scholarly journals Papillary craniopharyngioma in a patient following resection of nonfunctioning pituitary adenoma: illustrative case

2021 ◽  
Vol 1 (2) ◽  
Author(s):  
David J. Park ◽  
Akash Mishra ◽  
Danielle Golub ◽  
Jian Y. Li ◽  
Karen S. Black ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Visual Field Defects ◽  
Illustrative Case ◽  
Nonfunctioning Pituitary Adenoma ◽  
First Case ◽  
Initial Surgery ◽  
Suprasellar Region ◽  
Management Recommendations ◽  
Lost To Follow Up ◽  
Transsphenoidal Resection

BACKGROUNDAlthough craniopharyngioma and pituitary adenoma are common tumors of the sellar or suprasellar region, the development of papillary craniopharyngioma in the same sellar region after resection of a nonfunctioning pituitary adenoma has not been reported.OBSERVATIONSHere the authors report the first case of craniopharyngioma that developed long after resection of a pituitary adenoma. A 66-year-old male patient underwent endoscopic transsphenoidal resection for a large sellar mass, which histopathologically confirmed the diagnosis of a pituitary adenoma. He had an excellent recovery after surgery. For several years, he had no clinical or imaging evidence of tumor recurrence and then was lost to follow-up. Seven years after the initial surgery, the patient returned with a one-month history of visual field defects, and imaging confirmed a heterogeneous, cystic suprasellar mass. Endoscopic transsphenoidal resection of the tumor was performed, and histological examination showed it to be a papillary craniopharyngioma.LESSONSNeurosurgeons should be aware that after pituitary adenoma resection, a recurrent mass could be a craniopharyngioma, with implications for very different management recommendations.

scholarly journals A Case of Giant Pituitary Adenoma Associated with a Postoperative Mental Disorder That Ultimately Resulted in Bilateral Blindness

2020 ◽  
Vol 11 (1) ◽  
pp. 92-99
Author(s):  
Masahiro Tonari ◽  
Yuko Nishikawa ◽  
Junko Matsuo ◽  
Masashi Mimura ◽  
Hidehiro Oku ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Visual Field ◽  
Mental Disorder ◽  
Tumor Resection ◽  
Visual Field Defects ◽  
Light Perception ◽  
Visual Field Examination ◽  
Initial Surgery ◽  
Suprasellar Region

Purpose: To report the case of a patient with adrenocorticotropic hormone (ACTH)-producing pituitary adenoma who developed a mental disorder after initial surgery that kept him from undergoing scheduled follow-up visits and who ultimately had a giant recurrent tumor that resulted in blindness. Case Report: A 37-year-old male presented with the primary complaint of decreased visual acuity (VA) in both eyes and visual field defects. Visual field examination revealed bitemporal hemianopia. Magnetic resonance imaging (MRI) showed a pituitary tumor of approximately 4 cm in diameter extending from the intrasellar region to the sphenoid sinus and the suprasellar region. Transnasal transsphenoidal surgery was performed. Immunostaining of tumor tissue collected intraoperatively showed ACTH-positive cells, thus leading to the diagnosis of ACTH-producing pituitary adenoma. Postoperatively, the patient reportedly developed mental disorder that possibly interfered with scheduled appointments or continuous follow-up visits for many years, so we had no postoperative data about the vision/visual filed. Seven years later, he presented with markedly decreased VA (i.e., no light perception) in both eyes. Fundus examination showed bilateral marked optic disc atrophy. MRI showed a larger than 8-cm diameter giant recurrent pituitary adenoma in the suprasellar region, for which craniotomy was performed for partial tumor resection. Preoperatively, his blood cortisol level was low, and the lesion was deemed a nonfunctioning pituitary adenoma. Postoperatively, no significant complications occurred, yet his VA was no light perception OD and light perception OS. Conclusions: Clinicians should be aware that patients with ACTH-producing pituitary adenomas may develop a mental disorder following surgery and possibly be unable to undergo scheduled follow-up, thus illustrating the importance of establishing an adequate patient follow-up system.

Cerebellar hematoma following transsphenoidal surgery

2005 ◽  
Vol 46 (2) ◽  
pp. 184-186 ◽  
Author(s):  
P. Miranda ◽  
J. F. Alén ◽  
J. Rivas ◽  
A. Pérez ◽  
A. Ramos
Keyword(s):  
Brain Tumor ◽  
Pituitary Adenoma ◽  
Transsphenoidal Surgery ◽  
Underlying Mechanism ◽  
Tumor Surgery ◽  
Mechanism Of Formation ◽  
Brain Tumor Surgery ◽  
Cerebellar Hemorrhage ◽  
First Case ◽  
Transsphenoidal Resection

Cerebellar hemorrhage after supratentorial surgery is a very infrequent complication. Most cases occur following aneurysm or brain tumor surgery, or evacuation of extracerebral collections. The underlying mechanism of formation of these hematomas is unclear. We present an example of cerebellar hemorrhage following transsphenoidal resection of a pituitary adenoma. To our knowledge, this is the first case reported of hemorrhage in the posterior fossa after a transsphenoidal approach.

Intratumoral Rathke's Cleft Cyst Remnants Within Craniopharyngioma, Pituitary Adenoma, Suprasellar Dermoid, and Epidermoid Cysts: A Ubiquitous Signature of Ectodermal Lineage or a Transitional Entity?

Neurosurgery ◽  
2018 ◽  
Vol 85 (2) ◽  
pp. 180-188
Author(s):  
Sunil Manjila ◽  
Nadine El Asmar ◽  
Benjamin M Vidalis ◽  
Fernando Alonso ◽  
Gagandeep Singh ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Dermoid Cyst ◽  
Developmental Theory ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Epidermoid Cysts ◽  
Medical Chart Review ◽  
First Case ◽  
Suprasellar Region ◽  
Rathke's Cleft

Abstract BACKGROUND The authors present cystic epithelial masses in the suprasellar region which on histopathology revealed 4 mixed tumors having simple cuboidal epithelium of Rathke's Cleft Cyst (RCC) elements trapped within pituitary adenoma, epidermoid cyst, dermoid cyst, and papillary craniopharyngioma respectively. OBJECTIVE To highlight the developmental theory of ectodermal continuum in the realm of suprasellar epithelial cystic lesions and examines the cardinal aspects that distinguish RCC from its confounder, ciliary craniopharyngioma. METHODS The authors performed a medical chart review on 4 patients who had coexisting RCC with craniopharyngioma, pituitary adenoma, suprasellar dermoid, and epidermoid cysts. RESULTS This series of unique suprasellar lesions elucidate the spectrum of cases from Rathke's cyst to other suprasellar epithelial cysts including a recently identified clinical entity called ciliary craniopharyngioma, which authors feel is a misnomer. The authors also report the first case of ruptured dermoid cyst admixed with elements of Rathke's cyst elements and xanthogranuloma in neurosurgical literature. CONCLUSION We propose that the new entity of ciliary craniopharyngioma could be just another variant of RCC elements nested within a typical papillary or adamantinomatous lesion. Further study is warranted to understand the implications of natural history with tumors containing RCC elements.

Pituitary stone resulting in visual dysfunction and spontaneous rhinorrhea in nonfunctioning pituitary adenoma: illustrative case

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Takuya Kanemitsu ◽  
Naokado Ikeda ◽  
Masao Fukumura ◽  
Satoshi Sakai ◽  
Hidehiro Oku ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pituitary Adenoma ◽  
Tumor Size ◽  
Illustrative Case ◽  
Increased Intracranial Pressure ◽  
Csf Rhinorrhea ◽  
Vp Shunt ◽  
Nonfunctioning Pituitary Adenoma ◽  
Transnasal Surgery ◽  
Bone Trabeculae

BACKGROUNDCalcifications in pituitary adenomas are rare, being found in only 5.4%–25% of reported cases. These are divided into eggshell-like calcifications around the tumor and nodular calcifications at the center of the tumor, the latter of which are called “pituitary stones” (PSs).OBSERVATIONSThe authors report the case of a 60-year-old male with a nonfunctional pituitary adenoma with PSs and asymptomatic ventricular dilatation who presented with spontaneous cerebrospinal fluid (CSF) rhinorrhea and rapid visual aggravation without an increase in tumor size over the course of 4 years. After endoscopic transnasal surgery, his visual acuity immediately improved temporarily. It was believed that the increased intracranial pressure due to secondary hydrocephalus resulted in visual aggravation; thus, a ventriculoperitoneal (VP) shunt was created. After creation of the VP shunt, the patient’s visual acuity improved gradually and completely. Histological findings showed that adenoma cells were observed among the lamellar bone trabeculae. To the best of the authors knowledge, this is the first report of osteoid metaplasia–type PSs in nonfunctioning pituitary adenoma.LESSONSPSs formed near the sellar floor and caused spontaneous CSF rhinorrhea due to direct mechanical stress on the dura mater and optic nerves, which may have caused meningitis and secondary hydrocephalus that resulted in visual impairment independent of tumor size.

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

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.

MICROSURGICAL ANATOMY OF THE DIAPHRAGMA SELLAE AND ITS ROLE IN DIRECTING THE PATTERN OF GROWTH OF PITUITARY ADENOMAS

Neurosurgery ◽  
2008 ◽  
Vol 62 (3) ◽  
pp. 717-723 ◽  
Author(s):  
Alvaro Campero ◽  
Carolina Martins ◽  
Alexandre Yasuda ◽  
Albert L. Rhoton
Keyword(s):  
Pituitary Adenoma ◽  
Cavernous Sinus ◽  
Dura Mater ◽  
Pituitary Adenomas ◽  
Potential Role ◽  
Pituitary Tumors ◽  
Microsurgical Anatomy ◽  
Suprasellar Region ◽  
Lateral Distance ◽  
Diaphragma Sellae

Abstract OBJECTIVE To evaluate the anatomic aspects of the diaphragma sellae and its potential role in directing the growth of a pituitary adenoma. METHODS Twenty cadaveric heads were dissected and measurements were taken at the level of the diaphragma sellae. RESULTS The diaphragma sellae is composed of two layers of dura mater. There is a remarkable variation in the morphology of the diaphragm opening. The average anteroposterior distance of the opening was 7.26 mm (range, 3.4–10.7 mm) and the average lateral-to-lateral distance was 7.33 mm (range, 2.8–14.1 mm). CONCLUSION The variability in the diameter of the opening of the diaphragma sellae could explain the growth of pituitary tumors toward the cavernous sinus or toward the suprasellar region.

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