Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of purulent meningitis in subjects with misinterpreted chromophobe adenoma of the hypophysis are presented. Radiography in the acute stage revealed typical enlargement of the sella turcica and thus established the diagnosis, which was eventually confirmed histologically during surgery. The frequency with which this complication has occurred in a personal series is contrasted with its rarity in the literature, particularly neurosurgical works. It is felt, therefore, that the association of adenoma and meningitis is more common than is generally supposed. Routine cranial radiography is recommended in all cases of purulent meningitis, especially in young subjects and adults, from the outset. This will reveal hypophyseal involvement and enable replacement hormonal therapy with cortisone to be added to symptomatic and antibiotic management in cases of concomitant hypophyseal and adrenal insufficiency.
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PMID:[Clinical onset of meningitis in chromophobe adenoma of the pituitary: 2 cases]. 66 60

Thirteen patients aged 24 to 65 with Cushing's disease have been treated by transphenoidal hypophysectomy. There was one incident of meningitis and one late death from myocarditis. No radiotherapy was given. In 12 patients pituitary histology showed Crooke's changes and an adenoma was present in seven. On review of the 12 survivors two to 11 years later, 11 are in complete remission. One patient still showed some clinical features of Cushing's syndrome but steroid levels were normal. In five of the seven premenopausal women normal menstruation has returned and pregnancy has occurred in three. In four patients replacement hormone therapy is no longer required and a further four take only partial treatment. We conclude that transphenoidal hypophysectomy is an effective treatment for Cushing's disease.
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PMID:The treatment of Cushing's disease by trans-sphenoidal hypophysectomy. 86 66

The author has performed clinical and follow-up studies of 80 acromegalic patients treated by transanthro-sphenoidal removal of the pituitary adenoma. Heredity for acromegaly or gigantism was recorded in 3.8% of the patients and other hereditary factors in 13.8%. Head trauma, meningitis or encephalitis was recorded in the case histories in 18.8%. The predominant symptoms were sweating, paraesthesiae, headache and joint pain. Acromegaly was in 37.6% associated with goitre, parathyroid adenoma, gastric or duodenal ulcer, parotid tumours of submandibular swelling. The fecundity among the married patients was good, 34.4% having three or more children. Successful pregnancies occurred after the transanthro-sphenoidal removal of the adenoma.
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PMID:Heredity and symptoms in acromegaly. 98 80

Five cases of incidentally detected pituitary macroadenomas are described. All five had suprasellar extensions, but none had visual field defects as tested by computed perimetry. One patient had sellar changes seen on an X-ray film taken following a head injury, while the others were detected by computed tomography performed for seizures, stroke and meningitis. Four patients underwent trans-sphenoidal surgery for suprasellar extensions with or without hypopituitarism, while one was managed conservatively as he had normal visual fields and pituitary function and there was a spontaneous decrease in size of the adenoma. The management of such incidental pituitary macroadenomas is discussed.
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PMID:Incidental pituitary macroadenomas. 163 22

We studied for over 7 months the use of SMS 201-995, in 1 woman with pituitary adenoma. Eight years after surgical and irradiation therapy, adenoma relapsed with hyperthyroidism (T4 L = 71pmol/l, TSH = 5.3 mU/l, subunit: 309 micrograms/l) and was complicated by meningitis. It was invasive and removed only partly. SMS therapy, 100 micrograms SC q 8 h, allowed partial reduction of clinical hyperthyroidism and decreased TSH and alpha subunit of 47%. Increased dosage and changing route of administration did not increase efficacy. A modest decrease of adenoma was probably caused by several reasons. In summary in an adenoma unusual by the extremely high value of alpha subunit in contrast with modest value of TSH, SMS therapy allowed partial control only.
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PMID:[Pituitary adenoma treated with a somatostatin analog]. 281 65

An unusually therapy-resistant form of Nelson's syndrome developed in a 23-year-old woman two years after treatment of a pituitary-dependent Cushing's syndrome by bilateral adrenalectomy (1977). Removal of a corticotrophic adenoma by a first transsphenoidal pituitary operation (1979) brought only temporary relief. Two years later, regrowth and apoplexy of the pituitary adenoma led to oculomotor paralysis and had to be treated by a second transsphenoidal operation (1981). A second relapse became manifest two years later. Treatment with bromocriptine relieved the headaches but did not diminish the tumor size. A third pituitary operation (1984) became necessary when neurological signs revealed penetration of the cavernous sinus. The tumor was only partly removed by transsphenoidal surgery. Postoperative deterioration of the patient required emergency craniotomy to check a subarachnoidal hemorrhage and for removal of the remaining tumor. The patient died three days later of pneumococcal meningitis which had developed after the third pituitary operation.
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PMID:[A fatal course of Nelson syndrome]. 323 90

A 55-yr-old man presented with an atypical relapsing meningitis and was found to have intense unilateral adrenal uptake by 67Ga imaging. Computed tomography showed a 4-cm right adrenal mass which was hypointense on the T1-weighted images and mildly hyperintense on the T2-weighted images of a magnetic resonance (MR) scan. At surgery, a coincidental benign adrenocortical adenoma was found. Because 67Ga uptake is usually associated with inflammatory or malignant lesions and malignant adrenal lesions are hyperintense on T2-weighted MR images, these findings contributed to diagnostic uncertainty in this patient. Thus, a nonhyperfunctional adrenocortical adenoma may be associated with abnormal 67Ga uptake and atypical MR findings.
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PMID:Gallium-67 uptake by a benign adrenocortical adenoma. 326 35

In 255 patients with evidence of a pituitary tumor, 7 patients presented with typical symptoms of meningitis, which all proved to be sterile. In these patients a pituitary adenoma was surgically verified in 4. In one patient the presence of acromegaly indicated a pituitary adenoma. In 2 patients an enlarged, empty sella was found, taken to reflect spontaneous disappearance of an adenoma. It is thought that the cause of the sterile meningeal reaction in the 7 patients was a spontaneous necrosis of the adenoma with expulsion of necrotic material into the suprasellar subarachnoid space. Although this sequence has been described before it has been considered to occur very rarely. Pituitary apoplexy as the underlying cause of meningitis should be suspected in patients with evidence of pituitary endocrine disturbances or lesion of structures adjacent to the fossa. The diagnosis may be established by computer tomography. Therapeutically, it may be of importance that the nature of the meningeal reaction is promptly recognized. Swift neurosurgical decompression of the sella and adequate hormonal substitution therapy may be essential.
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PMID:Pituitary apoplexy with sterile meningitis. 381 36

A patient with meningitis and bacteremia due to Bacillus cereus is described. The patient had transsphenoidal hypophysectomy for chromophobe adenoma, complicated by rhinorrhea, which was corrected by subarachnoid drainage. Three weeks after removal of the drain, the patient presented with meningitis and died the following day. The causative organism was identified as B. cereus. The literature on Bacillus infections is reviewed with special attention to severe infections. A modified classification is proposed, dividing infections into superficial, closed-space and systemic ones. Sixty-one previously reported cases of systemic Bacillus infections are reviewed according to type of infection (endocarditis, meningitis or pulmonary infection), and the underlying conditions, ways of acquiring the infection, clinical picture and mortality are discussed.
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PMID:Meningitis and bacteremia due to Bacillus cereus. A case report and a review of Bacillus infections. 640 23

As an unusual complication of bromocriptine treatment for prolactinoma, CSF rhinorrhea has been reported in the relevant literature. The authors, on the contrary, experienced cessation of CSF rhinorrhea during bromocriptine treatment. A 37-year-old man with invasive prolactinoma underwent a frontal craniotomy for removal of pituitary adenoma on February 2, 1978. Postoperative CT showed residual adenoma within the sella and the sphenoid sinus. Postoperative irradiation was started on February 27 and given in a total dose of 5,000 rad. On March 30, 1979, the patient noticed clear fluid dropping out of his nostrils, the fluid contained glucose and CSF rhinorrhea was suspected. The CSF rhinorrhea was considered due to the regrowth of adenoma in the paranasal sinuses. On June 27, 1979, the patient developed headache together with fever and CSF rhinorrhea. On examination, the patient was drowsy and showed marked nucheal rigidity. Under the diagnosis of meningitis caused by CSF rhinorrhea antiseptic chemotherapy was started. Hypocycloidal tomogram showed extensive destruction of the sella and a soft density mass in the sphenoid and the ethmoid sinuses. CT also showed intrasphenoidal and lateral extension of the adenoma. To repair of the CSF leak, transsphenoidal surgery was performed on August 2, 1979 when the patient was in favorable condition. The sphenoid sinus was full of adenoma and it was removed, however, the exact location of the CSF leak could not be identified. The sphenoid sinus was packed with muscle tissue. Bromocriptine treatment was postoperatively started with 5 mg per day on August 25, 1979. The patient sustained CSF rhinorrhea which was decreased by lumbar drainage.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cessation of cerebrospinal fluid rhinorrhea by bromocriptine treatment of a patient with invasive prolactinoma]. 646 39


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