Pituitary dysfunction is a recognised, but potentially underdiagnosed complication of traumatic brain injury (TBI). Post-traumatic hypopituitarism (PTHP) can have major consequences for patients physically, psychologically, emotionally and socially, leading to reduced quality of life, depression and poor rehabilitation outcome. However, studies on the incidence of PTHP have yielded highly variable findings. The risk factors and pathophysiology of this condition are also not yet fully understood. There is currently no national consensus for the screening and detection of PTHP in patients with TBI, with practice likely varying significantly between centres. In view of this, a guidance development group consisting of expert clinicians involved in the care of patients with TBI, including neurosurgeons, neurologists, neurointensivists and endocrinologists, was convened to formulate national guidance with the aim of facilitating consistency and uniformity in the care of patients with TBI, and ensuring timely detection or exclusion of PTHP where appropriate. This article summarises the current literature on PTHP, and sets out guidance for the screening and management of pituitary dysfunction in adult patients with TBI. It is hoped that future research will lead to more definitive recommendations in the form of guidelines.
DescriptorName: Neoplasm Staging. DescriptorName: PituitaryNeoplasms... AbstractText: Nonfunctioning pituitaryadenomas (NFPAs) are fairly common and require a multidisciplinary approach. Reliable markers of a clinically aggressive course are lacking. Medical treatment is not available, and transsphenoidal surgery is the preferred primary treatment AbstractText: We aimed to characterize the somatostatin, estrogen, and progesterone receptor distribution for NFPAs and compare it with factors ...
However, a small subset of pituitarytumours does not respond to standard medical treatment and presents with multiple local recurrences (aggressive pituitarytumours) and in rare occasion with metastases (pituitarycarcinoma ... iii) Temozolomide monotherapy is the first line chemotherapy for aggressive pituitarytumours and pituitarycarcinomas after failure of standard therapies; treatment evaluation after 3 cycles ...
Oncology (1) Carcinoma (5), Pituitary Carcinoma (2), more mentions
... adenomas (SGA) in a single institution cohort of surgically treated pituitaryadenomas AbstractText: Retrospective analysis of SGHA surgically resected over 10 years ... and SCA control groups in a cohort of surgically resected pituitaryadenomas... a complete hormonal staining panel be routinely performed for all pituitaryadenomas Keyword: Acromegaly... Keyword: Silent pituitaryadenomas.
Pituitary Adenoma (5), Acromegaly (3), Neoplasms (3), more mentions
... are at high risk for several types of cancer, but pituitarytumors have not previously been reported AbstractText: A 51-year-old ... carcinoma presented with severe Cushing disease and a locally aggressive pituitarytumor... representing all known cases in Sweden, another two clinically relevant pituitarytumors were found: an invasive nonsecreting macroadenoma and a microprolactinoma (i ...
... the goal of generate uniform criteria among centers dealing with pituitarytumors and to enhance patient care, the Pituitary Society decided to generate criteria for developing PituitaryTumors Centers of Excellence (PTCOE) AbstractText: To develop that task, a ... tool to guide improvements of care delivery to patients with pituitarydisorders.
The authors report a rare case of bilateral Tolosa-Hunt syndrome, which occurred in a 80-year-old female and remitted spontaneously. Inflammatory lesions were found not only in typical locations, i.e. superior orbital fissures and cavernous sinuses, but also in the pituitary; these imitated gland's macroadenoma in imaging studies.
Perioperative complications after transsphenoidal surgery for pituitaryadenomas have been well documented in the literature; however, some complications can occur in a ... incidence of some of these complications is low, providing preoperative counseling to patients with pituitarytumors regarding these delayed complications and proper postoperative follow-up planning is an important part ...
Pituitary Adenoma (2), Epistaxis (2), Hypopituitarism (2), more mentions
Here we review the technical aspects of our experience with the neuroendoscopic bilateral nostril (binostril) transsphenoidal approach for pituitaryadenomas... Among the key advantages of the neuroendoscopic binostril transsphenoidal approach for pituitaryadenoma resection are its minimally-invasive nature, clear exposure of the operative field, high full-excision rates, improved peri ...
Silent subtype III pituitaryadenomas (SS-3) are clinically nonfunctional adenomas that are more aggressive in terms of invasion and risk of recurrence than their conventional null cell counterparts. We previously showed that these tumors can be distinguished by immunohistochemistry based on the identification of a markedly enlarged and fragmented Golgi apparatus.
Secondly, we analyzed the usefulness of the ellipsoid method in pituitaryadenoma volume determination.Two-hundred ninety-four pituitaryadenomas, which were surgically treated in our department, were retrospectively analyzed ... method, and the volume measurement obtained with complex planimetry methods.Pituitaryadenoma volume and cavernous sinus invasion, graded with the Knosp scale, are two pituitarytumor features which, when used in combination, predict the complexity of ... surgery and the difficulty of achieving gross total resection in pituitaryadenoma surgery.
Pituitary Adenoma (8), Neoplasms (3), Pituitary Neoplasms (1), more mentions
Pituitaryadenomas are a group of tumors arising from the pituitary gland: they may be subdivided in ... and neurotrophic factors in the normal development of pituitary gland and in the progression of pituitaryadenomas... growth factors (FGFs) and epidermal growth factor (EGF) which influence the proliferation and growth of pituitaryadenomas.
AbstractText: Extension of a pituitaryadenoma to the oculomotor cistern harbors the risk of oculomotor nerve impairment and further extension ... demonstrated partial recovery in both cases during the 3-month follow-up AbstractText: The pituitaryadenoma extending to the oculomotor cistern can be removed under the endoscope... Keyword: pituitaryadenoma.
... postoperative pituitary hormone levels in patients undergoing surgical resection of pituitaryadenoma and to identify factors associated with preoperative hypopituitarism... from 81 patients with histologically confirmed functioning and non-functioning pituitaryadenomas (NFPA) who underwent transsphenoidal resection from January 2011 to December ... In patients with functioning pituitaryadenomas, GH and PRL levels declined after the operation; TSH, FSH ...
Pituitary Adenoma (7), Hypopituitarism (5), Prolactinoma (1), more mentions
AbstractText: The concomitant presence of pituitaryadenoma (PA) with Rathke's cleft cyst (RCC) is rare, and most of the literature published is ... Of the PA subtypes available, five patients had nonfunctional pituitaryadenomas, three had multiple-hormone secreting PAs, three had prolactin-producing adenomas, and one had a ... Keyword: pituitaryadenoma.
Abstract: Multiple pituitaryadenomas are rare. We present a quite unique case of double pituitaryadenomas associated with persistent trigeminal artery (PTA) treated by endoscopic surgery ... We observed an extremely rare case of double pituitaryadenomas associated with PTA... modern endoscopic surgery are valuable to confirm diagnosis of double pituitaryadenomas and identify anatomical localization of PTA Keyword: Coexistence case.
Pituitary Adenoma (6), Neoplasms (2), Acromegaly (1), more mentions