Ectopic pituitary adenoma occurring in the interpeduncular cistern

1995 ◽  
Vol 83 (6) ◽  
pp. 1092-1094 ◽  
Author(s):  
Tetsuya Takahata ◽  
Yoichi Katayama ◽  
Takashi Tsubokawa ◽  
Hideki Oshima ◽  
Atsuo Yoshino
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Stalk ◽  
Surgical Removal ◽  
Pars Tuberalis ◽  
Pituitary Cells ◽  
Content Type ◽  
Ectopic Pituitary Adenoma ◽  
Interpeduncular Cistern ◽  
Suprasellar Cistern ◽  
Endocrine Symptoms

✓ Intracranial ectopic pituitary adenoma occurs most frequently in the suprasellar cistern, usually in continuity with the pituitary stalk. Such tumors probably originate from cells of the pars tuberalis located above the diaphragma sellae or from aberrant anterior pituitary cells of the pituitary stalk. The authors report the case of a 37-year-old woman with Cushing's syndrome caused by an ectopic pituitary adenoma of unique location: the tumor was separate from the pituitary stalk and confined within the interpeduncular cistern. After surgical removal of the tumor, continued improvement in the patient's laboratory results and disappearance of her endocrine symptoms strongly indicated the absence of adenoma cells in the pituitary gland or stalk. The tumor in the present case appears to have arisen from aberrant pituitary cells that were present in the leptomeninges of the basal surface of the hypothalamus.

Intracranial ectopic pituitary adenoma

1976 ◽  
Vol 44 (1) ◽  
pp. 96-99 ◽  
Author(s):  
Lewis M. Rothman ◽  
Joanna Sher ◽  
Robert M. Quencer ◽  
Michael S. Tenner
Keyword(s):  
Pituitary Adenoma ◽  
Aggressive Behavior ◽  
Sella Turcica ◽  
Pars Tuberalis ◽  
Unique Case ◽  
Content Type ◽  
Ectopic Pituitary Adenoma ◽  
Generalized Seizures ◽  
Fine Print

✓ The authors report a unique case of ectopic intracranial pituitary adenoma, associated clinically with generalized seizures and aggressive behavior. The lesion presumably arose from cells in the pars tuberalis and did not involve the sella turcica.

Ectopic pituitary adenoma in the suprasellar cistern: Case report

1991 ◽  
Vol 35 (5) ◽  
pp. 389-394 ◽  
Author(s):  
Norihiko Tamaki ◽  
Takayuki Shirakuni ◽  
Takashi Kokunai ◽  
Satoshi Matsumoto ◽  
Takahiro Fujimori ◽  
...  
Keyword(s):  
Case Report ◽  
Pituitary Adenoma ◽  
Ectopic Pituitary Adenoma ◽  
Suprasellar Cistern

Selective excision of adenomas originating in or extending into the pituitary stalk with preservation of pituitary function

1997 ◽  
Vol 87 (3) ◽  
pp. 343-351 ◽  
Author(s):  
R. Bryan Mason ◽  
Lynnette K. Nieman ◽  
John L. Doppman ◽  
Edward H. Oldfield
Keyword(s):  
Cushing’S Disease ◽  
Pituitary Tumors ◽  
Optic Chiasm ◽  
Anterior Lobe ◽  
Pituitary Function ◽  
Pituitary Stalk ◽  
Cushing's Disease ◽  
Content Type ◽  
Suprasellar Cistern ◽  
Fine Print

✓ When the surgeon identifies an adenoma within the gland and selectively excises it, endocrine-active pituitary tumors are usually cured and pituitary function is preserved. Occasionally ectopic adenomas arise primarily in the pituitary stalk or arise superiorly in the midportion of the anterior lobe and extend upward within the stalk. To determine if these tumors can be selectively excised with preservation of pituitary function, the authors examined the outcome of selective adenomectomy in 10 patients with Cushing's disease with an ectopic adenoma originating in, and confined to, the stalk (four microadenomas) or an adenoma extending superiorly through the diaphragma sella and into the stalk (five microadenomas and one macroadenoma) from an operative series of 516 patients with Cushing's disease. To reach the adenoma transsphenoidally in these patients, the diaphragma sella was incised anteroposteriorly in the midline to the anterior edge of the stalk, the suprasellar cistern was entered, and the adenoma was selectively excised using care to limit injury to the infundibulum. After selective adenomectomy, Cushing's disease remitted in all patients. All patients were hypocortisolemic immediately after surgery and required hydrocortisone for up to 21 months. Apart from the adrenal axis, pituitary function was normal in five patients in the immediate postoperative period, including two patients with tumors confined to the stalk and three patients with preoperative hypothyroidism (one patient) and/or hypogonadism (three patients). Three others with transient postoperative hypothyroidism (one patient) or diabetes insipidus (two patients) had normal pituitary function within 7 months of surgery. One patient with hypothyroidism and one with hypogonadism before surgery had panhypopituitarism postoperatively. A patient with a microadenoma located high in the stalk next to the optic chiasm had bitemporal hemianopsia postoperatively. These results demonstrate the feasibility of achieving curative transsphenoidal resection and preservation of pituitary function in cases of pituitary adenomas that are confined to the pituitary stalk or tumors that extend superiorly within the stalk from an intrasellar origin.

Suprasellar peri-infundibular ectopic adenohypophysis in fetal and adult brains

1985 ◽  
Vol 63 (1) ◽  
pp. 113-115 ◽  
Author(s):  
Akira Hori
Keyword(s):  
Pituitary Adenomas ◽  
Anterior Pituitary ◽  
Normal Adult ◽  
Pars Tuberalis ◽  
Pituitary Cells ◽  
Electron Microscopic ◽  
Content Type ◽  
Cell Groups ◽  
Immunohistochemical Methods ◽  
Fine Print

✓ Ectopic anterior pituitary cells, identified by histological, electron microscopic, and immunohistochemical methods, were consistently found in the leptomeninges of the suprasellar peri-infundibular region of fetal brains. The cell groups were not in continuity with the pars tuberalis of the adenohypophysis. Suprasellar peri-infundibular ectopic pituitary cells, which snowed no neoplastic character, were found in 15 of 20 “normal” adult brains that were similarly examined. This finding sheds new light on the possible origin of intracranial ectopic pituitary adenomas.

Ectopic pituitary adenoma of the third ventricle

1990 ◽  
Vol 72 (1) ◽  
pp. 139-142 ◽  
Author(s):  
B. K. Kleinschmidt-DeMasters ◽  
Ken R. Winston ◽  
David Rubinstein ◽  
Mary H. Samuels
Keyword(s):  
Pituitary Adenoma ◽  
Neurological Examination ◽  
Pituitary Adenomas ◽  
Sphenoid Sinus ◽  
Third Ventricle ◽  
Electron Microscopic ◽  
Content Type ◽  
The Third ◽  
Ectopic Pituitary Adenoma ◽  
Fine Print

✓ Ectopic pituitary adenomas without associated intrasellar adenomas are rare and are usually located in the sphenoid sinus. Most have been reported without modern radiological, endocrinological, or electron microscopic (EM) documentation. The case of a 47-year-old man with a third ventricular, ectopic, clinically non-secretory pituitary adenoma, which was shown to be a gonadotrophic adenoma by immunohistochemical and EM study, is reported. Neurological examination, extensive neurodiagnostic imaging, surgical anatomical observation, and endocrinological evaluation showed no evidence of neoplasia outside the third ventricle.

scholarly journals Cushing Disease Due to Ectopic Pituitary Adenoma.

2019 ◽  
pp. 1-5
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Adenomas ◽  
Adrenocorticotropic Hormone ◽  
Pituitary Tumors ◽  
Pituitary Stalk ◽  
Cushing Disease ◽  
Ectopic Acth ◽  
Common Cause ◽  
Ectopic Pituitary Adenoma ◽  
Acth Secreting

Abstract Adrenocorticotropic hormone (ACTH) - secreting pituitary adenomas are the most common cause of Cushing disease. A pituitary adenoma is rarely ectopic and suprasellar dependent (ectopic) ACTH -secreting pituitary tumors are extremely rare, with few cases described in the literature. Therefore, this study aimed to report the case of a patient with a diagnosis of Cushing disease because of a suprasellar ACTH-secreting tumor attached to the pituitary stalk, requiring a craniotomy.

Hyperprolactinemia, intrasellar pituitary tissue pressure, and the pituitary stalk compression syndrome

1987 ◽  
Vol 67 (2) ◽  
pp. 192-196 ◽  
Author(s):  
Peter D. Lees ◽  
John D. Pickard
Keyword(s):  
Pituitary Adenoma ◽  
Transsphenoidal Surgery ◽  
Pituitary Stalk ◽  
Consecutive Series ◽  
Tissue Pressure ◽  
Content Type ◽  
Compression Syndrome ◽  
The Mean ◽  
Intrasellar Pressure ◽  
Fine Print

✓ The intrasellar pressure has been studied in a consecutive series of 24 patients undergoing transsphenoidal surgery for pituitary adenoma. The mean intrasellar pressure for the group was 23 ± 2.5 mm Hg (± standard error of the mean), with a mean pulse pressure of 3.5 ± 1 mm Hg. The waveform partly resembled the arterial configuration. The results are correlated with the radiological and endocrinological features of the tumors. A hypothesis is proposed to explain the mechanism of hyperprolactinemia associated with the pituitary stalk compression syndrome.

scholarly journals A membranous structure separating the adenohypophysis and neurohypophysis: an anatomical study and its clinical application for craniopharyngioma

2015 ◽  
Vol 15 (6) ◽  
pp. 630-637 ◽  
Author(s):  
Yun-Tao Lu ◽  
Song-Tao Qi ◽  
Jia-Ming Xu ◽  
Jun Pan ◽  
Jin Shi
Keyword(s):  
Anatomical Study ◽  
Pituitary Stalk ◽  
Surgical Removal ◽  
Intermediate Lobe ◽  
Pars Tuberalis ◽  
Polarization Microscopy ◽  
Membranous Structure ◽  
Transcranial Approach ◽  
Normal Light ◽  
Sirius Red

OBJECT This study aimed to identify the membranous septation between the adeno- and neurohypophysis. The clinical impact of this septation in the surgical removal of infradiaphragmatic craniopharyngioma (Id-CP) is also clarified. METHODS The sellar regions from 8 fetal and 6 adult cadavers were dissected. After staining first with H & E and then with picro-Sirius red, the membranous structures were observed and measured under normal light and polarization microscopy. The pre- and postsurgical images and intraoperative procedures in 28 cases of childhood Id-CP were reviewed and analyzed. RESULTS There is a significant membranous septation (termed the adenoneurohypophysis septation [ANHS]) lying behind the intermediate lobe to separate the adeno- and neurohypophysis. The average thicknesses are 21.9 ± 16.9 μm and 79.1 ± 43.2 μm in fetal and adult heads, respectively. The median segment of the septation is significantly thicker than the upper and lower segments. The ANHS extends from the suprasellar pars tuberalis to the sellar floor, where it is fused with the pituitary capsule. During Id-CP surgery performed via a transcranial approach, the ANHS can be identified to reserve the neurohypophysis. Moreover, by understanding the anatomy of this membrane, the pituitary stalk was preserved in 3 patients (10.7%). CONCLUSIONS There is a significant membrane separating the anterior and posterior lobes of the pituitary gland, which lies behind the intermediate lobe. Understanding the anatomy of this septation is important for identifying and preserving the neurohypophysis and pituitary stalk during Id-CP surgery.

Monitoring optic nerve function during craniotomy

1976 ◽  
Vol 44 (1) ◽  
pp. 29-31 ◽  
Author(s):  
Moshe Feinsod ◽  
John B. Selhorst ◽  
William F. Hoyt ◽  
Charles B. Wilson
Keyword(s):  
Pituitary Adenoma ◽  
Optic Nerve ◽  
Surgical Removal ◽  
Evoked Responses ◽  
Nerve Function ◽  
Normal Vision ◽  
Content Type ◽  
Visual Evoked Responses ◽  
Normal Latency ◽  
Fine Print

✓ During surgical removal of a pituitary adenoma, conduction in the anterior visual pathways was monitored by continuous recording of visual evoked responses (VER). The method employed a scleral contact lens with an embedded flashing diode for delivery of visual stimuli. Evoked potentials of nearly normal latency, amplitude, and form were recorded from occipital scalp electrodes immediately after the optic nerves were decompressed. Restoration of the VER was correlated with restoration of normal vision.

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