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Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 21 year old male patient with hypoglycemia secondary to hyperinsulinism had no palpable adenoma at surgery, and failed to respond to a partial (75%) pancreatectomy. Subsequently, he was begun on oral Diazoxide. Soon after initiation of Diazoxide he developed a viral pneumonitis, and because of hyperglycemia, the Diazoxide was temporarily discontinued. He has been treated since June of 1975 with Diazoxide, 100 mg, three times daily. He is asymptomatic, completely rehabilitated, and physically active at work for 10 hours daily. Diazoxide therapy may be an option worth considering even in benign states of hyperinsulinism when surgery has failed to correct the process.
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PMID:Treatment of hyperinsulinism after partial pancreatectomy: medical or surgical? 28 80

A 21-year-old woman had sterility due to amenorrhoea-galactorrhoea with hyperprolactinaemia and hypoplastic ovaries. The sella turcica was asymmetrical but tomograms were suggestive of a congenital appearance. There was no suprasellar expansion. Treatment with bromocriptine and HMG resulted in pregnancy. Acute pituitary failure occurred at the 10th week, revealing an adenoma. The pregnancy proceeded to term after hypophysectomy. This complication, the first reported under the effects of bromocriptine, may serve as a reminder of the precautions to be taken during pregnancy in a hyperprolactinaemic woman.
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PMID:[Acute pituitary failure as the presentation of a prolactin cell adenoma during a pregnancy made possible by bromocriptine (author's transl)]. 60 Jul 24

Schwannoma or neurilemmoma and neurofibroma are two tumors of the peripheral nerves originating in the nerve sheaths. Schwannoma account for just over 1% of benign tumors reported in the oral cavity. The tongue is unanimously considered the most frequent site at this level; however, the tip is the least affected part of the organ. The case of schwannoma reported here is the third observed with a lingual localization in 18 years by the Division of Maxillo-Facial Surgery of The Odontostomatological Clinic of the University of Turin. The case is of interest due the rarity of this pathology and the presence of non-significant symptoms for a presumed initial diagnosis. CASE REPORT. A 21-year-old woman was referred to our attention following the appearance two years earlier of a slowly growing swelling on the tip of the tongue. The patient complained of the fastidious presence, disturbance to mastication and phonation and occasional paresthesia of the tip of the tongue. The small mass, which was clearly evident on examination, was covered with normal mucosa. On palpation it had a hard-elastic consistency; it was slightly painful, smooth and partial mobile on surrounding levels. The patient underwent the surgical removal of the neoplasia under anesthesia. The mass was well capsulated and a good cleavage plane was easily found. The neoformation was yellowy grey, oval bean-shaped, measuring 1.9 x 1.3 x 1.1 cm. The histological diagnosis, confirmed by immunohistochemical tests, was benign Antoni's, type A schwannoma. The postoperative period was good an there was no recidivation during the course of a one-year follow-up. DISCUSSION AND CONCLUSIONS. Benign schwannoma, which are relatively rare in the oral cavity, represent a pathology which are often not taken into account during clinical practice. Symptoms which take the form of slight hypoesthesia and vague paresthesia may lead to the suspected diagnosis of this type of neoplasia. The final diagnosis is always made after a definitive histological examination. Differential diagnosis must be made in relation to malignant tumors (on the basis of anamnestic data relating to the speed of growth and clinical appearance of the neoplasia) and, above all, in relation to numerous benign neoformations based on epithelial and connective tissues (lipoma, fibroma, leiomyoma and adenoma). Treatment is always surgical: in the case reported here, the exeresis of the lesion also allowed its histological characterization (excisional biopsy). Surgery was conservative and did not require local or locoregional prophylactic measures. After the final histological diagnosis of schwannoma, the patient underwent a thorough general objective examination to check the presence of other characteristic signs of Von Recklinghausen's syndrome, have a probability of malignant degeneration ranging between 5 and 16%. Isolated schwannoma hardly ever become malignant and in general, if exeresis is complete, no recidivation occurs after surgery.
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PMID:[Schwannoma located in the tongue. A clinical case report]. 130 93

A 21-year-old woman with Cushing's syndrome was found to have a marked diurnal variation in cortisol secretion. Serum cortisol concentrations and urinary excretion of 17-hydroxycorticosteroids were normal in the morning but clearly increased in the afternoon. The patient was cured by resection of an adrenocortical adenoma. ACTH and prostaglandin E1 stimulated cortisol release from incubated adenoma tissues in vitro. The cause of the abnormal diurnal rhythm of cortisol secretion is unknown.
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PMID:Phase-shifted diurnal rhythm of cortisol secretion in a patient with Cushing's syndrome due to adrenocortical adenoma. 320 5

A 21-year-old woman suffering from acromegaly was treated with transsphenoidal subtotal hypophysectomy (microscopy: acidophilic adenoma), followed by x-ray and bromocriptine therapy. Seven years later she was re-operated because of a partial bitemporal loss of vision, intracranial hypertension, and regrowth of the pituitary tumour seen on CT-scan. A large part of the invasive suprasellar tumour was then removed by transcranial approach. The neurosurgery was followed by cobalt radiotherapy and bromocriptine administration. Two years later, symptoms and signs of tumour growth reappeared. Administration of cytostatics, such as doxorubicin (Adriamycin) and lomustine (Belustine), resulted in distinct clinical improvement associated with a seven-fold decrease in the serum growth hormone concentration. The visual field became normal and the intracranial mass on a CT scan decreased markedly. As a result the patient was able to resume work.
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PMID:Cytostatics for acromegaly. Marked improvement in a patient with an invasive pituitary tumour. 368 20

We studied in vitro the presence of histamine and the effect of histamine and its antagonists on cAMP accumulation in parathyroid tissue (parathyroid adenoma or hyperplasia) from patients with primary hyperparathyroidism. Parathyroid adenomatous tissue contained 11.2 +/- 2.9 ng histamine/g wet weight (approximately 2 X 10(-5) M), as determined by a specific radioenzyme assay. Histamine caused a prominent increase in cAMP accumulation in parathyroid tissue slices in a dose-dependent manner, with half-maximal stimulation being achieved at 5 X 10(-6) M and maximal stimulation occurring at 10(-4) M histamine. The histamine H2 receptor antagonists, cimetidine and metiamide, caused profound inhibition of histamine-stimulated cAMP accumulation in the parathyroid tissue. Pyrilamine, an H1 antagonist, also inhibited histamine-stimulated cAMP accumulation. Isoproterenol, a beta-adrenergic agonist, elicited marked elevation of cAMP, and its stimulatory effect was blocked by propranolol, but the effects of histamine on cAMP levels in parathyroid tissue were not blocked by propranolol. Histamine significantly stimulated (an increase of 50%) the release of immunoreactive parathyroid hormone. The present observations demonstrate that parathyroid adenomatous tissue has a relatively high content of histamine, and the release of immunoreactive parathyroid hormone from this tissue. The effects of antagonists suggest that histamine stimulates cAMP accumulation in the parathyroid adenomatous tissue by an action on both H2 and H1 histamine receptors.
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PMID:Histamine and human parathyroid adenoma: effect on adenosine 3',5'-monophosphate accumulation in vitro. 626 86

A 21-yr-old woman with Turner's syndrome presented with signs and symptoms of acromegaly. The serum growth hormone (GH) (95+/-9.4 ng/ml; mean+/-SEM) and somatomedin C (11 U/ml) levels were elevated, and an increase in GH levels after glucose instead of normal suppression, increase after thyrotropin-releasing hormone (TRH) administration instead of no change, and decrease after dopamine administration instead of stimulation were observed. The pituitary fossa volume was greater than normal (1,440 mm(3)) and the presence of a pituitary tumor was assumed. After tissue removal at transsphenoidal surgery, histological study revealed somatotroph hyperplasia rather than a discrete adenoma. Postoperatively, she remained clinically acromegalic and continued to show increased GH and somatomedin levels. A search was made for ectopic source of a growth hormone-releasing factor (GRF). Computer tomographic scan revealed a 5-cm Diam tumor in the tail of the pancreas. Following removal of this tumor, serum GH fell from 70 to 3 ng/ml over 2 h, and remained low for the subsequent 5 mo. Serum somatomedin C levels fell from 7.2 to normal by 6 wk postoperatively. There were no longer paradoxical GH responses to glucose, TRH, and dopamine. Both the medium that held the tumor cells at surgery and extracts of the tumor contained a peptide with GRF activity. The GRF contained in the tumor extract coeluted on Sephadex G-50 chromatography with rat hypothalamic GH-releasing activity. Stimulation of GH from rat somatotrophs in vitro was achieved at the nanomolar range, using the tumor extract. The patient's course demonstrates the importance of careful interpretation of pituitary histology. Elevated serum GH and somatomedin C levels in a patient with an enlarged sella turcica and the characteristic responses seen in acromegaly to TRH, dopamine, and glucose do not occur exclusively in patients with discrete pituitary tumors and acromegaly. This condition can also occur with somatotroph hyperplasia and then revert to normal after removal of the GRF source. Thus, in patients with acromegaly a consideration of ectopic GRF secretion should be made, and therefore, careful pituitary histology is mandatory. Consideration for chest and abdominal computer tomographic scans before pituitary surgery, in spite of their low yield, may be justified.
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PMID:Somatotroph hyperplasia. Successful treatment of acromegaly by removal of a pancreatic islet tumor secreting a growth hormone-releasing factor. 629 May 40

A 21-year-old man with a history of recurrent urolithiasis was admitted. Hypercalcemia was found and a diagnosis of primary hyperparathyroidism was made. Neck exploration was performed without success. Localization studies were done. Repeated selective arteriography revealed a mediastinal parathyroid adenoma. CT scan as well showed the adenoma in the anterior mediastinum. Ultrasonotomography, 201Tl-chloride and 131I scintigraphy with subtraction image and two venous samplings were negative. Mediastinal exploration with partial sternotomy was performed and a parathyroid adenoma was subsequently removed. Serum calcium and phosphorous levels were normalized, several postoperative days.
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PMID:[A case of mediastinal parathyroid adenoma with primary hyperparathyroidism]. 673 Nov 97

The MtTW15 prolactin (PRL) secreting adenoma elevated serum PRL concentrations over controls within 5 weeks after tissue implantation. This treatment resulted in a significant reduction of peripheral beta-adrenergic responsiveness as assessed by three different parameters. Isoproterenol-induced thirst was significantly attenuated in the MtTW15 rats. The decrease in the thirst response was proportional to the increase in serum PRL. Unanesthetized heart rates of both groups were not significantly different before isoproterenol was administered. However, following administration of the beta-adrenergic agonist the heart rate response in rats with elevated PRL was significantly attenuated when compared to the controls. Elevation of serum PRL virtually abolished the elevation of tail skin temperature response associated with administration of isoproterenol. Collectively, these results suggest hyperprolactinemia reduces peripheral beta-adrenergic responsiveness; however the mechanism for this reduced response remains to be elucidated.
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PMID:Chronic hyperprolactinemia reduces peripheral beta-adrenergic responsiveness in male rats. 683 86

A 21-year-old woman with weight loss, palpitations and facial flush was found to have hypertension (up to 200/130 mm Hg) and mild hyperkalaemia (3.4 mmol/l). Extensive diagnostic tests revealed hyperaldosteronism with contrast storing in the right adrenal gland on scintigraphy after injection of dexamethasone (2 mg daily for one week). The hyperaldosteronism could not be suppressed by dexamethasone. Analysis of venous blood separately from each side pointed to aldosterone production in the right adrenal (right renal vein: 80 ng/dl, drainage area of the right adrenal vein: 114 ng/dl, left renal vein: too low to measure). The right adrenal gland was removed. No adenoma was found histologically. After the operation the aldosterone level was reduced and the blood pressure transiently fell. But both had risen again after 3 months. Renewed tests revealed dexamethasone-remediable hyperaldosteronism. On treatment with hydrocortisone (15-5-5 mg) and 50 mg metoprolol the patient became normotensive without any other medication.
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PMID:[Unilateral autonomous aldosterone production in hyperaldosteronism suppressible by dexamethasone]. 826 28


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