Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three years after radiation therapy for an intrasellar tumor, a 42-year-old housewife presented with headache, lethargy, and remarkable plain skull roentgenograms, in which dilated lateral and third ventricles were filled with air. Air apparently had entered the cranium through the sphenoid sinus and eroded sellar floor, extending directly through intrasellar remnants of the chromophobe adenoma and into the floor of the third ventricle. Frontal exploration showed an empty sella turcica and no residual tumor. She made an excellent recovery and has done well for 5 years after operative closure of the defect.
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PMID:Spontaneous pneumoventriculogram following radiation of a pituitary adenoma. 117 14

A 25 year old woman had galactorrhea and secondary amenorrhea since her first pregnancy at 20 years. After several treatments with Clomiphene, menses reappeared for 2 months and she became pregnant. At admission, she was in her 4th pregnancy month and had headaches and bitemporal hemianopsia. Hypophysectomy was performed during 5th pregnancy month. Prolactin adenoma with hemorragic lesions was found. Parturition of normal twins occurred 8th month. Partial hypophyseal recovery took place for the following 2 years, but hyperprolactinemia reappeared too.
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PMID:[Proceedings: Prolactin adenoma revealed by gemellary? pregnancy after clomiphen therapy. Hypophysectomy during 5 th month of pregnancy (author's transl)]. 119 Jul 20

The case is described of a 23-year-old female patient presenting with unilateral proptosis, headaches, and transient epiphora. Surgery revealed an encapsulated tumour composed exclusively of spindle-shaped cells within a richly vascularised myxoid stroma. Immunohistochemical staining showed focal positivity for smooth muscle actin, vimentin, and glial fibrillary acidic protein. These combined findings are interpreted as providing evidence of a myoepithelioma, which may be regarded as a monomorphic adenoma consisting solely of myoepithelial cells. To our knowledge this is only the second report of such a tumour in the lacrimal gland.
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PMID:Myoepithelioma of the lacrimal gland: report of a case with spindle cell morphology. 132 39

From 1975 to 1989, 52 patients with primary aldosteronism underwent adrenalectomy. There were 16 men and 36 women. The average age was 42.5 years, ranging from 28 years to 70 years. They were all hypertensive, with average pre-operative diastolic pressures varying from 105 to 140 mm Hg (median 117 mm Hg). The subjective symptoms most frequently reported were headache (71%) and asthenia (53%). In all patients except two, serum potassium concentration was 3.3 mEq/L (median 2.7 mEq/L) at the time of diagnosis. Plasma aldosterone concentration was elevated in all patients, 48 +/- 5.3 ng/mL in the recumbent position and 52.6 +/- 6.0 ng/mL in the upright position. The operations carried out were 50 unilateral and 2 bilateral adrenalectomies. In 4 patients a transperitoneal approach was employed and in the remaining 48 patients an extraperitoneal flank incision was used. The histological findings were 47 adenomas (with dimension ranging from 1 to 4.5 cm), unilateral macronodular hyperplasia in 2 patients, an adenoma plus controlateral hyperplasia in 1 patient, bilateral hyperplasia in 1 patient, and unilateral hyperplasia in 1 patient. After long-term follow-up (median 77 months, range 13 to 189 months), 15 patients remained hypertensive (diastolic blood pressure up to 100 mm Hg). In 9 of these patients the hypertensive illness had been present for more than 5 years prior to operation. In the remaining 37 (71%) patients, the arterial pressure returned to normal and in almost half of the patients this result was evident one or two days after operation.
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PMID:Adrenalectomy in primary aldosteronism: a long-term follow-up study in 52 patients. 141 36

In 12 cases of pituitary apoplexy, a preexisting unsuspected adenoma was found. The initial manifestations were sudden onset of headache (12 patients), signs of meningeal irritation (10) with fever (four), altered consciousness (12), and ophthalmologic disturbances (eight). The diagnosis was retrospective in three cases. Radiologic investigations were always suggestive if carefully considered. The plain skull roentgenograms, in particular, showed an enlarged sella turcica in 11 cases. Three patients had prolactin adenomas, and nine had nonfunctional adenomas. Medical treatment was successful in only three patients; surgery was performed in 10 cases by means of a sublabial transseptal microsurgical approach. Postoperative neurologic complications were serious in two cases. Endocrine insufficiencies were common: eight cases of permanent panhypopituitarism, two cases of pluritropic anterior pituitary dysfunction, and three cases of persistent hyperprolactinemia.
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PMID:Twelve cases of pituitary apoplexy. 837 8

A 19-year-old man with blurred vision, headache, and no signs or symptoms of hormone excess was found to have a pituitary adenoma. The tumor was removed by a transfrontal approach. He had postoperative radiation therapy, but subsequently had three recurrences, all removed surgically. By histology, the tumor was a chromophobic, slightly acidophilic pituitary adenoma. Immunohistochemistry revealed the presence of adrenocorticotropin (ACTH) in all four biopsies, alpha-subunit of glycoprotein hormones, and, to a lesser extent, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in the third and fourth tumor resection specimens. Ultrastructurally, the tumor had typical features of a silent corticotroph adenoma subtype 2. In tissue culture, the second, third, and fourth specimens released ACTH, alpha-subunit, FSH, and LH and responded to corticotropin-releasing hormone with increased release of ACTH, alpha-subunit, FSH, and LH. To our knowledge only one silent corticotroph adenoma has been reported previously which expressed plurihormonality. Change in immunohistochemical profile in malignant tumors is a well-known phenomenon; however, it was not reported previously in benign pituitary adenomas. The factors accounting for changing tumor phenotype are unknown.
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PMID:Changes in hormone production of a recurrent silent corticotroph adenoma of the pituitary: a histologic, immunohistochemical, ultrastructural, and tissue culture study. 164 19

The rationale for using alpha blockade to treat benign prostatic hyperplasia (BPH) is based on the physiology and pharmacology of prostate smooth muscle. Approximately 20% of the area density of the prostate adenoma is smooth muscle. In vitro isometric tension studies have demonstrated that the contractile properties of the human prostate adenoma are mediated primarily by alpha 1 adrenoceptors. Alpha blockers presumably decrease the resistance along the prostatic urethra by relaxing the smooth muscle component of the prostate. Over the past 14 years, at least 16 clinical trials have confirmed the efficacy of alpha blockade in the treatment of BPH. The primary advantage of terazosin over all other commercially available alpha blockers is that its longer half-life allows for a once-daily dosage regimen. Two Phase II studies conducted in the United States, a multicenter dose titration randomized withdrawal study and the author's personal experience with terazosin, are summarized in this report. Overall, the peak urinary flow rate increased 50% and the mean urinary flow rate increased 46% following terazosin therapy. The mean obstructive and irritative scores improved 67% and 35%, respectively. The adverse reactions occurring with an incidence greater than 5% included headache (10%), asthenia (7%), and dizziness (14%). All adverse events were reversible on termination of therapy. The preliminary experiences with alpha blockers for the treatment of BPH has been very encouraging. Yet, the definitive role of alpha blockade in BPH awaits the reporting of multicenter, randomized placebo-controlled studies.
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PMID:The emerging role of alpha antagonists in the therapy of benign prostatic hyperplasia. 172 95

We report an extremely unusual case of prolactinoma which emerged at recurrence as a null cell adenoma. A 53-year-old woman sought medical attention for progressive visual loss and headache. A pituitary tumour was detected by a computed tomographic scan, and hyperprolactinemia was noted. The tumour, removed by a transfrontal surgery, was a chromophobe adenoma, and immunohistochemically the adenoma cells were selectively positive for PRL, which indicated a prolactinoma. Postoperatively, her plasma PRL level was normalized. Seven years later, she noted blurred vision and again sought medical attention. A CT scan demonstrated recurrence of a pituitary tumour. On this occasion, however, she was not hyperprolactinemic. She underwent again a transfrontal resection of the pituitary tumour. Its histology was again a chromophobe adenoma, but the adenoma cells showed no positive immunostaining for any anterior pituitary hormone including PRL, which indicated a null cell adenoma. We have no clear explanation of the pathogenesis underlying her very unusual course. However, null cells (assuming that the original tumour was a mixed adenoma) left behind at the first surgery, or unidentified hypothalamic and/or pituitary derangements might possibly have been responsible for the recurrence. We learned from this patient that recurrent pituitary adenomas may not necessarily have the same endocrine features as did the original tumours. This information appears to make a valid clinical point, because if hormone levels alone are followed after pituitary surgery, recurrent pituitary tumours may be overlooked.
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PMID:A null cell adenoma of the pituitary detected seven years after removal of a prolactinoma. Recurrence or de novo tumourigenesis? 178 66

A case of sphenoid ridge meningioma and pituitary adenoma adjacent in the brain is reported. A 70-year-old female was admitted to our hospital with headache. She had no neurological deficit but did have acromegalic change. Hormonal examination showed elevation of plasma levels of HGH (19.0 ng/ml), with normal levels of the other hormones. CT examination revealed a tumor with calcification in the inner third of the sphenoid ridge and another in the pituitary fossa with suprasellar expansion. MRI showed flow void of ICA between these tumors. Intensity of the T1-weighted image of the tumor in the sphenoid ridge was homogeneously iso intensity, and low intensity in the pituitary fossa. The diagnosis of adjacent tumors in the sphenoid ridge meningioma and pituitary adenoma had been made preoperatively. Left front-temporal craniotomy and removal of these tumors were performed. These tumors were close to each other, but were separated by the internal carotid artery and anterior cerebral artery. Pathological examination demonstrated meningotheliomatous meningioma in the sphenoid ridge and sparsely granulated somatotroph adenoma in the pituitary fossa. Fourteen cases showing association of meningioma and pituitary adenoma, which had no history of radiation and trauma, have been reported previously. Although GH producing pituitary adenoma may stimulate adjacent dura and arachnoid cells resulting in the formation of meningioma, the possibility of coincidental occurrence of the two tumors cannot be ignored.
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PMID:[A case report of adjacent tumor of sphenoid ridge meningioma and GH producing pituitary adenoma]. 188 28

A 29-year old female, in her second pregnancy, complained of headache, nausea, vomiting and left blurred vision. In spite of improvement of these symptoms in the second postpartum, she complained of recurrent symptoms in her third pregnancy. CT and MRI showed a pituitary adenoma with hematoma. It was totally removed using the transsphenoidal approach during pregnancy at 8 months. The histological examination revealed that the tumor was an acidophilic adenoma with a hemorrhagic change. A healthy baby was born at the full term after the operation. Our transsphenoidal operation during pregnancy was only the second such attempt reported in our collected literature. The management of the pituitary tumor during pregnancy is discussed.
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PMID:[A report of a transsphenoidal operation during pregnancy for a pituitary adenoma]. 194 97


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