1/130. Coexistance of tubal ectopic pregnancy and adenomatoid tumor.The first case is presented of coexistance of an ectopic pregnancy and an adenomatoid tumor in the same fallopian tube. The ectopic pregnancy was diagnosed clinically, but the tumor was only detected microscopically as a result of extensive sampling of the salpingectomy specimen.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/130. Morules with biotin-containing optically clear nuclei in colonic tubular adenoma.Morules have been reported in pulmonary endodermal tumors (PET) resembling fetal lung, in thyroid carcinoma, and in endometrial and colonic neoplasms. A morule has biotin-containing optically clear nuclei (OCN) in PET and thyroid carcinoma. biotin-containing OCN have been also reported in endometrial tissue during pregnancy and in endometrioid carcinoma of the ovary, and it has been postulated that morules or OCN develop under the influence of female sex hormones. The authors report here the first case, to their knowledge, of morules with OCN in a colonic adenoma from a 68-year-old man. The colonic polyp consisted of ordinary tubular adenomatous tissue and morules. Many cells in the morules contained OCN. The OCN were immunopositive for biotin and reacted with streptavidin. The neoplastic cells in the morules were immunopositive for oncofetal antigens. serum levels of female sex hormones were within the normal range, and no cells in the adenoma were immunopositive for receptors for progesterone and estrogen. The results indicate that OCN are rich in biotin and that morules may be embryologically immature elements that develop independently of influence by female sex hormones.- - - - - - - - - - ranking = 0.16666666666667keywords = pregnancy (Clic here for more details about this article) |
3/130. Successful pregnancy in a woman with acromegaly treated with somatostatin analog (octreotide) prior to surgical resection.A 27-year-old woman with a GH-secreting pituitary macroadenoma was treated with continuous s.c. infusion of octreotide prior to surgical resection. Subsequently, she was found to be 6 months pregnant. Fetal echographs were normal, the newborn had no malformation, and postnatal development was normal.- - - - - - - - - - ranking = 0.66666666666667keywords = pregnancy (Clic here for more details about this article) |
4/130. Pharyngeal pituitary: development, malformation, and tumorigenesis.The development of the pharyngeal pituitary (PhP) in the fetal period was morphologically and, for the first time, immunohistochemically examined. PhP, found in every individual, begins its hormone production at the 17-18th week of gestation, that is, 4-8 weeks later than that of sellar pituitary (SP). Only 1 of 25 examined fetuses without any stigmata of developmental anomalies showed a residual pituitary fragment in the craniopharyngeal canal (craniopharyngeal pituitary, CPhP). An adult case of a rare clivus pituitary adenoma that we examined is demonstrated in discussing its relationship to PhP. Extracranial ectopic pituitary adenomas in the literature describe an exclusively sphenoid sinus/nasopharyngeal/clivus location of the tumor. Their location corresponded exactly with that of PhP, so that the origin of the tumors can be reasonably speculated as PhP, although another origin, e.g., CPhP, can not be excluded. A variety of malformations of PhP, although very rare, have been described for the fist time during the systemic examination of 16 fetuses with different cranioneural malformations, such as agenesis, unseparated PhP from SP (pharyngosellar pituitary), fragmentation, and residual pituitary tissue in the open craniopharyngeal canal. However, developmental anomaly of PhP was not specifically associated with cranioneural malformations except in cases of chromosomal aberrations. The hormone production in PhP in malformation cases tended to be retarded. Absence of SP was recorded in 50% of anencephalics in the literature; however, PhP was identified in all anencephalics in our series, independent of the existence of SP. This supports the opinion that agenesis of SP in anencephalics seems to be false information.- - - - - - - - - - ranking = 0.023022468672432keywords = gestation (Clic here for more details about this article) |
5/130. Lymphocytic hypophysitis and infundibuloneurohypophysitis; clinical and pathological evaluations.This report describes the clinical and pathological characteristics of two patients with lymphocytic hypophysitis (LHy) and two with infundibuloneurohypophysitis (INHy). Two of the patients were women and two were men, and their ages were between 27 and 38 years old. This disease was not associated with either pregnancy or the postpartum period in the female patients. Two of the patients presented with diabetes insipidus, one with panhypopituitarism and right abducens paralysis and one with headache and galactorrhea. At presentation three of the patients had mild to moderate hyperprolactinemia and one had low prolactin levels. All four had abnormal magnetic resonance imaging (MRI): focal nodular enlarging of the infundibulum and normal hypophysis in one, expanding sellar masses in two, and diffusely thickened stalk with slightly enlarged pituitary gland in one. Three cases showed no sign of adenohypophysial deficiency with stimulation tests. One patient had associated chronic lymphocytic thyroiditis. Of the first three patients, one patient underwent transcranial and two underwent transnasal transsphenoidal (TNTS) surgery for mass excisions since they were thought to have pituitary tumors. Endoscopic endonasal transsphenoidal biopsy was performed in the last one with a suspicion of LHy. The pathological and immunohistochemical examinations revealed lymphocytic infiltration. hyperprolactinemia resolved with surgery in two patients and one developed diabetes insipidus as a complication. We conclude that LHy and infundibuloneurohypophysitis should be considered in the differential diagnosis of the mass lesions of the sellar region and also should be kept in the mind for the etiopathogenesis of cases of hyperprolactinemia, galactorrhea and diabetes insipidus. In suspected cases endoscopic endonasal biopsy for the histopathological diagnosis can be a safe approach.- - - - - - - - - - ranking = 0.16666666666667keywords = pregnancy (Clic here for more details about this article) |
6/130. Clinical course of a pituitary macroadenoma in the first trimester of pregnancy: probable lymphocytic hypophysitis.Recent findings revealed that the clinical features of lymphocytic hypophysitis are more complicated than previously thought. It is rarely described in the first trimester of pregnancy and signs of meningeal irritation are infrequently reported. In this study, a pregnant woman in her first trimester of pregnancy with clinical and radiological characteristics of a pituitary macroadenoma is described. The patient's pituitary profile revealed a relatively low prolactin for her stage of pregnancy. Unusual findings were neck stiffness associated with headache, nausea and vomiting. She was treated conservatively. Spontaneous complete resolution of the pituitary mass in the postpartum period led us to conclude that the correct diagnosis should be hypophysitis. Hypophysitis should be considered in the differential diagnosis of a pituitary mass presenting in early stages of pregnancy with symptoms mimicking hyperemesis gravidarum and/or meningeal irritation.- - - - - - - - - - ranking = 1.3333333333333keywords = pregnancy (Clic here for more details about this article) |
7/130. Laparoscopic adrenalectomy for primary hyperaldosteronism during pregnancy.Laparoscopic adrenalectomy was performed early in the second trimester of pregnancy in a woman with an aldosteronoma causing hypertension (254/154 mm Hg). The patient was later delivered of a healthy baby. With suitable precautions and timing, major laparoscopic surgery can be performed safely during pregnancy.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
8/130. Lymphocytic adenohypophysitis mimicking a pituitary macroadenoma.A 24-year-old woman developed headache and rapidly progressive visual disturbances during the last trimester of her first pregnancy. Magnetic resonance tomography (MRI) of the brain documented an intra- and suprasellar mass lesion. For preservation of vision, transsphenoidal microsurgical decompression was performed. Immediately postoperatively, visual acuity improved and hemianopia resolved. Histological examination yielded the diagnosis of primary lymphocytic adenohypophysitis. This is a rare inflammatory pituitary disease. There are no typical clinical, laboratory, or radiological findings that allow precise preoperative diagnosis. Even though this autoimmune disorder is principally steroid-responsive, an improvement of visual disturbances under steroid therapy cannot be predicted. Therefore, surgery is justified not only to establish the diagnosis, but also to restore vision by decompression of the optic nerves and the chiasm.- - - - - - - - - - ranking = 0.16666666666667keywords = pregnancy (Clic here for more details about this article) |
9/130. Primary aldosteronism in pregnancy.Aldosteronism is a rare complication of pregnancy. We report a case of a 26-year-old woman who became pregnant soon after a diagnosis of primary aldosteronism due to left adrenal adenoma was made. Only oral potassium supplementation was required in addition to routine prenatal care until 36 weeks' gestation. Subsequently, antihypertensive medication was needed to control elevated blood pressure. A healthy male infant was delivered by cesarean section because of abruptio placentae. The postoperative course was uneventful. Left adrenalectomy was conducted eight months after delivery under laparoscopic visualization. In this case report, we discuss management of aldosteronism in pregnancy and review the literature.- - - - - - - - - - ranking = 1.0230224686724keywords = pregnancy, gestation (Clic here for more details about this article) |
10/130. Course and outcome of pregnancy in a patient with mild, asymptomatic, primary hyperparathyroidism diagnosed before conception.Primary hyperparathyroidism (PHP) during pregnancy is well known to confer an increased risk of complications to both the mother and the fetus. However, the risks and optimal management of patients with mild, asymptomatic disease during pregnancy are much less clear. We observed a patient with mild, asymptomatic PHP who was diagnosed before conception through pregnancy. The patient remained asymptomatic through the first 22 weeks of pregnancy, and her calcium levels remained under 11 mg/dL. This occurred despite a dramatic elevation in the level of 1,25-dihydroxyvitamin D and marked hypercalciuria. Parathyroid surgery was performed at 22 weeks of gestation and a parathyroid adenoma was removed. Postoperatively, the patient's calcium level normalized and the rest of the pregnancy was uncomplicated. The patient delivered a healthy baby at 40 weeks of gestation. The neonatal course was unremarkable. We conclude that mild, asymptomatic PHP during early pregnancy is compatible with normal fetal development and an uncomplicated pregnancy and that the serum calcium level in such patients can remain stable with medical management alone, despite the marked changes in maternal calcium metabolism that characterize normal pregnancy.- - - - - - - - - - ranking = 2.0460449373449keywords = pregnancy, gestation (Clic here for more details about this article) |
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