MyMedR

Fulltext Infrasellar craniopharyngioma of the posterior nasal septum: a rare entity

Chiun KC, Tang IP, Tharumalingam V, Nurshaline Pauline HK

Med J Malaysia, 2012 Feb;67(1):131-2.

PMID: 22582569 MyJurnal

To report an unusual location of infrasellar craniopharyngioma in a peadiatric patient.

Matched MeSH terms: Pituitary Neoplasms/diagnosis*; Pituitary Neoplasms/surgery

Fulltext Systemic lupus erythematosus with a non functioning pituitary macroadenoma

Nadira U, Cader RA, Kong NC, Mohd R, Gafor HA

Am J Case Rep, 2012;13:160-2.

PMID: 23569517 DOI: 10.12659/AJCR.883248

BACKGROUND: Malignancies are more common in patients with systemic lupus erythematosus (SLE) than the general population. SLE patients are recognized to have higher prolactin levels. However, there are very few reported cases of SLE with pituitary adenomas.
CASE REPORT: We report the second case of a pituitary adenoma in a patient with underlying SLE. A 51 year old lady presented with blurred vision and magnetic resonance imaging of the brain demonstrated a pituitary macroadenoma with mildly elevated serum prolactin levels. The diagnosis of a non functioning pituitary macroadenoma was confirmed histologically. The diagnosis of SLE was made on the basis of thrombocytopenia, antinuclear antibodies, anti double stranded DNA antibodies and lupus nephritis (confirmed on renal biopsy). The patient initially received medical therapy with carbegoline, followed by transsphenoidal neurosurgery for the pituitary macroadenoma. SLE with lupus nephritis was treated with steroids and low dose intravenous cyclophosphamide.
CONCLUSIONS: Hyperprolactinaemia is prevalent in twenty to thirty percent of SLE patients but it is rarely due to a prolactinoma. The source of excessive circulating prolactin in SLE patients has not been fully determined.
KEYWORDS: pituitary macroadenoma; prolactin; systemic lupus erythematosus

Matched MeSH terms: Pituitary Neoplasms*

Treatment of pituitary adenomas: a study of 66 cases

Arumugasamy N, Lestina FA, Bucy PC

Med J Malaya, 1971 Sep;26(1):3-14.

PMID: 4258574

Matched MeSH terms: Pituitary Neoplasms/therapy*

Fulltext Factors Influencing Disconnection Hyperprolactinemia and Reversal of Serum Prolactin after Pituitary Surgery in a Non-Functioning Pituitary Macroadenoma

Kumran T, Haspani S, Malin Abdullah J, Alias A, Ven FR

Malays J Med Sci, 2016 Jan;23(1):72-6.

PMID: 27540328 MyJurnal

To investigate factors influencing disconnection hyperprolactinemia, including tumour volume, degree of pituitary stalk displacement and extent of tumour growth based on a modified Wilson-Hardy classification in a non-functioning pituitary macroadenoma and to confirm reductions in serum prolactin levels after endoscopic transphenoidal surgery.

Matched MeSH terms: Pituitary Neoplasms

Fulltext Endoscopic assisted transseptal transphenoidal hypophysectomy

Mallina S, Harvinder S, Rosalind S, Philip R, Gurdeep S, Anil S

Med J Malaysia, 2006 Aug;61(3):320-2.

PMID: 17240583 MyJurnal

Eight patients with pituitary tumors were operated via the transseptal transsphenoidal approach from April to November 2004 at Hospital Ipoh. Seven patients presented with visual disturbances while three also had endocrine abnormalities. The post-operative follow-up period was between six months to a year. There was no mortality in this series. There were no complications related to the approach i.e. nasal or septal related. All patients with visual impairment showed improvement. Only one patient had hormonal irregularities. The endoscopic assisted transseptal approach to the sphenoid sinus for pituitary surgery was found to be easy and without sinonasal or labial complications often found with the sublabial approach.

Matched MeSH terms: Pituitary Neoplasms/surgery

Diabetes insipidus and syndrome of inappropriate antidiuretic hormone complicating pituitary surgery

Aboud SK, Yunus MR, Gendeh BS

Otolaryngol Head Neck Surg, 2011 Jun;144(6):1005-6.

PMID: 21493376 DOI: 10.1177/0194599810390899

Matched MeSH terms: Pituitary Neoplasms/diagnosis; Pituitary Neoplasms/surgery*

Fulltext ACTH producing pulmonary carcinoid and pituitary macroadenoma: a fortuitous association?

Wong M, Isa SH, Kamaruddin NA, Khalid BA

Med J Malaysia, 2007 Jun;62(2):168-70.

PMID: 18705457

We report a case of a 45 year-old man who presented initially with a non-functioning pituitary macroadenoma. A routine chest radiography done preoperatively revealed a right lung nodule which was confirmed by computed tomography (CT) of the thorax. Transfrontal hypophysectomy was performed while a conservative approach was taken for the lung nodule. Four years later, he presented acutely with adrenocorticotrophic hormone (ACTH) dependent Cushing's syndrome which resolved following a right lobectomy. Histological examination revealed an atypical carcinoid. To our knowledge, this is the first reported case of an ectopic ACTH secreting pulmonary carcinoid found in association with a non-functioning pituitary macroadenoma.

Matched MeSH terms: Pituitary Neoplasms/complications*; Pituitary Neoplasms/pathology

Intraventricular squamous papillary craniopharyngioma: report of a case with intraoperative imprint cytology

Madhavan M, P JG, Abdullah Jafri J, Idris Z

Acta Cytol., 2005 Jul-Aug;49(4):431-4.

PMID: 16124175

BACKGROUND: Squamous papillary craniopharyngioma is a distinct entity, and its cytologic features may be misleading. Because of the rarity of this tumor, this case is being reported with a note on the cytologic features.

CASE: A 56-year-old Malay man who had 1-month history of generalized lethargy was admitted for altered sensorium. On examination, he was found to have neck stiffness, bilateral papilledema and generalized atrophy of muscles, with reduced power in all limbs. Magnetic resonance imaging of the brain showed a solid mass in the third ventricle causing obstructive hydrocephalus. Intraoperative cytology of the mass diagnosed intraventricular meningioma. However, the final histopathologic examination revealed squamous papillary craniopharyngioma.

CONCLUSION: Craniopharyngioma, squamous papillary type, is a rare entity and usually occurs in adults as an intraventricular solid tumor. Awareness of this entity will aid in arriving at the correct cytologic diagnosis.

Matched MeSH terms: Pituitary Neoplasms/diagnosis*; Pituitary Neoplasms/pathology

Fulltext Bromocriptine for visual field defects in prolactinomas

Embong M, Satgunasingam N, Rejab SM, Singh H

Med J Malaysia, 1981 Mar;36(1):29-36.

PMID: 7321934

Matched MeSH terms: Pituitary Neoplasms/drug therapy*; Pituitary Neoplasms/secretion

Fulltext Granulomatous hypophysitis: a case of severe headache

Wan Muhamad Hatta SF, Hamdan MF, Md Ali SA, Abdul Ghani R

BMJ Case Rep, 2016 Sep 09;2016.

PMID: 27613264 DOI: 10.1136/bcr-2016-216395

Idiopathic granulomatous hypophysitis (GH) is an uncommon inflammatory disease of the pituitary with impairment of pituitary gland function due to infiltration by lymphocytes, plasma cells and macrophages. We report the case of a 39-year-old woman who presented with worsening of headaches for 1 month and blurring of vision over 5 days. An MRI revealed a homogeneous supra-sellar mass evoking a pituitary tumour with bulky pituitary stalk extending into the left and right cavernous sinuses. Hormonal investigations showed anterior pituitary hormone deficiencies; meanwhile histopathological examination revealed an aspect of hypophysitis. Clinical and radiological remission occurred immediately postglucocorticoid therapy with the addition of a steroid-sparing agent later in view of recurrence of symptoms on glucocorticoid dose reduction. GH has important diagnostic and therapeutic implications, as clinical and radiological features ameliorate via medical treatment. With further understanding and recognition of the disease, we hope to highlight a case of GH, in which signs and symptoms improved after initiation of corticosteroids.

Matched MeSH terms: Pituitary Neoplasms/diagnosis; Pituitary Neoplasms/etiology

Fulltext Pituitary apoplexy: a rare cause of middle cerebral artery infarction

Hassan R, Sharis Othman S, Ahmad Mukari SA, Abu Bakar A

Med J Malaysia, 2013 Jun;68(3):264-6.

PMID: 23749020 MyJurnal

Pituitary apoplexy is a well-known complication of a pituitary adenoma. However, an ischaemic event caused by pituitary apoplexy is rare. We reported a case of pituitary apoplexy with middle cerebral artery infarction in a 44-year old man who presented with a sudden onset of altered sensorium. Vasospasm is the most likely underlying cause of the infarction in this case secondary to transdiaphragmatic rupture of the sella tumour into the subarachnoid space.

Matched MeSH terms: Pituitary Neoplasms

Fulltext A combined case of macroprolactinoma, growth hormone excess and Graves' disease

Hussein Z, Tress B, Colman PG

Med J Malaysia, 2005 Jun;60(2):232-6.

PMID: 16114168

Thyrotoxicosis due to Graves disease is a relatively common endocrine disorder. The occurrence of a prolactinoma with co-secretion of growth hormone (GH) is on the other hand, rare. We report the rare co-existence of Graves' disease in a patient with macroprolactinoma and GH hypersecretion and describe the successful response to medical therapy with dopamine agonist and antithyroid therapy. We hypothesize that hyperprolactinaemia played a role in promoting autoimmune thyroid disease in our patient and that treatment of hyperprolactinaemia may have been important in suppressing autoimmune disease activity in Graves' disease. This case also reflects on the close and complex interactions between thyroid hormones, prolactin (PRL), GH and testosterone (T).

Matched MeSH terms: Pituitary Neoplasms/blood; Pituitary Neoplasms/complications*; Pituitary Neoplasms/drug therapy

Now You See, Now You Don't: A Case Of Spontaneous Regression of Pituitary Tumour

Jaafar AS, Mohd Shokri SS, Paramasvaran S, Palaniandy K, Fadzil F

Cureus, 2020 Jul 14;12(7):e9174.

PMID: 32802610 DOI: 10.7759/cureus.9174

Spontaneous regression of pituitary tumours are rare and can be due to tumour ischaemia, pituitary apoplexy, or lymphocytic hypophysitis. We report a case of a 32-year-old female, who presented with symptoms and signs of extrasellar pituitary enlargement and hypothyroidism. MRI revealed a pituitary mass that spontaneously regressed after a month, with complete resolution of symptoms. Not all pituitary tumours require surgical intervention especially in the case of autoimmune lymphocytic hypophysitis.

Matched MeSH terms: Pituitary Neoplasms

Fulltext Intracranial germinoma – a case report

Subha, S.T., Puaviappan, P., Ramesh, N., Dass, Dipak B

Malaysian Journal of Medicine and Health Sciences, 2013;9(1):81-82.

MyJurnal

Intracranial germinomas belong to the class of germ cell tumors which are relatively rare intracranial tumors. Early recognition of this neoplasm is vital as germinomas are highly radiosensitive and effective/ early radiation therapy can result in relatively favourable overall prognosis. In this article we describe a 19 years old man who presented with pituitary tumor in the suprasellar region for which transsphenoidal decompression and biopsy was done. The histopathological examination confirmed it to be germinoma and he underwent craniospinal radiotherapy.

Matched MeSH terms: Pituitary Neoplasms

Fulltext Radiation-induced meningioma following radiotherapy for pituitary adenonoma: a case report

Ellyda, M.N., Win Mar@Salmah, J.

International Medical Journal Malaysia, 2013;12(1):63-66.

MyJurnal

It is well known that ionizing radiation has an onco-genetic activity and has been implicated in the causation of brain tumors. However, when a new growth appears adjacent to the site of previous tumor, the diagnosis is more toward recurrence. In addition to that, the possible cause might be overlooked, when it occurs many years after radiation treatment. We report a case of radiation-induced meningioma developed 20 years after the patient received radiotherapy for pituitary adenoma.

Matched MeSH terms: Pituitary Neoplasms

Fulltext Psychosis post craniotomy for craniopharyngioma

Siti Rohana Abdul Hadi, Saminah Md Kassim, Suriati Mohamed Saini

ASEAN Journal of Psychiatry, 2013;14(2):183-186.

MyJurnal

Objective: This case report highlights psychosis post craniopharyngioma surgery.

Methods: We report a case of a young Malay lady who presented with psychotic symptoms after she underwent craniotomy for craniopharyngioma.

Results: Presence of prominent hallucinations and delusions after removal of the tumour and the symptoms lasted more than a month. The psychosis subsided with antipsychotic.

Conclusion: Psychosis post craniopharyngioma surgery is still possible whether possibly due to the residual tumour or as a result of treatment sequealae.

Matched MeSH terms: Pituitary Neoplasms

Fulltext Endocrinological Outcome of Endoscopic Transsphenoidal Surgery for Functioning and Non-Functioning Pituitary Adenoma

Yi LS, Alias A, Ghani ARI, Bidin MBL

Malays J Med Sci, 2019 May;26(3):64-71.

PMID: 31303851 MyJurnal DOI: 10.21315/mjms2019.26.3.5

Introduction: The present study analysed the (i) remission and preservation of hormones, (ii) endocrinological and anatomical complications and (iii) visual improvement after endoscopic transsphenoidal surgery (ETS).

Methods: The retrospective observational study of all consecutive cases of pituitary adenoma treated with ETS in Hospital Kuala Lumpur (HKL) between 2006 and 2015. Age, sex, pre- and post-operative hormone level, tumour size, and complications were noted.

Results: A total of 67 patients were diagnosed with non-functioning pituitary adenoma throughout this period. Of these, 11 patients had both visual and hormonal improvement post-operation. Of the 27 patients with tumour invaded into the cavernous sinus, 13 showed an improved vision. In the adenoma patients who had impaired hormonal function before the surgery, the hormone level normalised post-surgery in 42 patients. Moreover, 39 patients were diagnosed with functioning pituitary adenoma. Ten patients recovered from acromegaly and four patients recovered from Cushing disease within seven days post-operative. Also, five patients with functioning adenoma suffered complications.

Conclusion: Outcome for the preservation and hormone recovery in non-functioning pituitary adenoma group was satisfactory, with only one patient's hormonal level worsening. No visual deterioration and mortality were detected throughout this study. A dedicated team specialised in endoscopic transsphenoidal pituitary surgery further improved the outcome of this surgical method.

Matched MeSH terms: Pituitary Neoplasms

Fulltext Case Report of a Pituitary Metastasis from Lung Adenocarcinoma Masquerading as Pituitary Adenoma

Rajakumar R, Rahmatullah IH, Rahim AA

J ASEAN Fed Endocr Soc, 2020;35(1):133-136.

PMID: 33442183 DOI: 10.15605/jafes.035.01.24

Metastasis to the pituitary gland is an unusual situation in clinical practice and is typically observed in those with underlying malignancy with breast and lung being the commonest primary site. However, we report a case of an apparently well 49-year-old female with metastatic lung adenocarcinoma who presented with visual disturbance and diabetes insipidus related to pituitary metastasis as an initial presentation.

Matched MeSH terms: Pituitary Neoplasms

Intrasellar pituitary mucocele: diagnostic dilemma

Tang IP, Chai CK, Kumar G, Prepageran N, Waran V

Br J Neurosurg, 2014 Jun;28(3):390-2.

PMID: 23875880 DOI: 10.3109/02688697.2013.817535

Isolated intrasellar pituitary mucocele following transsphenoidal sinus surgery is extremely rare. The clinical features resemble a pituitary tumor, therefore careful radiological interpretation is crucial to reach the correct diagnosis. We report a case of intrasellar mucocele who had transsphenoidal sinus surgery performed 15 years prior.

Matched MeSH terms: Pituitary Neoplasms/surgery

Fulltext Endonasal endoscopic transsphenoidal pituitary surgery for pituitary adenoma: a retrospective analysis of surgical outcome

Sand MS, Gendeh BS, Husain S

Med J Malaysia, 2011 Dec;66(5):443-6.

PMID: 22390098 MyJurnal

The purpose of this retrospective joint rhino-neurosurgical study from January 1998 until September 2009 is to document the demographic data, clinical presentations, radiological findings, approaches and incidence of residual tumour. Forty-seven patients with pituitary adenoma underwent trans-sphenoidal hypophysectomy of which 25 patients with complete medical and radiological data were included in the study. The medical and radiological data were analyzed. There were 12 males and 13 females with age ranging from 17 to 76 years old (mean 49.2). Fourteen of the patients were Chinese, eight Malays and three Indians. Twelve of the patients had functioning tumour of which five each presented with acromegaly and Cushing disease respectively and two with amenorrhoea. The rest of 13 patients had non functioning tumour presenting with visual disturbances. Sixteen of the patients had pituitary macroadenomas and the rest 9 microadenomas. Eighteen patients had undergone transcollumellar trans-sphenoidal hypophysectomy and the rest 7 patients had undergone transnasal transsphenoidal hypophysectomy. About 68.8% of pituitary macroadenomas had residual tumour, compared to only 22.2% of patient with pituitary microadenomas. Radiologically, about 45.5% of residual macroadenoma had suprasellar extension and the majority had spread to suprasellar cistern and carvenous sinus (54.5%). About 16.6% of patients had undergone post operative radiotherapy. In conclusion, this study showed that patient with pituitary macroadenomas had higher incidence of residual tumour compared to pituitary microadenomas.

Matched MeSH terms: Pituitary Neoplasms/surgery*

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