PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “PITUITARY IRRADIATION”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 379 records · Page 21Linked to original sources
PubMed1986

Recurrent cystic craniopharyngioma management and course.

A 54-year-old woman had a permanent catheter placed connecting the cavity of an inoperable recurrent cystic craniopharyngioma and an extracranial reservoir for easy decompression by aspiration. The cyst refilled so frequently that radiation was given to the cystic tumour. Almost four years after radiation treatment, the patient has been well and no aspirations have been required. The cyst "dried out" and a year after radiation injection of isotope through the reservoir showed that the intracranial end of the catheter was now lodging in ventricular or cisternal space.

Cerebrospinal Fluid Shunts↗
PubMed1993

Malignant growth of a recurrent macroprolactinoma after radiation therapy.

The authors report a case of a 60-year-old woman with a macroprolactinoma. After radiation therapy of the subtotally excised recurrent tumor, it developed a rapid malignant-destructive growth with invasion into adjacent structures. The causal factors are discussed and the literature is briefly reviewed.

Bromocriptine↗
PubMed1981

Cushing's disease: a review of pathogenesis, diagnostic methods, and treatment.

Cushing's disease is a form of Cushing's syndrome that results from excessive ACTH secretion with consequent adrenal hyperplasia and increased cortisol secretion. Most patients have an ACTH-secreting tumor; in others, a hypothalamic defect may play an important role. Steroid determinations and the dexamethasone suppression test can confirm overproduction of cortisol. Measurement of basal plasma ACTH level is perhaps the most reliable way to determine the cause of overproduction. Transsphenoidal surgery seems to be the initial treatment of choice, if the necessary neurosurgical expertise is available. If it is not, bilateral adrenalectomy combined with conventional pituitary irradiation can be used. Other alternatives are cobalt 60 high-voltage or heavy-particle irradiation and drugs that interfere with cortisol biosynthesis.

Cushing Syndrome↗
PubMed1985

The first 100 transsphenoidally operated pituitary adenomas in a non-specialised centre: surgical results and tumour-recurrence.

From 118 transsphenoidally operated patients, 100 had a pituitary adenoma; 33 prolactinomas, 20 HGH-producing, 2 ACTH-producing and 45 inactive adenomas. The first transsphenoidal operation did not cause any mortality; after reoperation for suspected recurrence on follow-up, 2 patients died; thus, the global management mortality was 1.8%. As surgical complications, diabetes insipidus occurred in 5%, hypopituitarism in 4%. Age at operation was significantly higher in female patients with micro- than with macroprolactinomas, and also markedly higher in men than in women with prolactinomas. Preoperative serum prolactin levels were related to tumour size and age and demonstrated an important prognostic factor of postoperative cure. The prognosis of preoperative visual field defects was dependent on preoperative duration. During a follow-up period of 1-6.3 years, 7 patients were reoperated for recurrence of their tumour after intervals of 2-4.5 years; 6 of these patients had had inactive macroadenomas, 1 an ACTH-producing macroadenoma. In 3 of these patients, radiation therapy had been performed. The highest recurrence-rate (19%) among 100 patients was found in patients with inactive macroadenomas with a follow-up of more than 2 years.

Adenoma↗
PubMed1998

A case study comparing the relative benefit of optimizing beam weights, wedge angles, beam orientations and tomotherapy in stereotactic radiotherapy of the brain.

A treatment-planning case study has been performed on a patient with a medium-sized, convex brain tumour. The study involved the application of advanced treatment-plan optimization techniques to improve on the dose distribution of the 'standard plan' used to treat the patient. The standard plan was created according to conventional protocol at the Royal Marsden NHS Trust, and consisted of a three-field (one open and two wedged) non-coplanar arrangement, with field shaping to the beam's-eye view of the planning target volume (PTV). Three optimized treatment plans were created corresponding to (i) the optimization of the beam weights and wedge angles of the standard plan, (ii) the optimization of the beam orientations, beam weights and wedge angles of the standard plan, and (iii) a full fluence tomotherapy optimization of 1 cm wide (at isocentre), 270 degree arcs. (i) and (ii) were created on the VOXELPLAN research 3D treatment-planning system, using in-house developed optimization algorithms, and (iii) was created on the PEACOCK tomotherapy planning system. The downhill-simplex optimization algorithm is used, in conjunction with 'threshold-dose' cost-function terms enabling the algorithm to optimize specific regions of the dose-volume histogram (DVH) curve. The 'beam-cost plot' tool is presented as a visual aid to the selection of beneficial beam directions. The methods and pitfalls in the transfer of plans and patient data between the two planning systems are discussed. Each optimization approach was evaluated, relative to the standard plan, on the basis of DVH and dose statistics in the PTV and organs at risk (OARs). All three optimization approaches were able to improve on the dose distribution of the standard plan. The magnitude of the improvement was greater for the optimized beam-orientation and tomotherapy plans (up to 15% and 30% for the maximum and mean OAR doses). A smaller improvement was observed in the beam-weight and wedge-angle optimized plan (up to 5% and 10% in the maximum and mean OAR doses). In the tomotherapy plan, difficulty was encountered achieving an acceptable homogeneity of dose in the PTV. This was improved by treating the gross tumour volume (GTV) and (PTV - GTV) regions as separate targets in the inverse planning, with the latter region prescribed a slightly higher dose to reduce edge under-dosing. In conclusion, for the medium-sized convex tumour studied, the tomotherapy dose distribution showed a significant improvement on the standard plan, but no significant improvement over a conventional three-field plan where the beam orientations, beam weights and wedge angles had been optimized.

Adenoma↗
PubMed1975

Ectopic apudocarcinomas and associated endocrine hyperplasias of the foregut.

Foregut endocrine polypeptide-secreting APUD cells (Amine-Precursor-Uptake and Decarboxylation), in their embryologic migration from neural crest to foregut may become "arrested" in the mesoderm or in other ectopic locations. They may become hyperplastic, adenomatous or malignant. Eight illustrative patients are reported. One patient had "pancreatic hyperparathyroidism" with hypercalcemic crises, pancreatic apudocarcinoma, normal parathyroids, biologically active parathormone, but inert immunochemically to the usual parathyroid antisera. Two had gastrin-secreting malignancies in the mesoderm. Remission after excision, but eventual recurrence of the syndrome due to islet cell hyperplasia required total gastrectomy. One patient had a gastric corpus apudocarcinoma found prospectively with hypergastrinemia which required excision of the tumor. One patient had acromegaly with hypergastrinemia and antral gastrinosis treated by pituitary irradiation, One patient had the antral or intermediary type of the Zollinger-Ellison syndrome with moderate hypergastrinemia, duodenal ulcer and antral gastrinosis, treated by vagotomy and antrectomy. One patient had hyperparathyroidism with antral gastrinosis, treated by parathyroidectomy. One patient had malignant Zollinger-Ellison syndrome and developed associated thyroid parafollicular cell hyperplasia and parathyroid chief cell hyperplasia, treated by total gastrectomy and multiple endocrine excisions. These investigative observations demonstrate ectopic loci and associated hyperplasias which support the concept of migration and bizarre potentiality of polypeptide-secreting cells of the foregut.

Adenoma↗
PubMed1985

Cushing's disease today. Late follow-up of 17 adrenalectomy patients with emphasis on eight with adrenal autotransplants.

Cushing's disease has come full cycle. As originally asserted more than 50 years ago, modern diagnostic techniques now demonstrate an adrenocorticotropic hormone (ACTH) secreting pituitary adenoma in approximately 80% of such patients. At this historical juncture, we report a long-term follow-up of our 17 patients who underwent adrenalectomy (8) or later adrenalectomy plus adrenal autotransplantation (9) between 1955 and 1976. Two patients died soon after surgery and five others died later of "natural" causes. Four others moved away but were stable when last contacted. Of the six patients who remain available for current follow-up, three have undergone hypophyseal surgery. Another patient has evidence of pituitary enlargement, and the remaining two are yet to undergo computerized tomography (CT) scan. Four illustrative cases are reviewed in some detail. One case presented with Nelson's syndrome and acute onset blindness. The second represented multiple endocrine adenomatosis with hyperparathyroidism in addition to Cushing's disease. The third exhibited Cushing's syndrome from the autotransplants, finally cured by hypophysectomy. The fourth exhibited huge ACTH levels from a large pituitary adenoma that could not be totally resected and recurrent Cushing's syndrome associated with large autotransplant "adenomas." The initial surgical treatment of choice is pituitary adenectomy. Bilateral adrenalectomy will remain useful where curative pituitary surgery is not feasible. Neither pituitary irradiation nor medical therapy has been truly effective in our patients. Adrenal autotransplants survive, to some extent, in virtually all patients. However, the degree of function is variable, and the full function may not be achieved for many months or even years. Functioning autotransplants have not prevented Nelson's syndrome, and they would appear to offer little practical benefit at this time.

Adolescent↗