1/22. retinitis pigmentosa in association with acromegaly: a case report.Retinal abnormalities, unrelated to visual pathway compression, in acromegalic patients were originally described by Small in 1972 (Smail JM. Primary pigmentary degeneration of the retina and acromegaly in a case of pituitary adenoma. Br J Ophthalmol 1972; 56: 25-31). He illustrated a case of primary pigmentary degeneration of the retina occurring in a patient with a chromophobe adenoma of the pituitary gland. To the best of our knowledge this remains the sole, published case of this association. We report on two male patients, with an acromegalic appearance, one caused by a pituitary adenoma, the other associated with a Rathke's cleft cyst, presenting to our department of ophthalmology with the clinical picture of pigmentary degeneration of the retina.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/22. Unilateral exophthalmos. Occurrence after treatment for perichiasmatic neoplasms.Unilateral exophthalmos developed shortly after treatment in three patients with chromophobe adenoma of the pituitary gland and craniopharyngioma. In two patients, the exophthalmos followed surgery, while in the third it did not appear until after radiation treatment. The pathogenesis of the exophthalmos in these cases in obscure. However, the other findings and subsequent course indicate that the exophthalmos is not due to recurrence of the neoplasm nor to a complication of therapy.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
3/22. Parathyroid carcinoma in a patient with non-secretory pituitary tumor: a variant of multiple endocrine neoplasia type-I?We report a case of pituitary adenoma in association with parathyroid carcinoma as an unusual combination of multiple endocrine neoplasia (MEN). A 48-year-old man had a trans-sphenoidal hypophysectomy and transcranial partial removal of a recurrent pituitary chromophobe adenoma followed by a course of radiotherapy in 1980. Four years later, he developed hypercalcemic crisis from a parathyroid carcinoma with invasion to the adjacent thyroid gland and skeletal muscle. A hemithyroidectomy and resection of the left lower parathyroid gland was performed. Three years later, he had local recurrence and anterior chest wall metastasis accompanied by hypercalcemia. After resection of the remnant and metastatic lesion, eucalcemia was achieved. There was no family history of endocrine tumors. This case illustrates the rare association of a malignant parathyroid tumor and a chromophobe adenoma of the pituitary as a variant of MEN syndrome.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
4/22. Extracerebral subdural manifestation of Chester-Erdheim disease associated with a giant adenoma of the pituitary.Chester-Erdheim disease is a rare non-Langerhans histiocytosis, affecting within the CNS mainly the neurohypophyseal unit, the retrobulbar space and the parenchyma of cerebellum, cerebrum and brainstem. Here we present a case of a 55-year-old woman who developed an exophthalmus, edema and dyspnea, finally leading to death 4 months post admission to the hospital. A cMRI showed a retrobulbar fibrosis, a tumor in the sella turcica, and further tumor formation expanding from the pons to the spinal cord, but without involvement of the dural sheet. autopsy revealed multiple tumors attached to the pituitary gland, the tentorium, and the brainstem as well as a diffuse thickening of the dura. Histologically, the tumor tissue consisted of densely packed lipid-laden foamy macrophages positive for CD68 and intervening fibrillary cords. Interestingly, tumor cells did not infiltrate/affect the parenchyma but showed a strictly extracerebral/ subdural location. In addition, sections of the pituitary tumor revealed a chromophobe giant adenoma of the pituitary gland. As to our knowledge this is the first detailed description of an exceptional case of intracranial CED presenting with strictly extracerebral/subdural tumor masses accompanied by a giant adenoma of the pituitary gland.- - - - - - - - - - ranking = 3keywords = gland (Clic here for more details about this article) |
5/22. Transsphenoidal microsurgery for selective removal of functional pituitary microadenomas.The transphenoidal approach to the pituitary gland is emerging as the safest and most efficacious procedure for the management of pituitary tumors. With the aid of the microscope large tumors producing visual symptoms can be removed and microadenomata producing only signs and symptoms of endocrinopathies can be safely and adequately approached. The procedure is described in this report. The results of its use in 29 patients with selected illustrative case reports are described.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
6/22. Silent corticotropic adenoma of pituitary gland--a case report.A 79-year-old man complained progressive visual impairment and diplopia for 2 weeks. A big pituitary tumor was found and partially removed by the surgeon eventually. The tumor cells were chromophobic with H&E stain and exhibited focal positive staining with PAS. Immunoperoxidase method demonstrated moderate positivity for adrenocorticotrophic hormone (ACTH), while staining for growth hormone (G.H) and prolactin were negative. The patient was eucorticoid clinically and biochemically. Since silent corticotropic adenoma of the human pituitary gland is rarely encountered clinically, a review of the literature is included in this article.- - - - - - - - - - ranking = 5keywords = gland (Clic here for more details about this article) |
7/22. hyperthyroidism with an FSH-and TSH-secreting pituitary adenoma.A 34-year-old man was found to have elevated thyroxine (T4), triiodothyronine (T3), calculated free T4, thyroid-stimulating hormone (TSH), follicle-stimulating hormone (FSH), and alpha subunits of TSH and FSH. A computed tomography scan of the head showed a 16-mm macroadenoma of the pituitary gland. There was no evidence of loss or excess secretion of other pituitary hormones. The large chromophobe adenoma was removed via a transphenoidal approach. The patient has been taken off all medication. Thyroid function has returned to normal and there has been no loss of pituitary secretory capacity of other pituitary hormones. The occurrence of a combined TSH- and FSH-secreting pituitary adenoma is rare; to the authors' knowledge, only one case has been documented in the literature.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
8/22. In vivo and in vitro modulation of growth hormone and prolactin of a mixed somatotropic-lactotropic pituitary microadenoma.Both in vivo and in vitro responses of prolactin and growth hormone to stimuli were studied in an acromegalic, amenorrheic woman with a chromophobe adenoma of the pituitary gland. Preoperative testing revealed a prolactin rise after thyrotropin-releasing hormone and chlorpromazine and a decline after L-dopa and bromocriptine administration. During 3.5-hour incubations, cultured tumor cells produced significant increases of growth hormone and prolactin after dibutyryl adenosine 3',5'-cyclic monophosphate stimulation, while bromocriptine inhibited both hormones.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
9/22. Sphenoidal pituitary adenoma.A 62 year old female died of a chromophobe pituitary adenoma of the sphenoid bone. A normal pituitary gland was present within the sella turcica. She also had a chief cell parathyroid adenoma, a papillary thyroid carcinoma, and an ovarian thecoma (multiple endocrine neoplasia syndrome).- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
10/22. Silent corticotropic adenomas of the human pituitary gland: a histologic, immunocytologic, and ultrastructural study.Among 300 surgically removed pituitary adenomas, 17 tumors containing immunoreactive 1-39 adrenocorticotropin (ACTH) and/or 19-39 ACTH, beta-lipotropin, and alpha-endorphin but unassociated with clinical signs of Cushing's disease have been detected. These neoplasms were divided into basophilic adenomas with strong periodic acid-Schiff (PAS) and lead-hematoxylin positivity and chromophobic tumors with moderate or no PAS and lead-hematoxylin positivity. The former were densely granulated tumors with a fine structure strikingly similar to that of functioning corticotropic cell adenomas. The latter were sparsely granulated with varying ultrastructural patterns. The marked morphologic diversity suggests that these adenomas, despite their similar immunocytologic characteristics, represent more than one entity. Clinically, the most common finding was a rapidly progressing visual defect. An unusually high incidence of infarction (5 cases) and recurrence (5 cases) was noted, underlining the importance of correct morphologic diagnosis and careful follow-up.- - - - - - - - - - ranking = 4keywords = gland (Clic here for more details about this article) |
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