scholarly journals Rathke cleft cyst apoplexy: Hormonal and clinical presentation

2021 ◽  
Vol 12 ◽  
pp. 504
Author(s):  
Turki Elarjani ◽  
Meshari Rashed Alhuthayl ◽  
Mahammad Dababo ◽  
Imad N Kanaan
Keyword(s):  
Pituitary Adenoma ◽  
English Language ◽  
Pituitary Apoplexy ◽  
Clinical Presentation ◽  
Hormonal Status ◽  
Current Management ◽  
Management Guidelines ◽  
Rathke Cleft Cyst ◽  
Good Number

Background: Rathke cleft cyst (RCC) apoplexy is an uncommon type of lesion that is challenging to diagnose without histopathological samples. Very few articles have been published describing the details of RCC apoplexy. We studied a good number of published articles to analyze its demographics, clinical and hormonal presentations, and outcomes. Methods: A literature review of English language publications about RCC apoplexy or pituitary apoplexy was conducted using Medline and EMBASE search engines. Thirty articles with histological diagnosis of RCC apoplexy were identified, the earliest of which was published in 1990 and the latest in 2019. We combined the findings of these articles with our own case report and then compared the demographics, clinical and hormonal presentations, and outcomes between RCC apoplexy and pituitary adenoma apoplexy. Results: Our data included 29 patients with RCC, with a mean age of 36.87 years (8–72) and a predominance of female patients (68%). The hemorrhagic type was most common, reported in 86%. Headache was the most common presenting symptom, being reported in 93% followed by hypogonadism (73%) and hormonal deficits (52%). All but three patients improved neurologically (90%); however, 45% of patients required long-term hormonal replacement, mostly thyroid hormone. No cases of worsening neurological or hormonal status were reported. Conclusion: RCC apoplexy presents with less severe neurological and hormonal abnormalities than pituitary adenoma apoplexy; it also has a better prognosis in endocrine functional recovery. We recommend applying current management guidelines of pituitary adenoma apoplexy to RCC apoplexy.

scholarly journals Pituitary apoplexy induced by gonadotropin-releasing hormone (GnRH) agonist administration for treatment of prostate cancer: a systematic review

2021 ◽  
Author(s):  
Rishi Raj ◽  
Ghada Elshimy ◽  
Aasems Jacob ◽  
P. V. Akhila Arya ◽  
Dileep C. Unnikrishnan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Pituitary Adenoma ◽  
Gnrh Agonist ◽  
Tumor Size ◽  
Pituitary Apoplexy ◽  
Clinical Presentation ◽  
Pituitary Surgery ◽  
Laboratory Evaluation ◽  
The Mean

Abstract Objective We aimed to review of literature on the clinical presentation, management and outcomes of pituitary apoplexy following gonadotrophic release hormone (GnRH) agonist administration for the treatment of prostate cancer. Methods We used PRISMA guidelines for our systematic review and included all English language original articles on pituitary apoplexy following GnRH agonist administration among prostate cancer patients from Jan 1, 1995 to Dec 31, 2020. Data on patient demographics, prostate cancer type, Gleason score at diagnosis, history of pituitary adenoma, clinical presentation, GnRH agonist, interval to pituitary apoplexy, laboratory evaluation at admission, radiologic findings, treatment of pituitary apoplexy, time to surgery if performed, pathology findings, and clinical/hormonal outcomes were collected and analyzed. Results Twenty-one patients with pituitary apoplexy met our inclusion criteria. The mean age of patients was 70 (60–83) years. Leuprolide was the most common used GnRH agonist, used in 61.9% of patients. Median duration to symptom onset was 5 h (few minutes to 6 months). Headache was reported by all patients followed by ophthalmoplegia (85.7%) and nausea/vomiting (71.4%). Three patients had blindness at presentation. Only 8 cases reported complete anterior pituitary hormone evaluation on presentation and the most common endocrine abnormality was FSH elevation. Tumor size was described only in 15 cases and the mean tumor size was 26.26 mm (18–48 mm). Suprasellar extension was the most common imaging finding seen in 7 patients. 71.4% of patients underwent pituitary surgery, while 23.8% were managed conservatively. Interval between symptoms onset to pituitary surgery was 7 days (1–90 days). Gonadotroph adenoma was most common histopathologic finding. Clinical resolution was comparable, while endocrine outcomes were variable among patients with conservative vs surgical management. Conclusion Although the use of GnRH agonists is relatively safe, it can rarely lead to pituitary apoplexy especially in patients with pre-existing pituitary adenoma. Physicians should be aware of this complication as it can be life threatening. A multidisciplinary team approach is recommended in treating individuals with pituitary apoplexy.

Lithium-Induced Parathyroid Dysfunction: A Case Report and Review of the Literature

1993 ◽  
Vol 27 (9) ◽  
pp. 1040-1043 ◽  
Author(s):  
Jerry W. Taylor ◽  
Angela J. Bell
Keyword(s):  
Case Report ◽  
Clinical Presentation ◽  
Lithium Carbonate ◽  
Suspected Drug ◽  
Current Management ◽  
Therapy Discontinuation ◽  
Drug Induced ◽  
Parathyroid Dysfunction ◽  
Management Recommendations

OBJECTIVE: Twenty-six cases of lithium-induced hyperparathyroidism have been reported in the literature. This article describes an additional case that illustrates current management recommendations. DESIGN: Case report. Clinical presentation and proposed mechanisms of the suspected drug-induced effect are discussed. CONCLUSIONS: Serum calcium concentrations should be determined before and periodically during long-term lithium carbonate therapy. Discontinuation of therapy in patients who develop lithium-induced parathyroid dysfunction generally corrects calcium and parathyroid hormone concentrations. Surgery is indicated in patients with complications of hyperparathyroidism.

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 adenoma apoplexy

2017 ◽  
Vol 95 (2) ◽  
pp. 177-180
Author(s):  
Irina V. Tereshchenko
Keyword(s):  
Risk Factors ◽  
Pituitary Adenoma ◽  
Young Women ◽  
Pituitary Apoplexy ◽  
Clinical Presentation ◽  
Diagnostic Errors

We present 3 cases of pituitary adenoma apoplexy in young women (one microadenoma and two macroadenomas). The possible risk factors, clinical presentation and outcome of pituitary apoplexy are discussed. Diagnostic errors as regards pituitary adenoma apoplexy are analyzed.

scholarly journals Rosai-Dorfman disease of cranial and spinal origin - A case series

2020 ◽  
Vol 11 ◽  
pp. 298
Author(s):  
Saleh Salah Safi ◽  
Khaled Murshed ◽  
Arshad Ali ◽  
Surjith Vattoth ◽  
Abdulrazzaq Haider ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Inflammatory Diseases ◽  
Management Strategies ◽  
Case Series ◽  
Current Management ◽  
Rosai Dorfman Disease ◽  
Lymph Node Enlargement ◽  
Long Term Follow Up

Background: Rosai-Dorfman disease (RDD) is an idiopathic nonneoplastic lymphadenopathy disorder which is characterized by lymph node enlargement, but it may also presents primarily involving a variety of extranodal sites, including central nerves system and craniospinal axis. This study reports five cases of craniospinal RDD, with review of epidemiology, clinical presentation, imaging, and histopathological features with current management strategies. Case Description: Five cases of RDD are diagnosed at Hamad General Hospital, Qatar, during 2013–2018. Two cases had dural-based cranial lesions with overlying cranial involvement while three cases were having extradural thoracic spine lesions. All cases underwent surgical intervention and confirmed by histopathology. Conclusion: Craniospinal RDD is a rare clinical presentation and poses significant diagnostic challenges preoperatively due to its similarity with other neoplastic or inflammatory diseases. Surgical option to remove compressive neural pathology provides a good clinical outcome with no recurrence in long-term follow-up.

Pituitary Apoplexy: A Rare Cause of Cerebral Infarction

2008 ◽  
Vol 21 (5) ◽  
pp. 661-665 ◽  
Author(s):  
A. Ben-Nakhi ◽  
T.J.E. Muttikkal ◽  
V.N.K. Chavan ◽  
A. Yt Al-Turkomani ◽  
R. Gupta
Keyword(s):  
Pituitary Adenoma ◽  
Cerebral Ischemia ◽  
Sudden Death ◽  
Cerebral Infarction ◽  
Pituitary Apoplexy ◽  
Clinical Presentation ◽  
Mass Effect ◽  
Mechanical Obstruction ◽  
Hemorrhagic Infarction

Pituitary apoplexy is usually the result of hemorrhagic infarction in pituitary adenoma. The clinical presentation of pituitary apoplexy varies widely and includes asymptomatic hemorrhage, classical pituitary apoplexy and even sudden death. Few cases of cerebral infarction associated with pituitary apoplexy have been reported in the literature. Pituitary apoplexy can cause narrowing of intracranial vessels by mechanical obstruction due to mass effect or by vasospasm resulting in cerebral ischemia. We report a case of pituitary apoplexy associated with cerebral infarction and the putative mechanisms.

scholarly journals Experience in the Surgical Management of Two Cases with Acromegaly

2021 ◽  
Vol 35 (2) ◽  
pp. 35-37
Author(s):  
Eka J. Wahjoepramono
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenoma ◽  
Clinical Presentation ◽  
Radiologic Finding ◽  
Tumor Mass ◽  
Factor I ◽  
Chronic Disorder ◽  
Igf I ◽  
Radiation Treatments

Acromegaly is a chronic disorder that usually develops over many years due to long term exposure to elevated levels of growth hormone (GH) most typically caused by a somatotrophic cell pituitary adenoma. It has an annual incidence of approximately 3-4 cases / million. A diagnosis of acromegaly is made based on the clinical presentation, biochemical and radiologic finding. The classical feature is the change in appearance and acral enlargement. No single therapy is comprehensively successful in controlling the disease. Surgical, medical and radiation treatments are available for lowering GH and insulin-like growth factor I (IGF-I) hypersecretion, controlling pituitary tumor mass effects, and lowering morbidity.

Clinical Presentation of Tinnitus and a Review of, and Evidence Base for, Tinnitus Applications

2016 ◽  
Vol 1 (7) ◽  
pp. 43-56
Author(s):  
Kim Wise ◽  
Elaine Ma
Keyword(s):  
English Language ◽  
Clinical Presentation ◽  
Therapeutic Option ◽  
Evidence Base ◽  
Future Research ◽  
Long Term Outcomes ◽  
Sound Therapy ◽  
Technology Applications ◽  
Therapeutic Considerations

A lack of evidence base presently exists, to validate the efficacy of mobile technology applications (apps) for tinnitus—highlighting a need for research. We reviewed tinnitus apps available via two popular smartphone operating systems: the Apple iOS and Google Android platforms. A March (2016) search using platforms available in the Austral-Asia region yielded over 260 tinnitus-related apps. Search parameters required apps to employ an English language format and feature the keyword “tinnitus” in the app name or description. Those apps retained for consideration (257) enabled 4 primary themes to emerge, featuring apps offering: (1) sound therapy approaches, (2) information, tips or assessment, (3) health promotion or alternative approaches, and (4) miscellaneous, non-therapeutic apps. Themes enabled further organization of related app characteristics into sub-groups. Numerous apps (44.3%) presented sound menus, ordered into a virtual library of presumably beneficial listening options. To place tinnitus apps in the context of current therapeutic considerations, an overview of the clinical presentation of tinnitus, and approaches aimed at mediating the perception of tinnitus and affective responses, precedes the review. We suggest future research addresses: the relative benefit(s) of one app over another, efficacy of tinnitus apps as a therapeutic option, long-term outcomes, and generalizability across populations.

scholarly journals Management and outcomes of pituitary apoplexy

2015 ◽  
Vol 122 (6) ◽  
pp. 1450-1457 ◽  
Author(s):  
Tarun D. Singh ◽  
Navid Valizadeh ◽  
Fredric B. Meyer ◽  
John L. D. Atkinson ◽  
Dana Erickson ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Functional Outcomes ◽  
Pituitary Apoplexy ◽  
Histopathological Examination ◽  
Visual Fields ◽  
Visual Field Defects ◽  
Ocular Motility ◽  
Cranial Nerve Palsies

OBJECT This study was undertaken to analyze the predisposing factors, clinical presentation, therapeutic management, and clinical recovery in patients with pituitary apoplexy, with an emphasis on the long-term visual, endocrine, and functional outcomes. METHODS The authors performed a retrospective analysis of consecutive cases involving patients treated at Mayo Clinic between 1992 and 2013. Patients were included in the study only if they had 1) abrupt onset of severe headache or visual disturbance in the presence of a pituitary adenoma and 2) radiological or surgical confirmation of a pituitary mass. The primary endpoints of analysis were the visual (ocular motility, visual fields, and visual acuity), endocrine, and functional outcomes (using the modified Rankin Scale). RESULTS Eighty-seven patients were identified (57 males and 30 females, mean age 50.9 years, range 15–91 years). Twenty-two patients (25.3%) had a known pituitary adenoma. Hypertension was the most common associated factor (39%). Headache was the most frequent presenting symptom (89.7%), followed by visual abnormalities (47.1%). Cranial nerve palsies were present in 39% and visual field defects in 34.1%. MRI detected hemorrhage in 89% patients, as compared with 42% detected by CT scan. Sixty-one patients (70.1%) underwent surgery during acute hospitalization (median time from apoplexy 5 days, IQR 3–10 days), 8 (9.2%) had delayed surgery, and 18 (20.7%) were treated conservatively. Histopathological examination revealed adenoma with pure necrosis in 18 (30%), pure hemorrhage in 4 (6.7%), and both in 6 (10%) patients. Four patients died during hospitalization. The average duration of follow-up was 44.2 ± 43.8 months. All survivors were independent and had complete resolution or substantial improvement in eye movements and visual fields at the last follow-up. Many patients needed long-term hormonal replacement with levothyroxine (62.7%) and cortisol (60%). Daily desmopressin was needed in 23% of all surgical patients at 3 months (versus none of the medically treated) and this requirement decreased slightly over time. Regrowth of pituitary adenoma was seen in 7 patients (8.6%). There were no statistically significant differences in any of the outcome measures across the treatment groups. CONCLUSIONS The outcome of most patients with pituitary apoplexy is excellent. Selected patients can be managed conservatively, and patients with severe neuro-ophthalmological deficits treated with early surgery can achieve an excellent recovery.

scholarly journals Coexisting Rathke Cleft Cyst and Pituitary Adenoma Presenting with Pituitary Apoplexy: Report of Two Cases

2011 ◽  
Vol 1 (02) ◽  
pp. 099-104 ◽  
Author(s):  
Florian Gessler ◽  
Valerie Coon ◽  
Steven Chin ◽  
William Couldwell
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Apoplexy ◽  
Rathke Cleft Cyst
Sign in / Sign up

Export Citation Format

Share Document