scholarly journals A case of acromegaly (Greece, 7th century AD)

2011 ◽  
Vol 165 (5) ◽  
pp. 819-821 ◽  
Author(s):  
Philippe Charlier ◽  
Christina Tsigonaki
Keyword(s):  
Pituitary Adenoma ◽  
Sella Turcica ◽  
Medical Examination ◽  
History Of

ObjectiveTo diagnose hormone-secreting pituitary adenoma in dry bones.DesignWe present here the case of a pathological skull from the Byzantine site of Eleutherna (Greece).MethodsA complete anthropological and medical examination of the skull and the whole conserved skeleton was performed in the laboratory.ResultsAll anatomical signs of acromegaly were present on this skull. More importantly, enlargement of the sella turcica clearly indicated the development of a macroadenoma, at the origin of the disease.ConclusionsThis skeletal case, and other ancient ones are discussed, to better describe the history of the disease, and the possibilities of the diagnosis.

Concurrent lymphocytic hypophysitis and pituitary adenoma

2006 ◽  
Vol 105 (2) ◽  
pp. 309-314 ◽  
Author(s):  
Shaye I. Moskowitz ◽  
Amir Hamrahian ◽  
Richard A. Prayson ◽  
Mercedes Pineyro ◽  
Robert R. Lorenz ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Sella Turcica ◽  
Mass Effect ◽  
Lymphocytic Infiltration ◽  
Lymphocytic Hypophysitis ◽  
Null Cell ◽  
History Of ◽  
Concurrent Development ◽  
Lymphocytic Adenohypophysitis ◽  
Lesion Growth

✓Lymphocytic hypophysitis (LyH) is an uncommon intrasellar lesion characterized by lymphocytic infiltration of the adenohypophysis. Evidence suggests that the cause is autoimmune, and the symptoms are usually related to either a mass effect or endocrine dysfunction. Lymphocytic hypophysitis has been described rarely in the setting of other simultaneous pathological processes that involve the pituitary and sella turcica, and is postulated to arise from an intrinsic inflammatory response. The authors report the case of a 43-year-old woman who presented with a 2-month history of galactorrhea and pseudohyperprolactinemia secondary to a 10-mm lesion within an enlarged pituitary gland. She was nulliparous and had no contributory medical history. Serial neuroimaging performed over a 2-year period demonstrated lesion growth, and visual deficits had developed; together these warranted surgical intervention. A transsphenoidal resection was performed. Microscopic and immunohistopathological examinations revealed a nonsecreting pituitary adenoma with concurrent lymphocytic adenohypophysitis. This is the first documented case of LyH in the setting of a null-cell pituitary adenoma. The authors review the related literature and outline potential mechanisms for the concurrent development of LyH and a pituitary adenoma.

scholarly journals Persistence of intrasellar trigeminal artery and simultaneous pituitary adenoma: description of two cases and their importance for the differential diagnosis of sellar lesions

2014 ◽  
Vol 58 (6) ◽  
pp. 661-665 ◽  
Author(s):  
Marcio Carlos Machado ◽  
Sergio Kodaira ◽  
Nina Rosa Castro Musolino
Keyword(s):  
Differential Diagnosis ◽  
Pituitary Adenoma ◽  
Pituitary Gland ◽  
Female Patient ◽  
Pituitary Adenomas ◽  
Sella Turcica ◽  
Persistent Trigeminal Artery ◽  
Trigeminal Artery ◽  
Sellar Lesions ◽  
History Of

Persistent trigeminal artery (PTA) is the most frequent embryonic communication between the carotid and vertebrobasilar systems. However, hormonal changes or the association of PTA with other sellar lesions, such as pituitary adenomas, are extremely rare. The aim of the present study was to report two patients with intrasellar PTA and simultaneous pituitary adenoma in order to emphasize the importance of differential diagnoses for sellar lesions. Case 1. A female patient, 41 years old, was admitted with a history of chronic headache (> 20 years). Pituitary magnetic resonance imaging (MRI) showed a rounded lesion in the left portion of the pituitary gland suggestive of adenoma (most likely clinically non-functioning adenoma). In addition to this lesion, the MRI demonstrated ecstasy of the right internal carotid artery and imaging suggestive of an intrasellar artery that was subsequently confirmed by an angio-MRI of the cerebral vessels as PTA. Case 2. A female patient, 42 years old, was admitted with a history of amenorrhea and galactorrhea in 1994. Laboratorial investigation revealed hyperprolactinemia. Pituitary MRI showed a small hyposignal area in the anterior portion of pituitary gland suggestive of a microadenoma initiated by a dopaminergic agonist. Upon follow-up, aside from the first lesion, the MRI showed a well delineated rounded lesion inside the pituitary gland, similar to a vessel. Angio-MRI confirmed a left primitive PTA. Failure to recognize these anomalous vessels within the sella might lead to serious complications during transsphenoidal surgery. Therefore, although their occurrence is uncommon, a working knowledge of vascular lesions in the sella turcica or pituitary gland is important for the differential diagnosis of pituitary lesions, especially pituitary adenomas.

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.

scholarly journals Pituitary macroadenoma presenting as a nasal tumor: case report

2014 ◽  
Vol 132 (6) ◽  
pp. 377-381 ◽  
Author(s):  
Nivaldo Adolfo Silva Junior ◽  
Fabiano Reis ◽  
Larissa Kaori Miura ◽  
Guilherme Henrique Vieira ◽  
Luciano Souza Queiroz ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Nasal Cavity ◽  
Nasal Obstruction ◽  
Sphenoid Sinus ◽  
Sella Turcica ◽  
Rare Condition ◽  
Lower Surface ◽  
Large Mass ◽  
Histopathological Analysis ◽  
Tumor Extension

CONTEXT: Pituitary macroadenomas are rare intracranial tumors. In a few cases, they may present aggressive behavior and invade the sphenoid sinus and nasal cavity, causing unusual symptoms. In this paper, we report an atypical case of pituitary adenoma presenting as a nasal mass.CASE REPORT: The patient was a 44-year-old woman who had had amenorrhea and galactorrhea for ten months, with associated nasal obstruction, macroglossia and acromegaly. Both growth hormone and prolactin levels were increased. Magnetic resonance imaging showed a large mass originating from the lower surface of the pituitary gland, associated with sella turcica erosion and tumor extension through the sphenoid sinus and nasal cavity. Histopathological analysis demonstrated a chromophobe pituitary adenoma with densely packed rounded epithelial cells, with some atypias and rare mitotic figures. There was no evidence of metastases.CONCLUSION: Macroadenoma invading the nasal cavity is a rare condition and few similar cases have been reported in the literature. This study contributes towards showing that tumor extension to the sphenoid sinus and nasopharynx needs to be considered and investigated in order to make an early diagnosis when atypical symptoms like nasal obstruction are present.

scholarly journals GH-Producing Pituitary Adenoma and Concomitant Rathke’s Cleft Cyst: A Case Report and Short Review

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ryota Tamura ◽  
Satoshi Takahashi ◽  
Katsura Emoto ◽  
Hideaki Nagashima ◽  
Masahiro Toda ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Sella Turcica ◽  
Short Review ◽  
Pituitary Hormones ◽  
Rathke’S Cleft Cyst ◽  
Resonance Imaging ◽  
Mr Images ◽  
Rathke's Cleft Cyst ◽  
Magnetic Resonance Imaging Mri ◽  
Rathke's Cleft

Concomitant pituitary adenoma (PA) and Rathke’s cleft cyst (RCC) are rare. In some cases, such PA is known to produce pituitary hormones. A 53-year-old man was admitted to our hospital with a diagnosis of lacunar infarction in the left basal ganglia. Magnetic resonance imaging (MRI) incidentally showed a suprasellar mass with radiographic features of RCC. When he consulted with a neurosurgical outpatient clinic, acromegaly was suspected based on his appearance. A diagnosis of growth hormone- (GH-) producing PA was confirmed from hormonal examinations and additional MRI. Retrospectively, initial MR images also showed intrasellar mass that is compatible with the diagnosis of PA other than suprasellar RCC. The patient underwent endonasal-endoscopic removal of the PA. Since we judged that the RCC of the patient was asymptomatic, only the PA was completely removed. The postoperative course of the patient was uneventful and GH levels gradually normalized. Only 40 cases of PA with concomitant RCC have been reported to date, including 13 cases of GH-producing PA. In those 13 cases, RCC tended to be located in the sella turcica, and suprasellar RCC like this case appears rare. In a few cases, concomitant RCCs were fenestrated, but GH levels normalized postoperatively as in the cases without RCC fenestration. If radiographic imaging shows typical RCC, and PA is not obvious at first glance, the possibility of concomitant PA still needs to be considered. In terms of treatment, removal of the RCC is not needed to achieve hormone normalization.

scholarly journals Metastasis of a Dorsal Melanoma to a Pituitary Adenoma Mimicking Pituitary Apoplexy

2017 ◽  
Vol 36 (04) ◽  
pp. 238-242
Author(s):  
Rui Ramos ◽  
Maria Machado ◽  
Cristiano Antunes ◽  
Vera Fernandes ◽  
Olinda Marques ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pituitary Adenoma ◽  
Adjuvant Radiotherapy ◽  
Transsphenoidal Surgery ◽  
Pituitary Apoplexy ◽  
Clinical Presentation ◽  
Pituitary Macroadenoma ◽  
Histology Result ◽  
History Of ◽  
Transcranial Approach

AbstractMetastases to pituitary adenomas are very rare. From the 20 cases found in the literature, none originated from a cutaneous melanoma. We present the case of a 67-year-old man with a history of transcranial approach to treat a pituitary macroadenoma followed by adjuvant radiotherapy. Fifteen years later, he presented a dorsal nodular melanoma, and three years after that, he developed symptoms of pituitary apoplexy. He was submitted to transsphenoidal surgery, and the histology result revealed metastasis of the melanoma into a pituitary adenoma.The similarity in the clinical presentation of the two entities—pituitary apoplexy and metastasis of the melanoma into a pituitary adenoma—and the rarity of this type of metastization alert to challenges in the differential diagnosis that may confound the neurosurgeon's decision.

scholarly journals The Effect of Endoscopic Endonasal Transsphenoidal Skull Base Surgery on Cochlear Function

2019 ◽  
Vol 80 (06) ◽  
pp. 604-607
Author(s):  
Murat Samet Ates ◽  
Murat Benzer ◽  
Isa Kaya ◽  
Huseyin Biceroglu ◽  
Erkin Ozgiray ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Sella Turcica ◽  
Early Period ◽  
Distortion Product Otoacoustic Emission ◽  
Bone Drilling ◽  
Cochlear Function ◽  
Distortion Product ◽  
Significant Difference

AbstractEndoscopic transsphenoidal skull base surgery (ETSS) has become a standard approach in the treatment of sellar and clival lesions, such as pituitary adenoma and chordoma. Due to the close proximity of the clivus and the sella turcica to the inner ear, it is thought that bone drilling in the surgery may have effects on hearing. The aim of this study was to assess the effect of bone drilling in ETSS procedure on cochlear function. This study was performed on 18 patients who underwent ETSS procedure between December 2016 and May 2017. The study was designed as a prospective study. All of the data were prospectively collected. These included demographic data, date of surgery, type of surgery, preoperative pure-tone audiometry, and preoperative and postoperative distortion product otoacoustic emission (DPOAE) measurements. Of the DPOAE measurements of the patients who were operated for pituitary adenoma, there was a statistically significant difference between the signal-to-noise ratio (SNR) measurements at 0.5, 1, 2 and 4 kHz (p < 0.05). Additionally, there were no significant differences in preoperative and postoperative SNR measurements of six patients who were selected for clivus chordoma. When the preoperative and postoperative tonal audiometric tests of the patients were compared, no statistically significant difference was found (p > 0.05). In conclusion, it is found that bone drilling in ETSS procedure has a negative effect on cochlear function in the early period. This is the first study to evaluate the degree of noise-induced cochlear damage in patients who were gone under ETSS procedure.

Supraorbital Keyhole Approach for Resection of Prechiasmatic Craniopharyngioma: 2-Dimensional Operative Video

2020 ◽  
Vol 19 (3) ◽  
pp. E303-E303
Author(s):  
Adrien T May ◽  
Ramona Guatta ◽  
Torstein R Meling
Keyword(s):  
Third Ventricle ◽  
Sella Turcica ◽  
Skin Incision ◽  
Total Removal ◽  
Complex Anatomy ◽  
History Of ◽  
Keyhole Approach ◽  
Safe Access ◽  
Tomography Scan ◽  
Visual Disturbances

Abstract Craniopharyngioma are benign extra-axial tumors occurring classically in the vicinity of the sella. Because of the complex anatomy surrounding the sella turcica comprising, among others, the vessels of the circle of Willis, the optic nerves, chiasma and optic pathway, the hypothalamus, the third ventricle, and the pituitary gland, a large variety of technical approaches have been described. We illustrate, in this video, a unilateral supraorbital keyhole approach to access and entirely extirpate a prechiasmatic craniopharyngioma.  A 40-yr-old healthy male presented to the emergency department with a history of rapid visual deterioration in the left eye in the last 10 d. A brain computed tomography scan showed a circumscribed prechiasmatic cystic lesion partially calcified that was radiologically compatible with a craniopharyngioma on the magnetic resonance imaging. We decided to access the lesion by a right-sided subfrontal corridor using a frontal wrinkle for the skin incision. This technique allows rapid and safe access to the central prechiasmatic region. By choosing a contralateral approach, we aim at optimizing the control on the opposite optic nerve with a perpendicular view. Total removal of the craniopharyngioma was accomplished without causing neurological deterioration. In fact, left eye visual disturbances were immediately retrieved after the surgery. No endocrinological issue or postoperative complication was reported. Minimal cosmetic disturbances are achieved with a meticulous skin incision and bone flap reconstruction.

Follow-up of patients with prolactinomas after discontinuation of long-term therapy with bromocriptine

1983 ◽  
Vol 104 (2) ◽  
pp. 139-142 ◽  
Author(s):  
Arturo Zárate ◽  
Elías S. Canales ◽  
Carlos Cano ◽  
Carlos J. Pilonieta
Keyword(s):  
Sella Turcica ◽  
Ct Scanning ◽  
Serum Levels ◽  
Primary Treatment ◽  
Term Therapy ◽  
History Of ◽  
Permanent Cure ◽  
Long Term Therapy

Abstract. The effects of bromocriptine discontinuation after a 2 year course of therapy on prolactin (Prl) serum levels and the radiological size of the sella turcica were investigated in 16 women with amenorrhoea-galactorrhoea due to prolactinoma. During therapy, all but 2 patients had normalized serum Prl levels, and 4 women with macroprolactinomas exhibited a reduction in the size of the tumour as documented by CT-scanning and tomography of the sellae. After bromocriptine withdrawal and follow-up during 2 additional years, Prl levels remained normal in 6 patients, 2 of them with microprolactinomas and 4 with macroprolactinoma. The remaining 10 women developed hyperprolactinaemia associated with amenorrhoea and galactorrhoea within 3 months after discontinuation of therapy. No tumour expansion was observed in any case during the 4 year observation period. In the present study bromocriptine treatment seemed to result in permanent cure in 6 out of 16 cases of prolactinomas; nevertheless it is difficult to justify an indefinite medical treatment since the natural history of prolactinoma remains unknown. We presently feel that bromocriptine is more appropriate than neurosurgical transsphenoidal exploration for the primary treatment of prolactinomas. Further investigation is needed before a more definitive conclusion regarding the management of prolactinomas can be reached.

scholarly journals Pituitary autoantibodies in patients with hypopituitarism and their relatives

1998 ◽  
Vol 157 (3) ◽  
pp. 475-480 ◽  
Author(s):  
S Stromberg ◽  
P Crock ◽  
A Lernmark ◽  
AL Hulting
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Gland ◽  
Sella Turcica ◽  
Lymphocytic Hypophysitis ◽  
Human Pituitary ◽  
Endocrine Disease ◽  
Cytosolic Protein ◽  
Organ Specific ◽  
Immunological Process ◽  
End Stage

Autoantibodies to human pituitary cytosol proteins were determined by immunoblotting in sera from patients with hypopituitarism and their relatives. Reactivity to an M(r) 49,000 protein was significantly more frequent in patients (6/21 (28%) P < 0.05) as well as in relatives (10/35 (28%) P < 0.02) compared with controls (3/44 (6.8%)). Autoantibodies to this particular protein have previously been detected in sera from 70% of patients with biopsy-proven lymphocytic hypophysitis. Unlike patients with biopsy-proven lymphocytic hypophysitis, none of the patients in this study presented with a suspected pituitary adenoma or showed an enlarged sella turcica. Cisternal herniation was seen in 6/21 patients and this may very well represent the end stage of lymphocytic hypophysitis. Since organ specific autoantibodies are frequent in patients with autoimmune endocrine disease as well as in their unaffected relatives, autoantibodies to this M(r) 49,000 pituitary cytosolic protein may represent markers for an immunological process affecting the pituitary gland.

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