Sudden blindness with pituitary tumors

1972 ◽  
Vol 36 (1) ◽  
pp. 83-85 ◽  
Author(s):  
Julian L. Robinson
Keyword(s):  
Pituitary Tumor ◽  
Prognostic Value ◽  
Pituitary Tumors ◽  
Pituitary Neoplasm ◽  
Content Type ◽  
Visual Improvement ◽  
Sudden Blindness ◽  
Fine Print

✓ Three patients in whom pituitary tumor led to sudden blindness are described; in two, there had been no other indication of a pituitary neoplasm. The authors believe that observation of these patients for 24 hours after the onset of blindness has prognostic value and is safe. If visual improvement occurs during this time, the chances of useful recovery of vision are good. Further delay is contraindicated since in spite of visual improvement, these patients may show a general deterioration which may terminate fatally unless operation is performed.

Thyrotrophin-producing pituitary adenomas

1982 ◽  
Vol 57 (4) ◽  
pp. 515-519 ◽  
Author(s):  
Stephen A. Hill ◽  
James M. Falko ◽  
Charles B. Wilson ◽  
William E. Hunt
Keyword(s):  
Thyroid Hormone ◽  
Pituitary Adenomas ◽  
Preoperative Diagnosis ◽  
Pituitary Tumors ◽  
Recurrent Tumor ◽  
Hormone Production ◽  
Content Type ◽  
Aggressive Tumor ◽  
Tsh Levels ◽  
Fine Print

✓ Hyperthyroidism due to thyrotrophin (TSH)-secreting pituitary tumors is rare. Four cases are described, with the features that allow preoperative diagnosis. In all the patients, thyroid hormone production was consistently elevated despite antithyroid therapy, and TSH levels were inappropriately elevated. All patients were treated with both surgery and irradiation. Each patient had recurrent tumor with suprasellar, intrasphenoidal, or intraorbital spread. The combination of a recurrent, aggressive tumor complicated by thyrotoxicosis makes this a complex and difficult surgical problem.

Pituitary enlargement mimicking pituitary tumor

1985 ◽  
Vol 63 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Larissa T. Bilaniuk ◽  
Thomas Moshang ◽  
Jose Cara ◽  
Martin Z. Weingarten ◽  
Leslie N. Sutton ◽  
...  
Keyword(s):  
Pituitary Gland ◽  
Pituitary Tumor ◽  
Primary Hypothyroidism ◽  
Ct Scans ◽  
Content Type ◽  
Presenting Symptoms ◽  
Pituitary Enlargement ◽  
Work Up ◽  
Fine Print ◽  
Gland Enlargement

✓ Primary hypothyroidism can result in reactive enlargement of the pituitary gland which is indistinguishable from primary pituitary lesions on computerized tomography (CT) scans. The presenting symptoms may be due to pituitary gland enlargement, as in two of the three cases reported here. Therefore, the diagnosis of pituitary hypertrophy or hyperplasia secondary to hypothyroidism must be based on the endocrinological work-up. Following treatment of primary hypothyroidism, the diminution in size of the pituitary gland can be demonstrated with CT.

Cerebellar metastasis from a prolactinoma during treatment with bromocriptine

1981 ◽  
Vol 55 (4) ◽  
pp. 615-619 ◽  
Author(s):  
Neil A. Martin ◽  
Martha Hales ◽  
Charles B. Wilson
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Pituitary Adenoma ◽  
Pituitary Tumors ◽  
Metastatic Tumor ◽  
Metastatic Spread ◽  
Content Type ◽  
The Central Nervous System ◽  
Cerebellar Metastasis ◽  
Fine Print

✓ A 31-year-old woman developed a cerebellar metastasis from an invasive prolactin-secreting pituitary adenoma while undergoing treatment with bromocriptine. The metastatic tumor was totally excised. Metastatic spread of pituitary tumors within the central nervous system is reviewed briefly.

Pathology of invasive pituitary tumors with special reference to functional classification

1986 ◽  
Vol 65 (6) ◽  
pp. 733-744 ◽  
Author(s):  
Bernd W. Scheithauer ◽  
Kalman T. Kovacs ◽  
Edward R. Laws ◽  
Raymond V. Randall
Keyword(s):  
Pituitary Adenomas ◽  
Prognostic Significance ◽  
Pituitary Tumors ◽  
Thyroid Stimulating Hormone ◽  
Biological Behavior ◽  
Null Cell ◽  
Content Type ◽  
Acth Cell ◽  
Ultrastructural Characteristics ◽  
Fine Print

✓ Pituitary adenomas may remain intrasellar or infiltrate dura and bone. Invasive adenomas are not considered to be malignant; in biological behavior they are between non-infiltrative adenomas and pituitary carcinomas. The latter are defined as tumors with subarachnoid, brain, or systemic metastasis. Invasion may be defined radiologically, operatively, or histologically. On the basis of operatively assessed tumor size and gross invasion of dura and bone as well as immunocytochemical and ultrastructural analysis of 365 pituitary adenomas, the following data were obtained. There were 23 growth hormone (GH)-cell adenomas: 14% microadenomas and 86% macroadenomas; their overall frequency of invasion was 50%. There were 24 prolactin (PRL)-cell adenomas: 33% microadenomas and 67% macroadenomas, with an overall frequency of invasion of 52%. Mixed GH-cell and PRL-cell adenomas were found in 35 cases; 26% were microadenomas and 74% were macroadenomas, and the overall frequency of invasion was 31%. Sixty patients had adrenocorticotropic hormone (ACTH)-cell adenomas (Cushing's disease): 87% microadenomas and 13% macroadenomas; the overall frequency of invasion was 25% (in 8% of microadenomas and 62% of macroadenomas). Twenty patients had ACTH-cell adenomas (Nelson's syndrome): 30% microadenomas and 70% macroadenomas; the overall frequency of invasion in these cases was 50% (in 17% of microadenomas and 64% of macroadenomas). Silent ACTH-cell adenomas, 100% macroadenomas, were found in 11 patients, with an 82% frequency of invasion. There were 32 follicle-stimulating and luteinizing hormone adenomas, all macroadenomas, with a frequency of invasion of 21%. Four patients had thyroid-stimulating hormone adenomas, all macroadenomas, with a 75% frequency of invasion. Null-cell adenomas were found in 93 cases: 2% microadenomas and 98% macroadenomas, with a frequency of invasion of 42%. There were 63 plurihormonal adenomas (GH, PRL, glycoprotein): 25% microadenomas and 75% macroadenomas, with a 50% overall frequency of invasion. Based on this study, and on their usual frequency of occurrence, the estimated rate of gross invasion by pituitary adenomas of all types is approximately 35%. It is concluded that immunocytochemical and ultrastructural characteristics of pituitary adenomas reflect the tendency of these tumors to infiltrate and hence may be of prognostic significance.

Intracranial and intraspinal dissemination from a growth hormone-secreting pituitary tumor

1986 ◽  
Vol 64 (1) ◽  
pp. 140-144 ◽  
Author(s):  
Nobuo Hashimoto ◽  
Hajime Handa ◽  
Shogo Nishi
Keyword(s):  
Growth Hormone ◽  
Cerebrospinal Fluid ◽  
Radiation Therapy ◽  
Pituitary Adenoma ◽  
Pituitary Tumor ◽  
Invasive Growth ◽  
Metastatic Tumors ◽  
Content Type ◽  
Fine Print

✓ A 48-year-old woman developed multiple intracranial and intraspinal metastases from an invasive growth hormone-secreting pituitary adenoma after surgery and radiation therapy. This is the first reported case to show that the cells in the metastatic tumors and in the cerebrospinal fluid contained growth hormone.

Prognostic value of auditory brain-stem responses for late postconcussion symptoms following minor head injury

1988 ◽  
Vol 68 (5) ◽  
pp. 742-744 ◽  
Author(s):  
Rudolf Schoenhuber ◽  
Massimo Gentilini ◽  
Adelina Orlando
Keyword(s):  
Head Injury ◽  
Brain Stem ◽  
Prognostic Value ◽  
Memory Loss ◽  
Minor Head Injury ◽  
Postconcussion Syndrome ◽  
Content Type ◽  
Auditory Evoked Responses ◽  
Small Series ◽  
Fine Print

✓ Minor head injury is frequently followed by a subjective postconcussion syndrome. Brain-stem auditory evoked responses (BAER's) were found to be pathological in different small series of patients with a postconcussion syndrome who were examined months after sustaining a slight cranial or cervical trauma; abnormal BAER's have also been reported in larger groups of patients examined early after minor head injury. A relationship between these findings and late subjective symptoms has never been demonstrated. The results of a prospective study into the value of BAER's in the prognosis of a postconcussion syndrome after minor head injury are presented. In 103 patients with minor head injury, BAER's were recorded within 48 hours of the trauma. One year later, the patients were examined for headache, dizziness, depression, anxiety, subjective loss of memory and concentration, and irritability. Eighty percent claimed at least one symptom, most often irritability (54%), memory loss (47%), or depression (39%). Pathological BAER's were found with the same prevalence in patients with and without a postconcussion syndrome. This study confirms the disturbance of brain-stem function in some head-injured patients. However, the lack of correlation with a postconcussion syndrome limits the prognostic value of BAER recordings for postconcussion syndrome. The data suggest that BAER's not be used for medicolegal evaluation of patients with a postconcussion syndrome.

Intraoperative ultrasound-directed resection of pituitary tumors

1995 ◽  
Vol 83 (2) ◽  
pp. 225-230 ◽  
Author(s):  
Zvi Ram ◽  
Thomas H. Shawker ◽  
Mary H. Bradford ◽  
John L. Doppman ◽  
Edward H. Oldfield
Keyword(s):  
Mr Imaging ◽  
Cushing’S Disease ◽  
Intraoperative Ultrasound ◽  
Pituitary Tumors ◽  
Thyroid Stimulating Hormone ◽  
Cushing's Disease ◽  
Content Type ◽  
Normal Pituitary Gland ◽  
Intraoperative Localization ◽  
Fine Print

✓ Microadenomas of the pituitary vary in size, particularly those related to Cushing's disease. They are often not visualized on preoperative magnetic resonance (MR) imaging and may be difficult to find during surgical exploration of the pituitary. To enhance intraoperative localization of pituitary adenomas, we assessed the feasibility of using ultrasound to detect and localize pituitary tumors. Intraoperative ultrasound (IS) in the axial and sagittal planes was performed with an Intrascan system using a 12-MHz mechanically oscillating, end-firing transducer. Interpretation of the scans was performed by two individuals, who were usually blinded to the results of preoperative MR imaging or petrosal sinus sampling. Twenty-eight patients were examined. Eighteen of these patients had microadenomas (1.5–7 mm), all with Cushing's disease; nine had macroadenomas (10–20 mm), three of which were adrenocorticotropic hormone—secreting, three growth hormone—secreting, two thyroid-stimulating hormone—secreting, and one nonfunctioning; and one patient had an intrasellar craniopharyngioma. Normal sellar and parasellar structures, such as intrapituitary cysts, the intracavernous carotid arteries, and the diaphragma sella were easily visualized. Twenty-three of the 28 tumors, including 13 of the 18 microadenomas, were detected on IS (82% sensitivity). Tumors were seen as hyperechoic masses in 19 patients, mixed echogenicity in three, and isoechoic in one. In most macroadenomas IS allowed visualization of the interface between the tumor and the normal pituitary gland. These results indicate the potential of IS to aid the intraoperative localization and definition of pituitary tumors.

Serial plasma growth hormone concentration during selective removal of pituitary tumors in acromegaly

1974 ◽  
Vol 41 (1) ◽  
pp. 38-43 ◽  
Author(s):  
John P. Allen ◽  
David M. Cook ◽  
Monte A. Greer ◽  
Harold Paxton ◽  
Albert Castro
Keyword(s):  
Growth Hormone ◽  
Pituitary Tumors ◽  
Normal Function ◽  
Posterior Pituitary ◽  
Hormone Concentration ◽  
Plasma Growth Hormone ◽  
Tumor Removal ◽  
Content Type ◽  
Pituitary Dysfunction ◽  
Fine Print

✓ The pituitary function of two patients with acromegaly was monitored before, during, and after selective transnasal pituitary adenomectomy. The purpose of the study was to verify the efficacy of this technique, and to see if there was normal function in the residual pituitary tissue. Following surgery, both patients showed clinical improvement with no evidence of significant anterior or posterior pituitary dysfunction. Concentrations of plasma growth hormone obtained serially during surgery were elevated prior to tumor removal but fell precipitously after adenomectomy. The half-life for immunoreactive growth hormone in these patients was less than 35 minutes. We conclude that selective transnasal pituitary adenomectomy is an effective treatment for pituitary tumors. Furthermore, our data suggest that the pituitary tumor in these patients did not arise because of excessive stimulation by hypothalamic growth hormone-releasing factor.

Postirradiation sarcomatous transformation of a pituitary adenoma: a combined pituitary tumor

1982 ◽  
Vol 56 (2) ◽  
pp. 283-286 ◽  
Author(s):  
Steve Pieterse ◽  
Trevor A. R. Dinning ◽  
Peter C. Blumbergs
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Tumor ◽  
The Other ◽  
Content Type ◽  
Large Size ◽  
Irradiation Growth ◽  
Chromophobe Adenoma ◽  
Rare Lesion ◽  
Latent Interval ◽  
Fine Print

✓ A case is reported in which a fibrosarcoma developed 20 years after irradiation of a pituitary chromophobe adenoma. This rare lesion, like most of the other documented postirradiation pituitary sarcomas, was a combination of fibrosarcoma and pituitary adenoma. These lesions tend to behave in a characteristic fashion, with onset after a long latent interval following irradiation, growth to a large size, and failure to metastasize.

The specificity of serum prolactin as a diagnostic indicator of pituitary adenoma

1979 ◽  
Vol 51 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Saul Balagura ◽  
Andrew G. Frantz ◽  
Edgar M. Housepian ◽  
Peter W. Carmel
Keyword(s):  
Pituitary Adenoma ◽  
Neurological Disease ◽  
Pituitary Tumors ◽  
Serum Prolactin ◽  
Content Type ◽  
Regular Work ◽  
Work Up ◽  
Diagnostic Indicator ◽  
Fine Print ◽  
Rule Out

✓ Serum prolactin levels were determined in 205 patients with a variety of intracranial diseases, including 70 cases with pituitary tumors. It is concluded that although the absence of elevated prolactin levels does not help to rule out pituitary pathology, the presence of hyperprolactinemia is highly specific for diseases of the pituitary and hypothalamus, and prolactin determination should be part of the regular work-up of pituitary tumor suspects. Excluding known causes of hyperprolactinemia, such as tranquilizing drug ingestion, the presence of neurological disease outside the hypothalamic-pituitary area was not associated with increased serum prolactin concentrations.

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