Abstract:
BACKGROUND:Xanthogranulomas are inflammatory masses most commonly found at peripheral sites such as the skin. Sellar and parasellar xanthogranulomas are rare and present a diagnostic challenge as they are difficult to differentiate from other sellar lesions such as craniopharyngiomas and Rathke's cleft cysts pre-operatively. Their radiological imaging features are yet to be clearly defined, and clinical outcomes after surgery are also uncertain. This study reviews clinical presentation, radiological appearances, and clinical outcomes in a cohort of patients with pituitary xanthogranulomas. METHODS:A prospectively maintained pituitary surgery database was screened for histologically confirmed pituitary xanthogranulomas between May 2011-December 2016. Retrospective case note assessments were then performed by three independent reviewers. Patient demographics, clinical presentations, imaging, and clinical outcomes were analysed. RESULTS:During the study period 295 endoscopic endonasal pituitary surgeries were performed. Six patients had confirmed pituitary xanthogranulomas (2%). Patients most commonly presented with visual field deficits and/or endocrine dysfunction. Common imaging features included: a cystic consistency, hyperintensity on T1-weighted MR images, and contrast enhancement either peripherally (n = 3) or homogenously (n = 3). The most common pre-operative endocrine deficits were hyperprolactinaemia and hypoadrenalism (at least one of which was identified in 4/6 patients; 66%). Thirty-three percent (2/6) of patients presented with diabetes insipidus. The most common post-operative endocrinological deficits were adrenocortical dysfunction (66%) and gonadotropin deficiency (66%). Visual assessments normalised in all six patients post-operatively. Gross total resection was achieved in all patients, and at median follow up of 33.5 months there were no cases of tumour recurrence. CONCLUSIONS:The prevalence of pituitary xanthogranulomas in our series is higher than that suggested in the literature. Surgery restored normal vision to all cases, however four patients (67%) required long-term hormonal replacement post-operatively. Imaging features such peripheral rim enhancement, a suprasellar tumour epicentre, and the absence of both calcification or cavernous sinus invasion were identified as potential indicators that together should alert clinicians to the possibility of pituitary xanthogranuloma when assessing patients with cystic sellar and parasellar tumours.
journal_name
Pituitaryjournal_title
Pituitaryauthors
Ved R,Logier N,Leach P,Davies JS,Hayhurst Cdoi
10.1007/s11102-017-0859-xsubject
Has Abstractpub_date
2018-06-01 00:00:00pages
256-265issue
3eissn
1386-341Xissn
1573-7403pii
10.1007/s11102-017-0859-xjournal_volume
21pub_type
杂志文章相关文献
Pituitary文献大全abstract::Acute lymphoblastic leukaemia (ALL) is the most common childhood malignancy. The survival rate in the Scandinavian countries is now around 85 %. ALL patients treated with cranial radiotherapy (CRT) are at risk for growth hormone deficiency (GHD), but little is known about other pituitary insufficiencies, e.g. ACTH. Ad...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-012-0459-8
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:The growing interest in the molecular and genetic alterations of craniopharyngiomas (CPs) is embodied in recent studies revealing insights into the CP tumorigenesis and identifying novel molecular pathways amenable of targeted therapies. The actual impact of this new information, however, remains inconclusiv...
journal_title:Pituitary
pub_type: 杂志文章,评审
doi:10.1007/s11102-018-0890-6
更新日期:2018-08-01 00:00:00
abstract::160 clinically non-secreting pituitary adenomas were examined in regard to their expression of the markers PCNA, bcl2, Ki 67 in the mib-1 modification and p53 which are still under investigation for their relevance to cell proliferation. The series contained 60 null cell adenomas, 60 oncocytomas and 40 gonadotroph ade...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1023/a:1009933820856
更新日期:1999-05-01 00:00:00
abstract::Nonfunctioning pituitary adenomas (NFPA) are typically benign neoplasms that can cause significant morbidity through local mass effects. MIB-1/Ki-67 and p53 immuno-reactivity are used to predict aggressive behavior but have known limitations. No marker to date is widely used to reliably predict tumor progression. Phos...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-011-0367-3
更新日期:2012-12-01 00:00:00
abstract:PURPOSE:Hypofractionated stereotactic radiotherapy (HSRT) for refractory Cushing's disease may offer a condensed treatment schedule for patients with large tumors abutting the optic chiasm unsuitable for stereotactic radiosurgery (SRS). To-date only four patients have been treated by HSRT in the published literature. W...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-019-00992-6
更新日期:2019-12-01 00:00:00
abstract:PURPOSE:To evaluate the effects of somatostatin analogs and disease activity status on the upper gastrointestinal system in patients with acromegaly. METHODS:One hundred eighty-one patients with acromegaly were retrospectively assessed. The demographic, biochemical, pathologic, and radiologic data of the patients were...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-020-01095-3
更新日期:2020-10-19 00:00:00
abstract::Acromegaly is associated with serious morbidity and mortality, if not well controlled. Approved somatostatin receptor ligands (SRLs) are a mainstay of medical therapy and exhibit preferential affinity for somatostatin receptor (SSTR) subtype 2. Our objective was to assess whether characteristic features of individual ...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-012-0445-1
更新日期:2013-12-01 00:00:00
abstract:PURPOSE:To determine the particle size, concentration, airborne duration and spread during endoscopic endonasal pituitary surgery in actual patients in a theatre setting. METHODS:This observational study recruited a convenience sample of three patients. Procedures were performed in a positive pressure operating room. ...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-021-01125-8
更新日期:2021-01-19 00:00:00
abstract::A high incidence of venous thromboembolic (VTE) complications has been reported in Cushing's syndrome (CS), mostly post-operatively and attributable to hypercoagulability. The prevalence of symptomatic VTE was investigated retrospectively in 58 consecutive CS patients in relation to acquired and genetic thrombotic ris...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-012-0398-4
更新日期:2013-06-01 00:00:00
abstract::Symptomatic cerebral vasospasm (CVS) after transsphenoidal surgery (TSS) is very rare compared with vasospasm resulting from aneurysmal subarachnoid hemorrhage (SAH). Fewer than six cases documented by cerebral angiography have been reported. We evaluated the records of 15 patients in whom SAH developed after TSS. The...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-012-0415-7
更新日期:2013-06-01 00:00:00
abstract::In this case report we describe a 38 year-old-female with galactorrhea several months after the birth of an anencephalic child. She had hyperpolactemia and imaging of the pituitary gland revealed a midline defect and a nasopharyngeal mass compatible with a meningo-(hypophyso-) encephalocele and possibly an ectopic ter...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-011-0320-5
更新日期:2012-12-01 00:00:00
abstract:PURPOSE:Granular cell tumors of the neurohypophysis are rare, solitary lesions, mostly presenting in the adult age. They rarely grow to a sufficient size to cause mass effect related symptoms and they may be found in most cases incidentally at autopsy. Because of their rarity as of now they have been described only as ...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-016-0704-7
更新日期:2016-06-01 00:00:00
abstract::The diagnoses of acromegaly and dwarfism require biochemical confirmation of abnormal GH and IGF-1 concentrations. The same parameters are used for therapeutic decisions, i.e. initiation or termination of particular treatments. Therefore, reliable and epidemiologically and statistically proven criteria of normalcy for...
journal_title:Pituitary
pub_type: 杂志文章,评审
doi:10.1007/s11102-007-0029-7
更新日期:2007-01-01 00:00:00
abstract::Adequate ADH secretion, adrenal and thyroid functions are vital during the acute and post-acute phases of TBI. Deficiencies of these functions as a result of TBI are increasingly recognized. During the acute phase of TBI the incidence of severe DI is 2.9%; the incidence of less severe forms of DI is 21.6-26%. The deve...
journal_title:Pituitary
pub_type: 杂志文章,评审
doi:10.1007/s11102-006-6049-x
更新日期:2005-01-01 00:00:00
abstract:PURPOSE:To analyze the clinical characteristics of acromegalic patients with empty sella (ES, herniation of the subarachnoid space within the sella turcica) and the impact of ES on transsphenoidal surgery in such patients. METHODS:Seventy-eight patients, newly diagnosed with acromegaly who underwent transsphenoidal su...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-017-0798-6
更新日期:2017-08-01 00:00:00
abstract::The pituitary is the master endocrine gland of the body. It undergoes many changes after birth, and these changes may be mediated by the differentiation of pituitary stem cells. Stem cells in any tissue source must display (1) pluripotent capacity, (2) capacity for indefinite self-renewal, and (3) a lack of specializa...
journal_title:Pituitary
pub_type: 杂志文章,评审
doi:10.1007/s11102-013-0470-8
更新日期:2013-09-01 00:00:00
abstract::We report a 59-year-old acromegalic woman, who presented with generalized bone pain, weakness, fatigue and foamy urine, who was found to have multiple myeloma (MM); and a 60-year-old acromegalic woman with dizziness, vomiting and abdominal pain, high blood pressure and splenomegaly that was posteriorly diagnosed as ha...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-009-0176-0
更新日期:2011-12-01 00:00:00
abstract::We evaluated the efficacy of Gamma knife stereotactic radiosurgery (GKSR) as an adjunctive management modality for patients with drug resistant or intolerant cavernous sinus invasive prolactinomas. Twenty-two patients with cavernous sinus invasive prolactinoma underwent GKSR between 1994 and 2009. Thirteen patients we...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-012-0376-x
更新日期:2013-03-01 00:00:00
abstract:PURPOSE:Patients treated for pituitary adenomas generally report a reduced quality of life (QoL). At present, the patient's perspective of QoL has not been fully addressed and this, and further insight in potential determinants of QoL in pituitary diseases is required to design strategies to improve QoL. We aimed to de...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-014-0561-1
更新日期:2015-02-01 00:00:00
abstract::Most patients with acromegaly have some degree of insulin resistance. The principal mediator of insulin resistance in acromegaly is hypersecretion of growth hormone. Growth hormone acts at several levels to block insulin actions including inhibiting phosphorylation of the insulin receptor and one of its principal sign...
journal_title:Pituitary
pub_type: 杂志文章,评审
doi:10.1023/a:1023321421760
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND/PURPOSE:During the early phase of sepsis, hypotension is accompanied by increase of plasma vasopressin hormone (AVP) levels, which decline during the late phase. This hypotension is due in part to increase of nitric oxide (NO) synthesis by nitric oxide synthase (NOS) enzyme. Neuronal isoform of this enzyme (...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-017-0786-x
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:Lymphocytic hypophysitis (LH) is a rare chronic inflammatory disorder characterized by lymphocytic infiltration of the pituitary gland commonly affecting women during pregnancy or post-partum period. The pathogenesis remains uncertain, however an autoimmune process is frequently implicated. There is limited d...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-008-0119-1
更新日期:2009-01-01 00:00:00
abstract::The role of pituitary radiotherapy (RT) in the management of clinically non-functioning pituitary tumors (NFTs) remains controversial. Observational studies suggest that RT is effective in preventing the regrowth of NFT remnants following initial surgical debulking. However, not all tumor remnants will regrow in the a...
journal_title:Pituitary
pub_type: 杂志文章,评审
doi:10.1023/b:pitu.0000004801.95086.e2
更新日期:2003-09-01 00:00:00
abstract:INTRODUCTION:In order to perform trans-sphenoidal endoscopic pituitary surgery safely and efficiently it is important to identify anatomical and pituitary disease features on the pre-operative CT and MRI scans; thereby minimising the risk to surrounding structures and optimising outcomes. We aim to create a checklist t...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-017-0787-9
更新日期:2017-08-01 00:00:00
abstract::Growth hormone releasing hormone (GHRH) signals via G protein-coupled receptors (GHRH-R) to enhance intracellular Galphas/adenylyl cyclase/cAMP signaling, which in turn has positive effects on GH synthesis and release, as well as proliferation of the GH-producing cells of the anterior pituitary gland. Some GH-producin...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-005-5245-4
更新日期:2005-01-01 00:00:00
abstract::Acromegaly is a consequence of chronic growth hormone (GH) excess, due in the majority of cases to a GH-secreting pituitary adenoma, and occurring with a population prevalence of 60 per million and an incidence of 3-4 per million per year. Males and females appear to be equally affected with an average age of presenta...
journal_title:Pituitary
pub_type: 杂志文章,评审
doi:10.1023/a:1009965803750
更新日期:1999-06-01 00:00:00
abstract::Lanreotide depot (LD; commercial name Somatuline(®) Depot) is an injectable, extended-release formulation of the synthetic somatostatin analog (SSA) lanreotide. In recent clinical trials, LD was found to be suitable for self or partner administration, avoiding the need to travel to a medical facility. The Somatuline(®...
journal_title:Pituitary
pub_type: 杂志文章,多中心研究
doi:10.1007/s11102-012-0460-2
更新日期:2014-02-01 00:00:00
abstract::Glucocorticoids are important immunosuppressive hormones; these steroids also inhibit somatic growth by decreased growth hormone (GH) secretion and induced protein catabolism. The ability of ghrelin, the endogenous ligand for the GHS-1a receptor, to increase body weight is attributed to a combination of enhanced food ...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1007/s11102-007-0054-6
更新日期:2007-01-01 00:00:00
abstract::A diabetic acromegalic man, not cured after surgery and radiosurgery, received lanreotide i.m. with great clinical and biochemical improvement. He required NPH insulin (76 to 84 units/day) to control his diabetes mellitus. Thirty-six hours after changing to LAR-octreotide (20 mg i.m/month) he presented symptomatic hyp...
journal_title:Pituitary
pub_type: 杂志文章
doi:10.1023/a:1020710800842
更新日期:2001-09-01 00:00:00
abstract::The dexamethasone (DXM) test has been widely used for diagnosing Cushing's disease (CD). The purpose of this paper is to review its diagnostic merit based on calculation of data extracted from earlier publications. Studies presenting individual values for patients with CD and normal subjects were identified through Pu...
journal_title:Pituitary
pub_type: 杂志文章,评审
doi:10.1007/s11102-013-0509-x
更新日期:2014-08-01 00:00:00