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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The presenting signs, symptoms, roentgenographic findings, endocrine evaluations, treatment, and results in 68 cases of presumed pituitary adenomas treated over an 18-year period are discussed. The most common symptoms were headache, acromegalic changes, visual symptoms, and amenorrhea. Most common physical findings were obesity, acromegaly, and visual field defects, usually bitemporal hemianopsia. Roentgenographic evidence of sellar erosion was almost universal but angiography and pneumoencephalography were required to evaluate suprasellar extension. Brain scan was not considered a particularly useful diagnostic tool. Endocrine status was best evaluated by a battery of tests including 17-OH, 17-KS, T3, T4, PBI, ACTH stimulation, and FSH and STH levels. (Prolactin levels are currently being obtained, also). Surgical specimens were obtained in 29 patients, with subsequent diagnoses of 22 chromophobe adenomas, five eosinophilie adenomas, one cystic adenoma, and one necrotic tumor. All five eosinophilic tumors came from acromegalic patients. Patients treated by operation alone or operation followed by radiotherapy generally had less "medical morbidity" than did patients who received radiotherapy alone.
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PMID:Review of 18 years' experience with pituitary tumors. 19 48

Headache and visual impairment resulting from downward migration of the optic system in an acromegalic patient, occurred after one year postoperatively. A 25-year-old woman with eosinophilic adenoma was operated on via transsphenoidal approach and irradiated (5,000 rads) following the operation. After the operation, bitemporal hemianopia was thoroughly improved and serum HGH level was also markedly decreased after radiation therapy. One year later, headache and visual impairment recurred. Pneumoencephalogram revealed that the infundibular and optic recessus of the third ventricle were elongated and descended into the sella turcica. The second operation was performed by subfrontal approach and the optic system was found to be migrated into the sella, which we assumed to be the cause for the recurrence of the headache and visual field defect. In order to prevent this type of complication, it would be recommended to fill up the dead space in the sella with bone or cartilage fragments in addition to muscle pieces, as was suggested by Guiot et al.
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PMID:[Downward migration of the optic system after transsphenoidal approach of a giant eosinophilic adenoma (author's transl)]. 22 33

Sixty of 146 patients with intracranial neoplasms or arterial aneurysms had roentgenographic abnormalities of the sella turcica. These abnormalities were most commonly due to chromophobe adenoma, craniopharygioma, and acromegaly, but ten of them were caused by lesions arising distant to the sella. There were also three cases of empty sella syndrome. Headache, visual disturbance, and sexual dysfunction were the most frequent presenting complaints, with visual field abnormality being most common. Pituitary dysfunction was manifested most frequently by alterations in growth hormone level and gonadotrophin secretion and less frequently by hypothyroidism and adrenocortical insufficiency. When the abnormal sella was associated with evidence of symptomatic intracranial disease, endocrine dysfunction, or visual field compromise as evidence of an anatomically aggressive intracranial neoplasm, specialized neuroroentgenographic localizing procedures were usually positive, and treatment for most of the causative lesions was highly effective.
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PMID:Abnormal sella turcica. A tumor board review of the clinical significance. 29 8

This report describes light and ultrastructural features of a functional parathyroid gland adenoma, principally composed of transitional oxyphil cells, in a 64-yr-old hypertensive black woman. She was hospitalized for repeated episodes of headaches, lethargy, and dizzy spells. Her serum calcium level was 2.92 mmol/l and immunoassay for parathormone was 390 pg/ml. On neck exploration, the left lower parathyroid gland was found enlarged and therefore removed in toto. The serum calcium and phosphate levels returned to normal following parathyroidectomy. Microscopically, the diagnosis of functional oxyphil adenoma was made. On ultrastructural examination, the tumour was composed principally of transitional cells, occasional typical, and degenerating oxyphil cells. The predominant transitional cells were rich in mitochondria and contained multiple active Golgi complexes, stacked profiles of rough endoplasmic reticulum, and a few secretory granules. On the other hand, typical oxyphil cells were tightly packed with mitochondria at the expense of other organelles. It appeared that neoplastic oxyphil cells were chief cells transformed in response to some unknown oncogenic stimulus.
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PMID:A functional parathyroid gland adenoma of transitional oxyphil cells. A light and ultrastructural study. 53 Jul 57

Pituitary apoplexy, characterized by sudden onset or acute progression of signs and symptoms of pituitary adenoma, is rare yet well-known. One such case is presented with clinical course, neuroradiological findings and autopsy. A 53-year-old female complained of sudden onset of severe headache, and rapidly deteriorated in the level of consciousness. Five days later, she became comatose and was admitted to National Sendai Hospital. Plain skull films and carotid angiograms revealed a remarkably large mass in the pituitary fossa. Death came ten hours after admission. Autopsy revealed a giant tumor (10 X 5 X 7.5 cm) destroying the sella turcica and protruding toward both the nasopharyngeal cavity and the hypothalamic region. Microscopically, diagnosis was made as chromophobe adenoma with fresh hemorrhage in the tumor.
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PMID:[Pituitary apoplexy of giant pituitary adenoma--case report (author's transl)]. 59 22

The case of a 14-year old girl presenting with headaches, severe progressive hypertension and high plasma renin levels, in whom a voluminous epithelial liver hamartoma or adenoma was discovered at surgery is documented. The morphological characteristics of the hamartomatous abnormality are described and evidences are put forward which would suggest that the liver lesion might have been the site of the abnormal renin production which was responsible for the systemic arterial hypertension.
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PMID:Epithelial liver hamartoma, systemic arterial hypertension and renin hypersecretion. 80 56

The familial occurrence of brain tumors are exceedingly rare except in cases with phacomatosis. We encountered pituitary adenomas in two sisters of a family, so far presenting no evidence of multiple endocrine adenomatosis (MEA). Case 1, K. O. a 26-year-old woman was admitted to our Hospital on September 10, 1970 with visual acuity and field disturbance, irregular menstruation and acromegaly. Neurological examination: Her visual acuity was Vd 0.6 and Vs 0.3, visual field was bitemporal hemianopsia, and ther was papilledema bilaterally. She had left exophthalmos and left abducens palsy. Roentgenogram of the skull, brain scanning, cerebral angiogram, pneumoencephalogram suggested the presence of a pituitary tumor. On Sep. 17, 1970, through a left frontotemporal craniotomy the tumor was removed subtotally. The pathological diagnosis was pituitary adenoma (chromophobe). Case 2, M. T. a 31-year-old woman, sister of case 1, was admitted to the Hospital on September 19, 1973, with mild headache, left visual field disturbance and amenorrhea. She had a child, and a past history of pulmonary tbc. Neurological examination: Her visual acuity was Vd 1.2 and Vs 0.03, and visual field of the right eye was temporal lower quandrant anopsia. There was optic nerve atrophy in the left eye. Plain X-ray craniogram, brain scanning, cerebral angiogram and pheumoencephalogram suggested the presence of a pituitary tumor. On Sep. 28, 1973, a right frontal craniotomy was performed. The tumor tissue with capsule was removed subtotally. The pathological diagnosis was pituitary adenoma (mixed type). In the literatures about familial brain tumors with histological diagnosis, glioma and glioblastoma are common, meningioma is relatively rare. Pituitary adenoma with no evidence of MEA is exceedingly rare. The two sisters presented in this paper, have no evidence of hyperparathyroidism, pancreas adenoma and peptic ulcer. So, we consider, at present, these cases should not be field in MEA.
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PMID:[Familial occurrence of pituitary adenoma (author's transl)]. 94 79

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

It is not common to have experienced the nasopharyngeal extension of pituitary adenomas. Recently we have experienced such a case. A man, aged 18, height 168 cm, weight 66 kg, who admitted to the hospital with the complaints of headache, left nasal obstruction, loss of visual acuity and defect of his temporal fields. On examination of both fundi there was primary optic atrophy. At this time large tumor could be seen in the nasopharyngeal cavity. Plain X-ray showed that the pituitary fossa was definitely enlarged and that there was considerable destruction of the sella and the clivus. Definite soft tissue mass could be visualised clearly by tomography. Via transoral and transsphenoidal approach, total removal of the nasopharyngeal tumor and intracapsulary subtotal resection of the tumor were performed. Microscopical examination established the diagnosis of chromophobe adenoma. On postoperative examination of hypothalamopituitary function he had no responces to insulin hypoglycemia and arginine infusion in growth hormone. 60Co irradiation, totally 6,000 rad, was given. Two years postoperatively he showed fairly good deal of improvement of his visual field defect. There was no serious complaints other than visual impairment on the left eye.
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PMID:[Nasopharyngeal extension of a large chromophobe adenoma of the pituitary (author's transl)]. 98 20

In addition to progressive endocrine dysfunction and progressive visual loss, pituitary neoplasms may annouce their presence by the more catastrophic alternative of spontaneous tumor infarction. In two patients reported, illness due to the spontaneous infraction of pituitary tumors was heralded by sudden onset of focal headache associated with diplopia. Stupor, confusion, and evidence of increased intracranial pressure occurred without subarachnoid hemorrhage or massive extrasellar extension of tumor. One patient developed inappropriate antidiuretic hormone secretion with spontaneous infarction in a large but clinically silent chromophobe adenoma. In both patients, skull x-rays suggested a long-standing intrasella mass. Both underwent prompt treatment with endocrinologic replacement therapy and subsequent successful transsphenoidal removal of voluminous, infarcted, pituitary masses.
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PMID:Spontaneous infarction in pituitary tumors: neurologic and therapeutic aspects. 116 78


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