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.

Pituitary adenoma producing growth hormone and adrenocorticotropin: a histological, immunocytochemical, electron microscopic, and in situ hybridization study

1998 ◽  
Vol 88 (6) ◽  
pp. 1111-1115 ◽  
Author(s):  
Kalman Kovacs ◽  
Eva Horvath ◽  
Lucia Stefaneanu ◽  
Juan Bilbao ◽  
William Singer ◽  
...  
Keyword(s):  
Growth Hormone ◽  
In Situ Hybridization ◽  
Pituitary Adenoma ◽  
Immunoelectron Microscopy ◽  
Secretory Granules ◽  
Cell Types ◽  
Content Type ◽  
Separate Cell ◽  
Fine Print

✓ The authors report on the morphological features of a pituitary adenoma that produced growth hormone (GH) and adrenocorticotropic hormone (ACTH). This hormone combination produced by a single adenoma is extremely rare; a review of the available literature showed that only one previous case has been published. The tumor, which was removed from a 62-year-old man with acromegaly, was studied by histological and immunocytochemical analyses, transmission electron microscopy, immunoelectron microscopy, and in situ hybridization. When the authors used light microscopy, the tumor appeared to be a bimorphous mixed pituitary adenoma composed of two separate cell types: one cell population synthesized GH and the other ACTH. The cytogenesis of pituitary adenomas that produce more than one hormone is obscure. It may be that two separate cells—one somatotroph and one corticotroph—transformed into neoplastic cells, or that the adenoma arose in a common stem cell that differentiated into two separate cell types. In this case immunoelectron microscopy conclusively demonstrated ACTH in the secretory granules of several somatotrophs. This was associated with a change in the morphological characteristics of secretory granules. Thus it is possible that the tumor was originally a somatotropic adenoma that began to produce ACTH as a result of mutations that occurred during tumor progression.

Results of surgical treatment for growth hormone-secreting pituitary adenomas

1993 ◽  
Vol 79 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Dudley H. Davis ◽  
Edward R. Laws ◽  
Duane M. Ilstrup ◽  
James K. Speed ◽  
Michela Caruso ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Radiation Therapy ◽  
Hormone Level ◽  
Growth Hormone Level ◽  
Surgical Excision ◽  
Postoperative Radiation ◽  
Postoperative Radiation Therapy ◽  
Content Type ◽  
Prior Surgery ◽  
Fine Print

✓ The results of surgical therapy for acromegaly were reviewed in a series of 175 patients treated between 1972 and 1983. Patients with prior surgery or radiation therapy were excluded from the study. Postoperative radiation therapy was given to 54 patients. The criterion of achieving a postoperative basal or glucose-suppressed growth hormone level of 2 ng/ml or less was used to indicate remission. Utilizing the most recently available growth hormone determinations, 90 (51.7%) of 174 patients were in remission. The actuarial probability of remission at 1 and 5 years after surgery was 48.8% and 62.7%, respectively. Tumor size and the preoperative basal growth hormone level were correlated with outcome. Surgical excision of a pituitary adenoma is the most effective therapy currently available for acromegaly.

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.

Benign pituitary adenoma associated with hyperostosis of the sphenoid bone and monocular blindness

1977 ◽  
Vol 46 (1) ◽  
pp. 107-110 ◽  
Author(s):  
Robert W. Milas ◽  
Oscar Sugar ◽  
Glen Dobben
Keyword(s):  
Radiation Therapy ◽  
Pituitary Adenoma ◽  
Sphenoid Bone ◽  
Orbital Decompression ◽  
Content Type ◽  
Tumor Mass ◽  
Postoperative Course ◽  
Visual Defects ◽  
Chromophobe Adenoma ◽  
Fine Print

✓ The authors describe a case of benign chromophobe adenoma associated with hyperostosis of the lesser wing of the sphenoid bone and monocular blindness in a 38-year-old woman. The endocrinological and radiological evaluations were all suggestive of a meningioma. The diagnosis was established by biopsy of the tumor mass. After orbital decompression and removal of the tumor, the patient was treated with radiation therapy. Her postoperative course was uneventful, and her visual defects remained fixed.

Suprasellar osteogenic sarcoma following radiation for pituitary adenoma

1976 ◽  
Vol 44 (1) ◽  
pp. 88-91 ◽  
Author(s):  
Abdul R.C. Amine ◽  
Oscar Sugar
Keyword(s):  
Radiation Therapy ◽  
Pituitary Adenoma ◽  
Osteogenic Sarcoma ◽  
Content Type ◽  
Fine Print

✓ The authors report a case in which sellar and suprasellar osteogenic sarcoma developed 10 years after radiation therapy for pituitary adenoma. The literature is reviewed and the rarity of this condition discussed.

Transsphenoidal surgery and adjuvant gamma knife treatment for growth hormone—secreting pituitary adenoma

2001 ◽  
Vol 95 (2) ◽  
pp. 285-291 ◽  
Author(s):  
Hidetoshi Ikeda ◽  
Hidefumi Jokura ◽  
Takashi Yoshimoto
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenoma ◽  
Mr Imaging ◽  
Transsphenoidal Surgery ◽  
Residual Tumor ◽  
Cure Rate ◽  
Content Type ◽  
Transsphenoidal Microsurgery ◽  
Biochemical Cure ◽  
Fine Print

Object. The results of combined transsphenoidal surgery and adjuvant gamma knife surgery (GKS) for growth hormone (GH)—secreting adenoma were investigated using biochemical cure criteria for surgery and biological cure criteria for adjuvant GKS. Methods. Ninety patients (42 male and 48 female patients), ranging from 11 to 75 years of age, underwent transsphenoidal surgery for GH-secreting pituitary adenoma. Preoperative and postoperative GH and insulin-like growth factor-I levels were measured, as was the postoperative GH level after the oral glucose tolerance test. Tumor size, cavernous sinus (CS) invasion, and residual tumor were evaluated using magnetic resonance (MR) imaging. Transsphenoidal microsurgery was performed, followed by adjuvant GKS when there was persistent biochemical evidence of GH hypersecretion with residual tumor detectable in the CS on MR imaging. Patients in whom GKS was contraindicated were treated with conventional radiotherapy or by medical means. Conclusions. The overall surgical cure rate was 57% based on recently accepted biochemical cure criteria. Patients with no CS invasion achieved a 100% cure rate, whereas patients with CS invasion achieved an 82% cure rate (14 of 17 patients) after adjuvant GKS. The combination of transsphenoidal microsurgery and adjuvant GKS is the optimal therapy for patients with GH-secreting adenoma.

Familial acromegaly with pituitary adenoma

1986 ◽  
Vol 64 (3) ◽  
pp. 510-512 ◽  
Author(s):  
Kazem Abbassioun ◽  
Vahab Fatourehchi ◽  
Abbass Amirjamshidi ◽  
Nemotallah Aghai Meibodi
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenoma ◽  
Pituitary Adenomas ◽  
Autosomal Recessive ◽  
Empty Sella ◽  
Review Of Literature ◽  
Familial Incidence ◽  
Content Type ◽  
The Third ◽  
Fine Print

✓ The authors report the cases of three brothers with pituitary adenomas who had classical findings of acromegaly and gigantism. Two had irreducibly elevated growth hormone (GH) values and underwent transsphenoidal microsurgical extirpation of their tumors. The third acromegalic brother had a normal GH value and evidence of panhypopituitarism; he had a small intrasellar tumor and a partially empty sella. The pattern of inheritance was probably autosomal recessive. A review of literature indicated that familial incidence of isolated acromegaly with pituitary adenomas is rare.

Growth hormone deficiency following radiation therapy of primary brain tumors in children

1991 ◽  
Vol 74 (5) ◽  
pp. 743-748 ◽  
Author(s):  
Paul M. Kanev ◽  
John F. Lefebvre ◽  
Richard S. Mauseth ◽  
Mitchel S. Berger
Keyword(s):  
Growth Hormone ◽  
Radiation Therapy ◽  
Brain Tumors ◽  
Growth Velocity ◽  
Bone Age ◽  
Somatomedin C ◽  
Content Type ◽  
Gh Replacement ◽  
Catch Up ◽  
Fine Print

✓ The medical records of 123 patients treated for brain tumors at Children's Hospital and Medical Center, Seattle, Washington, between 1985 and 1987 were reviewed. The endocrinological complications of radiation therapy and the effectiveness of growth hormone (GH) replacement therapy were assessed. These were the first 2 years after synthetic GH became available. The disease pathology was confirmed at craniotomy or biopsy in 108 patients. Ninety-five children completed radiation therapy and 65 of these were alive at the time of review; these 65 children represent the study population. The most common tumor types were medulloblastoma, craniopharyngioma, and ependymoma. Endocrine evaluation was initiated with changes in the patients' growth velocity. Patient workup included skeletal x-ray films for determination of bone age, and analysis of thyroxin, thyroid-stimulating hormone, and somatomedin-C levels. Following l-dopa and clonidine stimulation, provocative studies of GH levels were performed. Growth hormone failure and short stature were observed in 26 children, most commonly in the 2nd year after tumor treatment. Eight patients with GH failure were also hypothyroid. Hormone replacement therapy was initiated with recombinant GH, 0.05 mg/kg/day, and all children so treated showed an increase in height, with eight patients experiencing catch-up growth. There were no complications of therapy or tumor recurrence. Studies of baseline bone age and somatomedin-C levels on completion of radiation therapy are recommended. Comprehensive endocrine studies should follow changes in the patients' growth velocity. With early GH replacement, catch-up growth is possible and normal adult heights may be achieved.

Pituitary apoplexy in an acromegalic patient during bromocriptine therapy

1985 ◽  
Vol 63 (2) ◽  
pp. 288-392 ◽  
Author(s):  
Antoine Alhajje ◽  
Michel Lambert ◽  
Jean Crabbé
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenoma ◽  
Visual Impairment ◽  
Tumor Necrosis ◽  
Pituitary Apoplexy ◽  
Causal Role ◽  
Acromegalic Patient ◽  
Content Type ◽  
Fine Print

✓ The authors report a case of pituitary apoplexy that developed in a patient shortly after bromocriptine therapy was started for a growth hormone-secreting pituitary adenoma. The tumor was associated with visual impairment and ocular palsies, and was treated by transsphenoidal decompression. Although spontaneous tumor necrosis cannot be excluded, a causal role of bromocriptine treatment is suggested.

Fulminant postsurgical Bacillus cereus meningitis

1981 ◽  
Vol 55 (4) ◽  
pp. 637-639 ◽  
Author(s):  
Eric Berke ◽  
William F. Collins ◽  
Alexander Von Graevenitz ◽  
Frank J. Bia
Keyword(s):  
Growth Hormone ◽  
Cerebrospinal Fluid ◽  
Bacillus Cereus ◽  
Neurosurgical Procedures ◽  
Content Type ◽  
Intracranial Surgery ◽  
Level Of Consciousness ◽  
Csf Pleocytosis ◽  
Serious Disease ◽  
Fine Print

✓ A 25-year-old woman presented with decreased level of consciousness, bilateral papilledema, and bitemporal hemianopsia. While receiving oxacillin prophylaxis, she underwent ventriculostomy and a transsphenoidal approach for the removal of a growth hormone- and prolactin-secreting adenoma of the pituitary. Within 4 days, fever, symptoms of meningitis, and marked cerebrospinal fluid (CSF) pleocytosis developed, associated with many large Gram-positive rods in the CSF, subsequently identified as Bacillus cereus. This case emphasizes the potential for Bacillus species to cause serious disease following surgery, including meningitis after intracranial surgery. Meningitis may be severe, and organisms are often resistant to standard surgical prophylactic regimens, which might include penicillin or cephalosporin derivatives. Isolation of Bacillus species from the CSF requires evaluation; these organisms should not be dismissed as contaminants or “non-pathogens,” particularly when isolated from CSF of patients who have recently undergone neurosurgical procedures.

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