...  
Keyword(s):  
Prolactin Level ◽  
Pituitary Adenomas ◽  
Pituitary Tumors ◽  
The Other ◽  
Careful Study ◽  
List Type ◽  
Pathological Analysis ◽  
Level Elevation ◽  
Learning Points ◽  
Endocrinological Investigation

Summary Pituitary adenomas are usually solitary lesions. Rarely, patients may present with two distinct pituitary tumors. We report a case of synchronous secretory pituitary adenomas in a woman who initially presented with elevated prolactin levels. She was initially treated with cabergoline, but, after many years, she began developing symptoms consistent with acromegaly. Imaging revealed two distinct tumors within the pituitary gland. Endocrinological investigation confirmed acromegaly. At the time of surgery, two separate tumors were identified and resected. Pathological analysis demonstrated one tumor as a prolactinoma, and the other tumor as a GH-secreting adenoma. Postoperatively, her GH and IGF1 levels normalized, while the prolactin level remained slightly above normal. This case highlights that GH and prolactin level elevation is not always from co-secretion by the same adenoma. Learning points Synchronous pituitary adenomas represent <0.5% of pituitary tumors requiring surgery. In the setting of elevated GH and prolactin levels, one cannot assume that they are co-secreted by the same adenoma. A careful study of hormonal workup and pre-operative imaging is necessary for synchronous pituitary adenomas to assure resection of both tumors.

scholarly journals Effective long-term temozolomide rechallenge in a macroprolactinoma

2018 ◽  
Vol 2018 ◽  
Author(s):  
Benedetta Zampetti ◽  
Giorgia Simonetti ◽  
Roberto Attanasio ◽  
Antonio Silvani ◽  
Renato Cozzi
Keyword(s):  
Aggressive Behavior ◽  
Acquired Resistance ◽  
Pituitary Tumors ◽  
List Type ◽  
Fractionated Radiotherapy ◽  
Resistance To Treatment ◽  
Aggressive Tumors ◽  
Learning Points ◽  
Treatment Surgery

Summary We describe the 20-year course of a 63-year-old male with a macroprolactinoma that acquired resistance to treatment and aggressive behavior after a 4-year successful treatment with cabergoline. He was submitted to multiple surgical resections by a skilled surgeon, fractionated radiotherapy and was eventually treated with temozolomide. After a first 6-month standard cycle, a relapse occurred and he was treated again successfully. Learning points: Prolactinomas are the most frequent type of pituitary adenoma. They usually have a benign course. In most cases dopamine-agonist drugs, mainly cabergoline, are first-line (and usually only) treatment. Occasionally prolactinomas can have or acquire resistance to treatment and/or aggressive behavior. Temozolomide (TMZ), an oral alkylating drug, can be effective in such aggressive tumors. Multimodal treatment (surgery, radiation, cabergoline and TMZ) is warranted in aggressive pituitary tumors. We describe here successful rechallenge with TMZ after relapse occurring 18 months after a first TMZ cycle.

scholarly journals A case of a co-secreting TSH and growth hormone pituitary adenoma presenting with a thyroid nodule

2018 ◽  
Vol 2018 ◽  
Author(s):  
Laura Hamilton Adams ◽  
Derick Adams
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenoma ◽  
Complete Remission ◽  
Pituitary Adenomas ◽  
Thyroid Nodules ◽  
Pituitary Hormones ◽  
Pituitary Hormone ◽  
List Type ◽  
Learning Points ◽  
Pituitary Macroadenomas

Summary Co-secreting TSH and growth hormone pituitary adenomas are rare. We present a case of a 55-year-old woman who presented with symptoms of neck fullness. Ultrasound revealed multiple thyroid nodules and examination revealed several clinical features of acromegaly. She was found to have a co-secreting TSH and growth hormone pituitary macroadenoma. She underwent surgical resection followed by gamma knife radiation, which resulted in complete remission of her TSH and GH-secreting adenoma. Learning points: TSH-secreting pituitary adenomas are rare and about one-third co-secrete other hormones. Thyroid nodules are common in acromegaly and can be the presenting sign of a growth hormone-secreting pituitary adenoma. In the workup of acromegaly, assessment of other pituitary hormones is essential, even in the absence of symptoms of other pituitary hormone dysfunction. Complete remission of co-secreting GH and TSH pituitary macroadenomas is possible with surgery and radiation alone.

scholarly journals An intrasellar pituitary adenoma–gangliocytoma presenting as acromegaly

2017 ◽  
Vol 2017 ◽  
Author(s):  
Melissa H Lee ◽  
Penelope McKelvie ◽  
Balasubramanian Krishnamurthy ◽  
Yi Yuen Wang ◽  
Carmela Caputo
Keyword(s):  
Pituitary Adenoma ◽  
Surgical Resection ◽  
Pituitary Adenomas ◽  
Histological Analysis ◽  
Good Prognosis ◽  
List Type ◽  
Ongoing Research ◽  
Learning Points ◽  
Mixed Tumours ◽  
Gh Excess

Summary Most cases of acromegaly are due to growth hormone (GH)-secreting pituitary adenomas arising from somatotroph cells. Mixed pituitary adenoma and gangliocytoma tumours are rare and typically associated with hormonal hypersecretion, most commonly GH excess. Differentiating these mixed tumours from conventional pituitary adenomas can be difficult pre-operatively, and careful histological analysis after surgical resection is key to differentiating the two entities. There is little literature addressing the possible mechanisms for the development of mixed pituitary adenoma–gangliocytomas; however, several hypotheses have been proposed. It still remains unclear if these mixed tumours differ from a clinical perspective to pituitary adenomas; however, the additional neural component of the gangliocytoma does not appear to modify the aggressiveness or risk of recurrence after surgical resection. We report a unique case of acromegaly secondary to a mixed GH-secreting pituitary adenoma, co-existing with an intrasellar gangliocytoma. Learning points: Acromegaly due to a mixed GH-secreting pituitary adenoma and intrasellar gangliocytoma is rare. These mixed tumours cannot be distinguished easily from ordinary pituitary adenomas on the basis of clinical, endocrine or neuroradiologic findings, and histological analysis is required for a definitive diagnosis. Surgical resection is usually sufficient to provide cure, without the need for adjuvant therapy. These mixed tumours appear to have a good prognosis although the natural history is not well defined. The pathogenesis of these mixed tumours remains debatable, and ongoing research is required.

Ultrastructural Immunocytochemistry of Five Rat Pituitary Adenomas

1980 ◽  
Vol 38 ◽  
pp. 724-725
Author(s):  
D. J. McComb ◽  
N. Ryan ◽  
E. Horvath ◽  
K. Kovacs ◽  
E. Nagy ◽  
...  
Keyword(s):  
Pituitary Adenomas ◽  
Pituitary Tumors ◽  
Electron Microscopic ◽  
Electron Microscopic Immunocytochemistry ◽  
Transmission Electron ◽  
Rat Pituitary ◽  
Radiation Induced ◽  
Group 5 ◽  
Group 2 ◽  
Microscopic Techniques

Conventional light and electron microscopic techniques failed to clarify the cellular composition and derivation of spontaneous and induced, intrasellar and transplanted pituitary adenomas in rats (1). In the present work, electron microscopic immunocytochemistry was applied to evaluate five adenohypo-physial tumors using a technique described by Moriarty and Garner (2). Spontaneously occurring pituitary adenomas (group 1) were harvested from aging female Long-Evans rats. R-Amsterdam rats were treated with 2 x 1.0 mg estrone acetate (HogivaI) s.c. weekly for 6 months. Pituitary adenomas in excess of 30 mg were removed from these animals to make up the tumors of group 2. Groups 3 and 4 consisted of estrogen-induced autonomous transplan¬ted pituitary tumors MtT.WlO and MtT.F4. Group 5 was a radiation-induced transplanted autonomous pituitary tumor MtT.W5. The tumors of groups 3,4 and 5 were allowed to proliferate in host rats 6-8 weeks prior to removal for processing. Tissue was processed for transmission electron microscopy (glutaraldehyde fixation, OsO4 postfixation and epoxy resin embedding), and electron microscopic immunocytochemistry (3% paraformaldehyde fixation and Araldite embedding).

Law for Aerospace Activities 1966-2066

1969 ◽  
Vol 73 (700) ◽  
pp. 255-270
Author(s):  
H. Caplan
Keyword(s):  
The Other ◽  
List Type ◽  
Type Number ◽  
The Future ◽  
Impossible Task

The purpose of this prologue is to outline how I have approached the arrogant and impossible task of surveying an unborn century of law. I may also be able to illustrate that the nature and quality of the task is completely different from that attempted in the preceding papers. In the whole paper I have done little more than infer repeatedly, in different ways (a) that the shape of the future so far as law is concerned will be determined by the methods of communication adopted between sectors of the aerospace community and between the aerospace community and society at large, and (b) that the search for effective methods of communication is urgent. But my target is not the lawyers of our community—who I am not qualified to advise. I write for the other members of the Royal Aeronautical Society and I return to the task of persuading them that they have a role to play in evolving future laws for aerospace activities.

scholarly journals XIII.—On the Churches at Rome earlier than the year 1150

Archaeologia ◽  
1866 ◽  
Vol 40 (1) ◽  
pp. 157-224
Author(s):  
Alexander Nesbitt
Keyword(s):  
The Other ◽  
Careful Study ◽  
Christian Church ◽  
Roman Art ◽  
Other Hand ◽  
Articles Of Faith ◽  
The Church

It will doubtless be generally admitted that the ecclesiastical buildings of the earlier centuries of the Christian era merit careful study, as well from the investigator into the history and antiquities of the Christian Church, as from the architectural antiquary. The style and ornamentation of the church and the baptistery must necessarily reflect something of the tone of feeling towards religious matters which prevailed at the time of their erection, whilst the form of the structure, and even more those fittings and arrangements by which it was adapted to ritual purposes, must obviously have been planned and modified in accordance with the views of the age as regarded liturgical and ritual observances, ecclesiastical discipline, and even articles of faith. To the architectural antiquary, on the other hand, these buildings are interesting as enabling him to study the decline of Roman art, and as links in the great chain of architectural progress.

MICROSURGICAL ANATOMY OF THE DIAPHRAGMA SELLAE AND ITS ROLE IN DIRECTING THE PATTERN OF GROWTH OF PITUITARY ADENOMAS

Neurosurgery ◽  
2008 ◽  
Vol 62 (3) ◽  
pp. 717-723 ◽  
Author(s):  
Alvaro Campero ◽  
Carolina Martins ◽  
Alexandre Yasuda ◽  
Albert L. Rhoton
Keyword(s):  
Pituitary Adenoma ◽  
Cavernous Sinus ◽  
Dura Mater ◽  
Pituitary Adenomas ◽  
Potential Role ◽  
Pituitary Tumors ◽  
Microsurgical Anatomy ◽  
Suprasellar Region ◽  
Lateral Distance ◽  
Diaphragma Sellae

Abstract OBJECTIVE To evaluate the anatomic aspects of the diaphragma sellae and its potential role in directing the growth of a pituitary adenoma. METHODS Twenty cadaveric heads were dissected and measurements were taken at the level of the diaphragma sellae. RESULTS The diaphragma sellae is composed of two layers of dura mater. There is a remarkable variation in the morphology of the diaphragm opening. The average anteroposterior distance of the opening was 7.26 mm (range, 3.4–10.7 mm) and the average lateral-to-lateral distance was 7.33 mm (range, 2.8–14.1 mm). CONCLUSION The variability in the diameter of the opening of the diaphragma sellae could explain the growth of pituitary tumors toward the cavernous sinus or toward the suprasellar region.

Protocol for the Examination of Specimens From Patients With Primary Pituitary Tumors

2011 ◽  
Vol 135 (5) ◽  
pp. 640-646 ◽  
Author(s):  
Vania Nosé ◽  
Shereen Ezzat ◽  
Eva Horvath ◽  
Kalman Kovacs ◽  
Edward R. Laws ◽  
...  
Keyword(s):  
Pituitary Adenomas ◽  
Pituitary Tumors ◽  
Diagnosis And Classification ◽  
Pathology Reporting ◽  
Synoptic Approach ◽  
Clear Information

Abstract In an effort to improve the diagnosis of pituitary tumors, we propose a synoptic approach to pituitary pathology reporting that will provide clear information to endocrinologists, neurosurgeons, neuropathologists, and surgical pathologists to advance the diagnosis and classification of pituitary adenomas.

Characteristics of Particulate Matter Emissions from Swine and Poultry Production Houses in the United States

2021 ◽  
Vol 64 (5) ◽  
pp. 1569-1579
Author(s):  
Fei Hu ◽  
Bin Cheng ◽  
Lingjuan Wang-Li
Keyword(s):  
Particulate Matter ◽  
Broiler Chicken ◽  
The United States ◽  
The Other ◽  
Emission Characteristics ◽  
List Type ◽  
Poultry Production ◽  
Emission Rates ◽  
Emission Data ◽  
Poultry Houses

HighlightsParticulate matter (PM) data were analyzed to identify PM emission characteristics among different animal types.The PM concentrations were higher in broiler chicken and swine farrowing houses and were higher in winter.The PM emissions were also higher in broiler chicken houses and swine farrowing rooms.The PM in the layer chicken house in Indiana had narrower distributions with a greater percentage of smaller particles.Abstract. Understanding the characteristics of particulate matter (PM) emissions from animal feeding operations (AFOs) is essential to address the associated health and environmental impacts and to develop control strategies to mitigate such impacts. This article reports a study of PM concentrations and emission characteristics from 26 poultry and swine production houses to investigate the similarities and differences in PM emission characteristics, e.g., concentrations, emission rates, and particle size distribution (PSD), among different animal and housing types. Concentration and emission data for PM2.5, PM10, and total suspended particulates (TSP) collected by the National Air Emission Monitoring Study (NAEMS) were used to compare the differences among different production practices and animal types. The PSDs of the PM were examined based on the PM2.5/PM10 and PM10/TSP emission rate ratios. It was discovered that the concentrations of PM varied among animal types. For poultry, the concentrations of PM were higher in broiler houses than in other poultry houses. For swine, the average concentrations of PM were higher in farrowing rooms than in swine barns. Moreover, the PM concentrations in poultry and swine houses exhibited significant seasonal trends, with higher concentrations in winter and lower concentrations in summer, which were in a reverse relationship with ventilation rates. The PM emissions also varied among animal types. For poultry, the PM emissions were significantly higher for poultry production houses in California. For swine, the PM emissions were significantly higher for farrowing rooms than other swine houses. The PSD of PM varied among animal types, with mass median diameters (MMD) in the ranges of 6.51 to 13.62 µm for poultry houses and 7.94 to 17.19 µm for swine houses. The geometric standard deviations (GSD) were in the ranges of 1.66 to 2.71 and 1.65 to 2.9 for poultry and swine PM, respectively. The PM in the layer house in Indiana had a narrower distribution (smaller GSD) with a greater percentage of smaller particles than the other poultry houses, while the PM in the broiler house in California had a broader distribution (larger GSD) than the other poultry houses. For swine, the PM in the sow barn in North Carolina had a narrower distribution (smaller GSD) than the other swine houses, while the PM in the farrowing houses in Oklahoma had a broader distribution (larger GSD) than the other swine houses. The knowledge gained from this research may provide insights for addressing the PM emissions from various animal production systems. Keywords: Concentration and emission, Particulate matter, PM2.5, PM10, Poultry, swine, PSD, TSP.

scholarly journals Endoscopic endonasal transsphenoidal approach for pituitary adenomas: technical aspects and report of casuistic

2010 ◽  
Vol 68 (4) ◽  
pp. 608-612 ◽  
Author(s):  
Américo Rubens Leite dos Santos ◽  
Roberto Monteiro Fonseca Neto ◽  
José Carlos Esteves Veiga ◽  
José Viana Jr ◽  
Nilza Maria Scaliassi ◽  
...  
Keyword(s):  
Pituitary Adenomas ◽  
Pituitary Tumors ◽  
Hormonal Control ◽  
Subtotal Resection ◽  
Endoscopic Endonasal ◽  
Technical Aspects ◽  
Transphenoidal Approach ◽  
Acth Secreting ◽  
Csf Leaks

OBJECTIVE: Analyse technical aspects, effectiveness and morbidity of the endoscopic endonasal transphenoidal approach for pituitary adenomas. METHOD: From January 2005 to September 2008, 30 consecutive patients underwent endoscopic endonasal resection of pituitary adenomas with a follow up from 3 to 36 months. Their medical charts were retrospectively analysed. RESULTS: There were 18 women and 12 men, mean age 44 years (range 17-65 yr). Among the 30 patients, 23 had macroadenomas and 7 microadenomas. Twelve patients had non-functioning tumors, 9 had ACTH-secreting tumors, 8 had GH-secreting tumors and 1 prolactinoma. Complete resection and hormonal control was achieved in all microadenomas. Macroadenomas were completely removed in 6 patients, subtotal resection in 6 and partial resection in 11. Three patients had diabetes insipidus and 5 had CSF leaks treated with lumbar drainage. CONCLUSION: The endonasal endoscopic approach for pituitary tumors is effective and has low morbidity.

Sign in / Sign up

Export Citation Format

Share Document