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At least 649 records · Page 36Linked to original sources
PubMed1976

Responsiveness of growth hormone release in acromegalics after irradiation or hypophysectomy.

Effects of X-ray irradiation to the pituitary and transfrontal hypophysectomy were evaluated on the responsiveness of plasma growth hormone (GH) to exogenous stimuli in 8 patients with acromegaly. As exogenous stimuli, arginine, TRH, LH-RH and L-dopa were administered. In 2 out of 3 patients treated with Liniac irradiation, the responsiveness to arginine was essentially unchanged, while in the third patient positive response to arginine disappeared after therapy. Of 2 patients who received a combination of hypophysectomy and Liniac irradiation, the responsiveness to arginine, TRH, LH-RH and L-dopa did not change in 1 patient, but in the other it was observed that negative response to L-dopa became positive after the treatment, remaining the unchanged responsiveness to arginine, TRH, and LH-RH. In 3 hypophysectomized patients, little change in responses to the above 4 stimuli was observed. In summary, out of 22 pairs of responses (pre- and post-therapy) examined 20 were not altered. In 11 pairs of responses (pre- and post-irradiation) particularly, 10 were essentially unchanged. It might be concluded that the responsiveness of GH to exogenous stimuli in acromegalics would not be affected by irradiation or transfrontal hypophysectomy.

Acromegaly↗
PubMed2001

Pituitary tumors: pathophysiology, clinical manifestations and management.

Pituitary tumors are frequently encountered intracranial neoplasms. They present with a variety of clinical manifestations that include symptoms and signs of excessive hormone secretion by the tumor, signs of hormone deficits by the normal pituitary gland and others related to expansion of the tumor mass and the resulting compression of surrounding structures such as the optic chiasm and cranial nerves. Advances in molecular biology, immunocytochemical staining and imaging, and the introduction of new treatment options have improved our understanding of the natural history of these adenomas and their management. Available treatments include surgical, medical and radiation therapy. Although the primary treatment for each tumor type may vary, it is important to consider all available options and select the most applicable for that patient. The interaction of all members of management team, including the primary care provider, the endocrinologist and the neurosurgeon in selecting the treatment course can only improve therapeutic outcome. Regardless of the initial choice of treatment,follow-up of all patients should be maintained indefinitely. The managing physician should be familiar with the natural history and long-term complications of pituitary adenomas, and with the side effects of treatments given over the years.

Acromegaly↗
PubMed2003

Treatment of lymphocytic hypophysitis by high-dose methylprednisolone pulse therapy.

A 26-year-old woman 3 months post-partum was admitted to our hospital suffering from gross visual disturbance. Magnetic resonance imaging (MRI) revealed a pituitary mass, extending into the suprasellar cistern, with intense gadolinium enhancement. Lymphocytic hypophysitis (LHy) was suspected, and the patient received high dose methylprednisolone pulse therapy (HDMPT). Her visual disturbance was dramatically ameliorated on the first day following initiation of HDMPT, and MRI revealed marked mass reduction. Her pituitary function recovered 6 months after therapy. This case report suggests that HDMPT proved effective for mass reduction of severe LHy and could obviate the need for a useless surgery.

Adult↗
PubMed1993

Endocrine functions in children with suprasellar germinoma.

Clinical manifestations and endocrine functions were evaluated in 17 children with suprasellar germinoma. Polyuria and growth retardation were the most common initial symptoms. Physical and neurological examinations revealed diabetes insipidus in 17, growth retardation in five, and visual disturbance in three of the patients. Assessment of hypothalamic-pituitary function before treatment revealed pituitary deficits in all patients involving growth hormone, thyroid-stimulating hormone, luteinizing hormone, follicle-stimulating hormone, and adrenocorticotropic hormone. These pituitary dysfunctions persisted after tumor remission due to radiation therapy. These results indicate that children with suprasellar germinoma need long-term hormone replacement therapy to prevent growth retardation, thyroid dysfunction, and delayed secondary sexual development.

Adolescent↗
PubMed1995

Intra- and suprasellar germinoma mimicking a pituitary adenoma--case report.

A 25-year-old female presented with amenorrhea and bitemporal hemianopsia without diabetes insipidus due to an intra- and suprasellar dumbbell tumor. The preoperative and operative diagnosis was pituitary adenoma, but the histological diagnosis was germinoma. Differential diagnosis between germinoma and pituitary adenoma based on computed tomograms and magnetic resonance (MR) imaging features and signal intensity characteristics was difficult in this patient. An enhanced mass posterior to the normal pituitary gland on the mid-sagittal MR image normally indicates an intrasellar germinoma rather than a pituitary adenoma, but this finding was equivocal in our patient.

Adenoma↗
PubMed1997

Giant cell granulomatous hypophysitis manifesting as an intrasellar mass with unilateral ophthalmoplegia--case report.

A 62-year-old female presented with giant cell granulomatous hypophysitis manifesting as subacute unilateral ophthalmoplegia. Neuroimaging revealed a mass lesion expanding in the pituitary fossa. The mass was totally removed through the transsphenoidal approach. The histological diagnosis was giant cell granuloma. The oculomotor nerve paresis resolved completely 10 days after the operation. Giant cell granulomatous hypophysitis is symptomatically and radiologically indistinguishable from non-functioning pituitary adenoma, but is less likely to cause visual disturbance than pituitary adenoma. Giant cell granulomatous hypophysitis should be considered in the differential diagnosis of sellar and suprasellar lesions, particularly if oculomotor nerve paresis is observed without impaired visual field or acuity.

Diagnosis, Differential↗
PubMed2004

Craniopharyngiomas with intratumoral hemorrhage--two case reports.

Two cases of craniopharyngioma with intratumoral hemorrhage are reported. A 22-year-old male was admitted with meningitis. Lumbar tapping was performed twice. He subsequently developed reduced visual acuity and field deterioration due to intratumoral hemorrhage from an intra- and suprasellar tumor. He underwent emergency craniotomy and total extirpation of the tumor. A 29-year-old female underwent partial extirpation of an intra- and suprasellar cystic tumor via transsphenoidal surgery. Two months after the first operation, she suffered intratumoral hemorrhage necessitating emergency surgery and subsequent gamma-knife therapy. The histological diagnosis was craniopharyngioma in both cases. Hemorrhage is extremely rare in craniopharyngiomas and difficult to discriminate from that in pituitary adenoma, but both diseases require decompression by clot extirpation.

Craniopharyngioma↗