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 A case report of disseminated cysticercosis in Bali, Indonesia

2017 ◽  
Vol 1 (2) ◽  
pp. 1
Author(s):  
A.A Raka Sudewi ◽  
Toni Wandra ◽  
Oka Adnyana ◽  
NFN Moestikaningsih ◽  
A A.B.N. Nuartha ◽  
...  
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Ct Scan ◽  
Recombinant Antigen ◽  
The Body ◽  
Antibody Responses ◽  
Repeated Treatment ◽  
Subcutaneous Nodules ◽  
The Brain

Abstract. We reported the case of a 36-year-old Balinese man who disseminated cysticercosis, presented neuro-, subcutaneous- and oral-cysticercosis. Diagnosis of it was based on anamnesis, clinical examination including CT Scan, histopathological and serological examinations. The patient visited outpatient clinic of Sanglah Denpasar Hospital in Bali, in June 2003 with two subcutaneous nodules in the body. Serological examinations (ELISA and immnunoblot) used both purified glycoproteins and chimeric recombinant antigen were positive. The two subcutaneous nodules disappeared after treatment with albendazole. In January 2004, the patient presented neuro-, and oral-cysticercosis. CT Scan showed multiple active lesions in the brain. During the treatment with 800 mg albendazole daily during for one month. The side effects of it such as nausea and vomit were found in that patient. Antibody responses in ELISA and immnunoblot were still positive and follow up CT scan in May 2004, it showed that very similar figures as previously. Repeated treatment with 400mg albendazole daily for one and half month was applied. Antibody responses became low, and CT scan in March 2006 did not show any active cysts but only calcified lesions.

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 Pediatric Pituitary Adenoma: Case Series, Review of the Literature, and a Skull Base Treatment Paradigm

2018 ◽  
Vol 79 (01) ◽  
pp. 091-114 ◽  
Author(s):  
Avital Perry ◽  
Christopher Graffeo ◽  
Christopher Marcellino ◽  
Bruce Pollock ◽  
Nicholas Wetjen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pituitary Adenoma ◽  
Skull Base ◽  
Pituitary Adenomas ◽  
Pediatric Population ◽  
Csf Leak ◽  
Persistent Disease ◽  
Treatment Paradigm ◽  
Surgical Cure

Background Pediatric pituitary adenoma is a rare skull base neoplasm, accounting for 3% of all intracranial neoplasms in children and 5% of pituitary adenomas. Compared with pituitary tumors in adults, secreting tumors predominate and longer disease trajectories are expected due to the patient age resulting in a natural history and treatment paradigm that is complex and controversial. Objectives The aims of this study were to describe a large, single-institution series of pediatric pituitary adenomas with extensive long-term follow-up and to conduct a systematic review examining outcomes after pituitary adenoma surgery in the pediatric population. Methods The study cohort was compiled by searching institutional pathology and operative reports using diagnosis and site codes for pituitary and sellar pathology, from 1956 to 2016. Systematic review of the English language literature since 1970 was conducted using PubMed, MEDLINE, Embase, and Google Scholar. Results Thirty-nine surgically managed pediatric pituitary adenomas were identified, including 15 prolactinomas, 14 corticotrophs, 7 somatotrophs, and 4 non-secreting adenomas. All patients underwent transsphenoidal resection (TSR) as the initial surgical treatment. Surgical cure was achieved in 18 (46%); 21 experienced recurrent/persistent disease, with secondary treatments including repeat surgery in 10, radiation in 14, adjuvant pharmacotherapy in 11, and bilateral adrenalectomy in 3. At the last follow-up (median 87 months, range 3–581), nine remained with recurrent/persistent disease (23%).Thirty-seven publications reporting surgical series of pediatric pituitary adenomas were included, containing 1,284 patients. Adrenocorticotropic hormone (ACTH)-secreting tumors were most prevalent (43%), followed by prolactin (PRL)-secreting (37%), growth hormone (GH)-secreting (12%), and nonsecreting (7%). Surgical cure was reported in 65%. Complications included pituitary insufficiency (23%), permanent visual dysfunction (6%), chronic diabetes insipidus (DI) (3%), and postoperative cerebrospinal fluid (CSF) leak (4%). Mean follow-up was 63 months (range 0–240), with recurrent/persistent disease reported in 18% at the time of last follow-up. Conclusion Pediatric pituitary adenomas are diverse and challenging tumors with complexities far beyond those encountered in the management of routine adult pituitary disease, including nuanced decision-making, a technically demanding operative environment, high propensity for recurrence, and the potentially serious consequences of hypopituitarism with respect to fertility and growth potential in a pediatric population. Optimal treatment requires a high degree of individualization, and patients are most likely to benefit from consolidated, multidisciplinary care in highly experienced centers.

Ki-67/MIB-1 and Recurrence in Pituitary Adenoma

2021 ◽  
Author(s):  
Kent Tadokoro ◽  
Colten Wolf ◽  
Joseph Toth ◽  
Cara Joyce ◽  
Meharvan Singh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pituitary Adenoma ◽  
Recurrence Rate ◽  
Pituitary Adenomas ◽  
Cellular Proliferation ◽  
Published Data ◽  
Ki 67 ◽  
Institutional Data ◽  
Mib 1

Abstract Objectives Ki-67/MIB-1 is a marker of cellular proliferation used as a pathological parameter in the clinical assessment of pituitary adenomas, where its expression has shown utility in predicting the invasiveness of these tumors. However, studies have shown variable results when using Ki-67/MIB-1 association with recurrence. The purpose of this study is to determine if a high Ki-67/MIB-1 labeling index (LI) is predictive of recurrence in pituitary adenomas. Methods A retrospective chart review was performed for patients undergoing pituitary adenoma resection with at least 1 year of follow-up. Additionally, systematic data searches were performed and included studies that correlated recurrence rate to Ki-67/MIB-1 LI. Our institutional data were included in a synthesis with previously published data. Results Our institutional review included 79 patients with a recurrence rate of 26.6%. We found that 8.8% of our patients had a high Ki-67/MIB-1 LI (>3%); however, high Ki-67/MIB-1 was not associated with recurrence. The systematic review identified 244 articles and 49 full-text articles that were assessed for eligibility. Quantitative analysis was performed on 30 articles including our institutional data and 18 studies reported recurrence by level of Ki-67/MIB-1 LI. Among studies that compared Ki-67/MIB-1 ≥3 vs. <3%, 10 studies reported odds ratios (OR) greater than 1 of which 6 were statistically significant. A high Ki-67/MIB-1 had higher odds of recurrence via the pooled odds ratio (OR = 4.15, 95% confidence interval [CI]: 2.31–7.42). Conclusion This systematic review suggests that a high Ki-67/MIB-1 should prompt an increased duration of follow-up due to the higher odds of recurrence of pituitary adenoma.

Torticollis as an Initial Manifestation of a Seronegative Demyelinating Disorder in a Child: A Case Report

2021 ◽  
Author(s):  
Sandesh Kini ◽  
Yellanthoor Ramesh Bhat ◽  
Lakshmikanth Halegubbi Karegowda
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Case Report ◽  
Demyelinating Disease ◽  
Oligoclonal Bands ◽  
Initial Manifestation ◽  
Demyelinating Disorder ◽  
The Brain

AbstractTorticollis refers to a condition in which the head is persistently tilted to one side, sometimes associated with pain. Torticollis in a child can be congenital or acquired. Torticollis as an initial manifestation of an underlying demyelinating syndrome is quite rare in children. Here, we report a 7-year-old girl who presented with persistent torticollis. Neuroimaging of the brain revealed features of a demyelinating disease. Further studies did not show any evidence of multiple sclerosis. Cerebrospinal fluid was negative for antiaquaporin-4 antibodies, antimyelin oligodendrocyte glycoprotein antibodies, and oligoclonal bands. A seronegative demyelinating disorder was considered. She was treated with pulsed methylprednisolone therapy. She responded well to steroids with no progression of illness during follow-up. Torticollis was partially improved.

scholarly journals Adjuvant hypofractionated partial-brain radiation therapy for pediatric Ewing sarcoma brain metastases: case report

2016 ◽  
Vol 17 (4) ◽  
pp. 434-438 ◽  
Author(s):  
Ritchell van Dams ◽  
Henry S. Park ◽  
Ahmed K. Alomari ◽  
Adele S. Ricciardi ◽  
Harini Rao ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Case Report ◽  
Ewing Sarcoma ◽  
Tumor Resection ◽  
Symptomatic Treatment ◽  
Reasonable Approach ◽  
Inflammatory Changes ◽  
Brain Radiation ◽  
The Brain

This case report demonstrates that hypofractionated partial-brain radiation therapy with limited margins is a reasonable approach following gross tumor resection of Ewing sarcoma metastases to the brain. The patient presented with 2 intracranial metastases treated with gross-total resection followed by radiation therapy to 30 Gy in 5 fractions. The patient experienced symptomatic treatment-related inflammatory changes with resolution after receiving dexamethasone. He remains alive at 21 months of follow-up with no evidence of disease.

HYPOFRACTIONATED CYBERKNIFE RADIOSURGERY FOR PERICHIASMATIC PITUITARY ADENOMAS

Neurosurgery ◽  
2009 ◽  
Vol 64 (suppl_2) ◽  
pp. A19-A25 ◽  
Author(s):  
Brendan D. Killory ◽  
John J. Kresl ◽  
Scott D. Wait ◽  
Francisco A. Ponce ◽  
Randall Porter ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Pituitary Adenomas ◽  
Pituitary Tumors ◽  
Field Testing ◽  
Optic Chiasm ◽  
Conformity Index ◽  
Tumor Control ◽  
Cyberknife Radiosurgery ◽  
The Mean

Abstract OBJECTIVE Radiation therapy is recommended for pituitary tumors that are refractory to surgical and medical therapies. The efficacy of single-fraction radiosurgery is established for these lesions, but lesions within 3 mm of the optic pathway cannot be safely treated with doses higher than 8 to 10 Gy. We hypothesized that the optic nerve will tolerate 5 consecutive daily radiosurgery fractions of 500 cGy with effective tumor control. METHODS We reviewed our first 20 patients with recurrent or residual pituitary adenomas within 3 mm of the optic chiasm treated with the CyberKnife radiosurgery system (Accuray, Inc., Sunnyvale, CA). Tumors were treated with a mean coverage of 97 ± 2.2% (range, 89.8–99.7%), a mean conformity index of 1.3 ± 0.2 (range, 1.1–1.6), and a mean treatment isodose line of 74.5 ± 6.6% (range, 60–86%). The primary end point was an interim analysis of visual preservation, and secondary end points were radiographic and endocrinological tumor control. RESULTS The mean follow-up period for visual field testing was 26.6 ± 10.5 months (range, 10.6–41 months). The vision of all 14 patients with intact preoperative vision remained intact. Of the 5 patients with impaired vision, 2 remained stable, and 3 improved. No patient's vision deteriorated. The mean radiographic follow-up was 29.3 ± 8.6 months (range, 10.2–40.5 months). On magnetic resonance imaging, 12 tumors were stable, 8 were smaller, and none enlarged. CONCLUSION This preliminary study establishes that the optic nerve and chiasm tolerate CyberKnife hypofractionated radiosurgery of 5 × 500 cGy to perichiasmatic pituitary adenomas. Early data suggest that this dosing paradigm may achieve satisfactory radiographic and endocrinological tumor control for these challenging lesions, but longer follow-up is necessary to confirm these results.

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.

Giant Cell Lesions with a Noonan-like Phenotype: A Case Report

2007 ◽  
Vol 8 (4) ◽  
pp. 67-73 ◽  
Author(s):  
Manoel Sant'Ana Filho ◽  
Claudia Marcela H. Cancino ◽  
Léonilson Gaião ◽  
Flavio Augusto Marsiaj Oliveira
Keyword(s):  
Case Report ◽  
Giant Cell ◽  
Surgical Intervention ◽  
Heart Defects ◽  
Sporadic Case ◽  
Giant Cells ◽  
The Body ◽  
Phenotypic Characteristics ◽  
Previous Diagnosis

Abstract Aim The purpose of this article is to describe a case of multiple giant cell lesions of the mandible that occurred in a 14-year-old girl with phenotypic characteristics associated with Noonan Syndrome (NS). Background NS is a dysmorphic disorder characterized by hypertelorism, short stature, congenital heart defects, short and webbed neck, skeletal anomalies, and bleeding diathesis. Report A 14-year-old girl with a previous diagnosis of NS (sporadic case) presented with multiple radiolucent lesions in the body and ramus of her mandible. Summary In terms of clinical behavior and the described radiographic characteristics, giant cells lesions with Noonan-like phenotype can be considered a form of cherubism. Therefore, surgical intervention is not necessary, but radiographic follow-up and observation is very important during the control and gradual regression of the lesions. Citation Cancino CMH, Gaião L, Sant'Ana Filho M, Oliveira FAM. Giant Cell Lesions with a Noonan-like Phenotype: A Case Report. J Contemp Dent Pract 2007 May;(8)4:067-073.

Ossified Prolactinoma: Case Report

Neurosurgery ◽  
1987 ◽  
Vol 20 (3) ◽  
pp. 473-475 ◽  
Author(s):  
Kazutoshi Mukada ◽  
Masahiro Ohta ◽  
Tohru Uozumi ◽  
Kazunori Arita ◽  
Kaoru Kurisu ◽  
...  
Keyword(s):  
Case Report ◽  
Pituitary Adenoma ◽  
Connective Tissue ◽  
Pituitary Adenomas ◽  
First Report

Abstract The authors report a case of ossified prolactinoma that was identified as a calcified nodule on the roentgenograms. Histologically, the ossified tissues were diffuse, and the osteoid was mineralized in various degress, subsequently forming bones. Adenoma cells were sparse among the ossified tissues. This is probably the first report of ossified pituitary adenoma associated with osteoid metaplasia. The pathogenesis of osteoid metaplasia in pituitary adenomas is possibly due to proliferative connective tissue resulting from degeneration of the pituitary adenoma; this connective tissue may possess osteogenic potency.

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