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.

Intrasellar persistent trigeminal artery associated with a pituitary adenoma

1989 ◽  
Vol 70 (2) ◽  
pp. 271-273 ◽  
Author(s):  
K. Stuart Lee ◽  
David L. Kelly
Keyword(s):  
Pituitary Adenoma ◽  
Sella Turcica ◽  
Preoperative Imaging ◽  
Persistent Trigeminal Artery ◽  
Pituitary Macroadenoma ◽  
Trigeminal Artery ◽  
Imaging Studies ◽  
Content Type ◽  
Fine Print ◽  
Transsphenoidal Resection

✓ The case of a patient with Cushing's disease and a pituitary macroadenoma, who also had a persistent trigeminal artery coursing through the sella turcica on preoperative imaging studies, is presented. The patient was treated by transsphenoidal resection of the tumor.

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.

Diseases of the Pituitary Gland

2018 ◽  
pp. 373-394
Author(s):  
Vânia Nosé ◽  
Sandro Santagata ◽  
Edward R. Laws
Keyword(s):  
Cell Differentiation ◽  
Infectious Diseases ◽  
Pituitary Gland ◽  
Pituitary Adenomas ◽  
Sella Turcica ◽  
Vascular Lesions ◽  
Malignant Neoplasms ◽  
Systemic Diseases ◽  
Pathological Findings ◽  
Hormone Production

Diseases of the pituitary gland are common, and the most frequently encountered lesions within the sella turcica and pituitary are described and illustrated in details in this chapter. The lesions present within this chapter include cysts and malformations, vascular lesions, inflammatory disorders, infectious diseases, systemic diseases, and both benign and malignant neoplasms. The most common neoplasms of the pituitary are the pituitary adenomas, and these are described in detail including the numerous subtypes depending on the cell differentiation and hormone production. The chapter contains numerous tables and figures illustrating the pathological findings.

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 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.

The efficacy of dopamine agonist therapy in a young man with a giant prolactinoma: case report

2017 ◽  
Vol 63 (4) ◽  
pp. 231-235
Author(s):  
Alexandr I. Tsiberkin ◽  
Tatiana L. Karonova ◽  
Anna B. Dalmatova ◽  
Elena N. Grineva
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Adenomas ◽  
Young Patients ◽  
Young Male ◽  
Serum Prolactin ◽  
Agonist Therapy ◽  
Giant Prolactinoma ◽  
Dopamine Agonist Therapy ◽  
History Of

Prolactinomas are the most common of hormone secreting pituitary adenomas. Patients with prolactinomas generally have a benign prognosis. An algorithm is currently available for managing of this disease. Giant prolactinoma larger than 40 mm with severe invasive growth account for about 2—3% of the prolactin-secreting pituitary adenomas and evidence about management of such patients is limited. This case illustrates progress of a giant prolactin-secreting pituitary adenoma up to 70 mm in young male with a family history of prolactinomas in the absence of the adequate therapy for 8 years after initial diagnosis. After evaluation, it was decided to prescribe medical treatment. Cabergoline therapy started after evaluation appeared to be effective and had lead to significant decrease of serum prolactin level and shrinkage of pituitary adenoma. Described case emphasize the crucial role of identification of hyperprolactinemia among young patients on early stages of the disease. Our observation implies that treatment with dopamine agonists might be effective even in cases with giant prolactinomas.

Transnasal Endoscopic Approach to the Sella Turcica

1998 ◽  
Vol 12 (4) ◽  
pp. 283-288 ◽  
Author(s):  
Michelle R. Aust ◽  
Thomas V. McCaffrey ◽  
John Atkinson
Keyword(s):  
Pituitary Gland ◽  
Pituitary Adenomas ◽  
Sphenoid Sinus ◽  
Sella Turcica ◽  
Cerebrospinal Fluid Leak ◽  
Pituitary Surgery ◽  
Endoscopic Approach ◽  
Transseptal Approach ◽  
Transnasal Endoscopic Approach ◽  
Posterior Septum

The transseptal/transsphenoidal approach to the pituitary gland has been the most commonly used approach for resection of pituitary adenomas for the last 50 years. This procedure has a low morbidity and provides direct midline access to the sella and pituitary gland. Recent advancements in endoscopic surgery, however, suggest that a lower morbidity approach to the sella would be possible via transnasal endoscopic route. Prior reports have confirmed effectiveness of this approach to the pituitary gland and we report here an early series of endoscopic transnasal pituitary surgery from our institution. We report seven cases of transnasal endoscopic pituitary surgery. Our technique consists of endoscopic exposure of the sphenoid ostium unilaterally, excision of the posterior septum anterior to the rostrum of the sphenoid sinus with resection of the sphenoid rostrum for bilateral exposure of the sphenoid sinus. A specially designed nasal speculum is positioned to displace the posterior septum and lateralize the middle turbinates, permitting direct midline exposure of the sphenoid sinus and sella. We have progressively modified the technique over the seven cases that we present and will discuss our specific instrumentation, indications, and technique for this procedure. We have encountered one cerebrospinal fluid leak in this series. Patient satisfaction has been high and hospitalization is less than with the conventional transseptal approach, averaging 1 day. Our impression is that the transnasal endoscopic approach to pituitary adenomas is a safe technique with reduced morbidity permitting shortened hospital stay.

scholarly journals Bilateral Persistent Trigeminal Arteries with Unilateral Trigeminal Artery to Cavernous Sinus Fistula

2013 ◽  
Vol 19 (3) ◽  
pp. 339-343 ◽  
Author(s):  
David Chen ◽  
Chi-Jen Chen ◽  
Jiann-Jy Chen ◽  
Ying-Chi Tseng ◽  
Hui-Ling Hsu ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Cavernous Sinus ◽  
Coil Embolization ◽  
Persistent Trigeminal Artery ◽  
Digital Subtraction ◽  
Pulsatile Tinnitus ◽  
Trigeminal Artery ◽  
Detachable Coil ◽  
History Of

A 59-year-old man who denied a history of trauma presented with left pulsatile tinnitus and left orbital swelling for six months. Digital subtraction angiography showed a left persistent trigeminal artery (PTA) with a trigeminal artery to cavernous sinus (trigeminal-cavernous sinus) fistula and a right PTA. Transarterial detachable coil embolization of the left trigeminal-cavernous sinus fistula was performed, and the symptoms subsided. There has been no report of bilateral PTAs with a spontaneous fistula connected from one PTA to the ipsilateral cavernous sinus. This paper reports such a rare circumstance.

Double pituitary adenomas associated with persistent trigeminal artery: a rare case report and the review of literature

2017 ◽  
Vol 41 (1) ◽  
pp. 341-345 ◽  
Author(s):  
Naohisa Miyagi ◽  
Ryou Doi ◽  
Terukazu Kuramoto ◽  
Kiyohiko Sakata ◽  
Shigeyuki Tahara ◽  
...  
Keyword(s):  
Case Report ◽  
Pituitary Adenomas ◽  
Rare Case ◽  
Persistent Trigeminal Artery ◽  
Review Of Literature ◽  
Trigeminal Artery ◽  
Rare Case Report ◽  
Double Pituitary Adenomas

scholarly journals The Combination of 13N-ammonia and 11C-methionine in Differentiation of Residual/Recurrent Pituitary Adenoma From the Pituitary Gland Remnant After Trans-sphenoidal Adenomectomy

2021 ◽  
Author(s):  
lei ding ◽  
Qiao He ◽  
Ganhua Luo ◽  
Yali Long ◽  
Ruocheng Li ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Gland ◽  
Standard Uptake Value ◽  
Pet Ct ◽  
History Of ◽  
Group A ◽  
Multiple Variables ◽  
G Ratio ◽  
Clinical Mri ◽  
Met Pet

Abstract ObjectiveTo assess the usefulness of 13N-ammonia and 11C- Methionine (MET) PET/CT in the differentiation of residual/recurrent pituitary adenoma (RPA) from the pituitary gland remnant (PGR) after trans-sphenoidal adenomectomy.Patients and MethodsBetween June 2012 to December 2019, 19 patients [clinical/MRI suggestion of RPA (14 female and 5 male, mean age: 44.86 ± 15.58 years, range: 18–79 years)] with a history of trans-sphenoidal adenomectomy before PET/CT scans in our department were enrolled in this study. The maximum standard uptake value (SUVmax) of the target and gray matter was measured, and then the T/G ratio was calculated. First, the T/G ratios of RPA and PGR for each tracer were compared by Student t-test. Second, the T/G ratios of the two tracers were adopted as multiple variables for canonical discrimination analysis. According to the canonical discriminant function, every patient was classified into one group. A P value less than 0.05 was considered statistically significant. ResultsThe T/G ratios of 13N-ammonia were significantly higher in PGR than RPA (1.58±0.69 vs 0.63±1.37, P< 0.001), whereas the T/G ratios of 11C-MET were significantly lower in PGR than RPA (0.78±0.35 vs 2.17±0.54, P < 0.001). By the canonical discriminant analysis, we calculated the predicted accuracy of RPA (100%), PGR (92.9%), and the overall predicted accuracy (96.43%). ConclusionsThe combination of 13N-ammonia and 11C-MET PET/CT is valuable in the differentiation of RPA from PGR after trans-sphenoidal adenomectomy.

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