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Results for “PITUITARY IRRADIATION”

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PubMedDate not supplied

Successful long-term management of a gonadotroph adenoma with bromocriptine.

OBJECTIVE: To report the successful 10-year management of a gonadotroph macroadenoma with bromocriptine and review the management of gonadotroph adenomas with bromocriptine. METHODS: We present a case and review the pertinent literature. The effectiveness of bromocriptine in the management of gonadotroph adenomas is evaluated. RESULTS: A 62-year-old man was found to have a pituitary tumor after seeking medical assistance because of a 6-month history of headaches and blurred vision. He had decreased visual acuity and bitemporal field defects. Serum follicle-stimulating hormone (FSH) levels were increased, whereas serum luteinizing hormone and total testosterone levels were normal. Treatment with bromocriptine resulted in a decrease in serum FSH levels, complete resolution of his symptoms, and considerable improvement in his visual acuity and visual field defects. Treatment with only bromocriptine for 10 years resulted in maintenance of normal serum FSH levels and no recurrence of symptoms. CONCLUSION: In the management of a gonadotroph adenoma, we recommend consideration of a therapeutic trial of bromocriptine. In cases that are refractory to this therapy, surgical treatment or external pituitary irradiation could then be used.

Journal Article↗
PubMed1977

Nelson's syndrome.

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Adrenalectomy↗
PubMed2000

Conventional radiotherapy for pituitary tumors.

Radiosurgery for pituitary adenomas is clearly attaining a more prominent position in the spectrum of management of these lesions. It is our belief that improvements in radiosurgical technology can significantly enhance the outcome for patients with these lesions.

Adenoma↗
PubMed2002

[Cushing's disease and corticotrophic adenoma: results of pituitary microsurgery].

Between November 1994 and June 2001, 194 patients with Cushing's disease underwent transsphenoidal surgery: 167 patients had adenomectomy, 14 had ante hypophysectomy, 5 had subtotal hypophysectomy, 4 had hemihypophysectomy 4 had central hypophysectomy. Complications occurred in 18 patients (9.3%), including 4 deaths (three were apparently not related to surgery). Remission of disease was achieved in 162 of 190 (85.3%) patients analyzed. Surgical failures were associated with lack of pituitary adenoma, size of the tumor and invasiveness. Among patients with confirmed adenomas, the rate of remission was significantly higher (p<0.01) in patients with microadenomas (92.6%) than in patients with macroadenomas (66.7%). Reoperation in 6 failures was followed by remission in 4 cases. The overall remission rate was 87.4%. In the 162 patients with immediate success, duration of follow-up was 10.0 +/- 5.9 years (m +/- DS; median=10.0). Recurrence of the disease occurred in 24 (14.8%) of 162 patients at a mean 4.8 years (range: 0.8-12.0 years). Our longest sustained remission is 25.6 years. Actuarial analysis indicates that the probability of a patient remaining well 12 years after surgery is 80.0%. It is 86.2% in microadenomas versus 52.5% in macroadenomas and 94.5% in the patients with postoperative hypocortisolism versus 59.2% in the others.

Adenoma↗
PubMed2002

[Follow-up of Cushing syndrome in western Sweden. More than one treatment method needed for cure, hormonal deficiencies common].

Results from a follow-up of all patients with Cushing's syndrome who visited the Division of Endocrinology at Sahlgrenska University Hospital, Göteborg, Sweden, during 1997-1998 revealed 28 patients with ACTH-dependent disease and 3 with ACTH-independent disease. Female/male ratio was 4:1 with mean age at diagnosis 30 years. Mean time from first symptoms to diagnosis was three years (range 0-8). The most frequent signs were hypertrichosis, easy bruising, hypertension, osteoporosis and diabetes mellitus. Out of the 28 patients with ACTH-dependent disease, 16 underwent more than one treatment method (transcranial/transsphenoidal pituitary surgery, pituitary irradiation, adrenalectomy), 26 were cured and 25 developed hormonal deficiencies after treatment. Five of the 11 patients who underwent adrenalectomy developed Nelson tumors. All patients in the ACTH-independent group were cured after unilateral adrenalectomy.

Adrenocorticotropic Hormone↗
PubMed1992

Radiation-induced optic neuropathy.

Radiation-induced optic neuropathy is a well-known complication of cranial radiotherapy. We describe four cases. In two cases, the diagnosis was made on MRI. After administration of Gadolinium-DTPA, there was an enhanced captation at the level of the optic nerve. In addition we reviewed 47 cases reported in the literature. Visual prognosis is less than 1/10 in 78% of affected eyes. In case of associated brain necrosis, the mortality rate is 62%.

Adult↗