Pregnancy, Diabetes Insipidus and Adrenal Insufficiency after Surgical Treatment in Clinically Non-functioning Pituitary Adenoma: A Case Report

2018 ◽  
Vol 04 (02) ◽  
Author(s):  
Joao Jornada Ben ◽  
Erika Cesar Oliveira Naliato ◽  
Alice Helena Dutra Violante
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Pituitary Adenoma ◽  
Diabetes Insipidus ◽  
Adrenal Insufficiency

Pituitary gland recovery following fully endoscopic transsphenoidal surgery for nonfunctioning pituitary adenoma: results of a prospective multicenter study

2020 ◽  
Vol 133 (6) ◽  
pp. 1732-1738 ◽  
Author(s):  
Andrew S. Little ◽  
Paul A. Gardner ◽  
Juan C. Fernandez-Miranda ◽  
Michael R. Chicoine ◽  
Garni Barkhoudarian ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Gland ◽  
Diabetes Insipidus ◽  
Adrenal Insufficiency ◽  
Transsphenoidal Surgery ◽  
Pituitary Surgery ◽  
Male Hypogonadism ◽  
Endoscopic Transsphenoidal Surgery ◽  
Gland Function

OBJECTIVERecovery from preexisting hypopituitarism after transsphenoidal surgery for pituitary adenoma is an important outcome to investigate. Furthermore, pituitary function has not been thoroughly evaluated after fully endoscopic surgery, and benchmark outcomes have not been clearly established. Here, the authors characterize pituitary gland outcomes with a focus on gland recovery following endoscopic transsphenoidal removal of clinically nonfunctioning adenomas.METHODSThis multicenter prospective study was conducted at 6 US pituitary centers among adult patients with nonfunctioning pituitary macroadenomas who had undergone endoscopic endonasal pituitary surgery. Pituitary gland function was evaluated 6 months after surgery.RESULTSThe 177 enrolled patients underwent fully endoscopic transsphenoidal surgery; 169 (95.5%) of them were available for follow-up. Ninety-five (56.2%) of the 169 patients had had a preoperative deficiency in at least one hormone axis, and 20/95 (21.1%) experienced recovery in at least one axis at the 6-month follow-up. Patients with adrenal insufficiency were more likely to recover (10/34 [29.4%]) than were those with hypothyroidism (8/72 [11.1%]) or male hypogonadism (5/50 [10.0%]). At the 6-month follow-up, 14/145 (9.7%) patients had developed at least one new deficiency. The study did not identify any predictors of gland recovery (p ≥ 0.20). Permanent diabetes insipidus was observed in 4/166 (2.4%) patients. Predictors of new gland dysfunction included a larger tumor size (p = 0.009) and Knosp grade 3 and 4 (p = 0.051).CONCLUSIONSFully endoscopic pituitary surgery resulted in improvement of pituitary gland function in a substantial minority of patients. The deficiency from which patients were most likely to recover was adrenal insufficiency. Overall rates of postoperative permanent diabetes insipidus were low. This study provides multicenter benchmark neuroendocrine clinical outcome data for the endoscopic technique.

scholarly journals Transcranial approach as surgical treatment for giant pituitary adenoma during COVID 19 pandemic – What can we learn?: A case report

2021 ◽  
Vol 25 ◽  
pp. 101153
Author(s):  
Nyoman Golden ◽  
Wayan Niryana ◽  
Steven Awyono ◽  
Putu Eka Mardhika ◽  
Made Bhuwana Putra ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Pituitary Adenoma ◽  
Giant Pituitary Adenoma ◽  
Transcranial Approach

scholarly journals Minirin for the sublingual application to manage diabetes insipidus in the patients treated for brain tumours

2012 ◽  
Vol 58 (5) ◽  
pp. 46-49 ◽  
Author(s):  
N A Mazerkina
Keyword(s):  
Single Dose ◽  
Surgical Treatment ◽  
Pituitary Adenoma ◽  
Diabetes Insipidus ◽  
Patient Compliance ◽  
Brain Tumours ◽  
Adverse Reactions ◽  
Therapeutic Modality ◽  
Sublingual Tablet ◽  
Therapeutic Modalities

The objective of the present study was to compare the effectiveness of desmopressin (standard oral and sublingual minirin tablets) and patient compliance with these two therapeutic modalities. The study included 51 patients at the age from 1 to 23 years presenting with diabetes insipidus (DI) at least 6 months in duration who had undergone the surgical treatment of craniopharyngioma (n=25), germinoma (n=21, glioma (n=3), and pituitary adenoma (n=2). The patients were transferred from the oral minirin formulation to the sublingual one (the dose of 100 mcg of oral minirin is equivalent to a 60 mcg sublingual tablet). The patients were interviewed to estimate their preference as regards either therapeutic modality within one week after the onset of the treatment. It turned out after the completion of the study that 30 of the 51 patients (59%) adhered to the new sublingual formulation of minirin. Their preferences were unrelated to the age of the patients, diagnosis, and duration of the disease but significantly correlated with a single dose of the preparation. Specifically, the single dose was lower than 1 tablet in 71% of the patients who chose to use oral minirin. No adverse reactions in response to the treatment with sublingual minirin were documented.

The Role of Navigation and Ultrasound Piezosurgery in the Surgical Treatment of Hypertelorism: A Case Report

2014 ◽  
Vol 75 (S 02) ◽  
Author(s):  
S. Heredero ◽  
J. Solivera ◽  
A. Romance ◽  
A. Dean ◽  
J. Lozano
Keyword(s):  
Case Report ◽  
Surgical Treatment

Primary Pituitary Malignant Lymphoma Was Difficult to Differentiate from Nonfunctioning Pituitary Adenoma: A Case Report

2016 ◽  
Vol 77 (S 02) ◽  
Author(s):  
Yuta Murakami ◽  
Shinya Jinguji ◽  
Yugo Kishida ◽  
Taku Sato ◽  
Tadashi Watanabe ◽  
...  
Keyword(s):  
Case Report ◽  
Pituitary Adenoma ◽  
Malignant Lymphoma ◽  
Nonfunctioning Pituitary Adenoma

Transient Prealbumin- Associated Hyperthyroxinemia in TSH-Producing Pituitary Adenoma

1990 ◽  
Vol 29 (01) ◽  
pp. 40-43 ◽  
Author(s):  
W. Langsteger ◽  
P. Költringer ◽  
P. Wakonig ◽  
B. Eber ◽  
M. Mokry ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Pituitary Adenoma ◽  
Thyroid Hormones ◽  
Protein Binding ◽  
Alpha Subunit ◽  
Normal Range ◽  
Thyroxine Binding Globulin ◽  
Free Thyroid Hormones ◽  
Transmission Computed Tomography

This case report describes a 38-year-old male who was hospitalized for further clarification of clinically mild hyperthyroidism. His increased total hormone levels, the elevated free thyroid hormones and the elevated basal TSH with blunted response to TRH strongly suggested a pituitary adenoma with inappropriate TSH incretion. Transmission computed tomography showed an intrasellar expansion, 16 mm in diameter. The neoplastic TSH production was confirmed by an elevated alpha-subunit and a raised molar alpha-sub/ATSH ratio. However, T4 distribution on prealbumin (PA, TTR), albumin (A) and thyroxine binding globulin (TBG) showed a clearly increased binding to PA (39%), indicating additional prealbumin-associated hyperthyroxinemia. The absolute values of PA, A and TBG were within the normal range. After removal of the TSH-producing adenoma, basal TSH, the free thyroid hormones and T4 binding to prealbumin returned to normal. Therefore, the prealbumin-associated hyperthyroxinemia had to be interpreted as a transitory phenomenon related to secondary hyperthyroidism (T4 shift from thyroxine binding globulin to prealbumin) rather than a genetically conditioned anomaly of protein binding.

Cyclic Cushing's Disease in Mixed Gangliocytoma–Pituitary Adenoma Tumor: Case Report

2020 ◽  
Author(s):  
Yury Anania ◽  
Venteicher S. Andrew ◽  
Pearce M. Thomas ◽  
Gardner A. Paul
Keyword(s):  
Case Report ◽  
Pituitary Adenoma ◽  
Cushing’S Disease ◽  
Cushing's Disease
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