Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Successful pregnancy and delivery is dependent upon normal function of the pituitary gland. Benign tumors of the pituitary are relatively common and may interfere with normal pregnancy in a variety of ways. Symptoms related to pituitary tumors can include headache, fatigue, and visual loss. Some may present dramatically with pituitary tumor apoplexy, mimicking subarachnoid hemorrhage, meningitis, or myocardial infarction. In this article, the types of tumors likely to become symptomatic during pregnancy are reviewed. The various options of management are determined by the stage of pregnancy and whether there is visual loss or other signs of mass effect. Management options include close observation, medical therapy, or surgical removal of the tumor. Decision making for symptomatic adenomas during pregnancy is illustrated by two representative case reports.
 ...
PMID:Management of pituitary tumors in pregnancy. 2211 15

We report here a rare case of a young male patient presenting with a Multiple Endocrine Neoplasia Type 1 - prolactin-secreting pituitary carcinoma, controlled long-term after temozolomide withdrawal. Initial presentation was pituitary apoplexy leading to surgery. Dopamine agonists and radiotherapy allowed control of prolactin secretion and pituitary remnant. Metastasis appeared 10 years after initial presentation, leading to the diagnosis of pituitary carcinoma. At that time, dopamine agonists were no more effective; temozolomide, an oral alkylating agent, was administered for 24 cycles, and allowed decrease of the volume of the pituitary lesion and metastases. The patient is still currently followed in our department, 3 years after temozolomide withdrawal: prolactin level and pituitary tumor volume remain controlled without any chemotherapy. To our knowledge, this is the first case of MEN1 prolactin secreting pituitary carcinoma controlled long-term after temozolomide discontinuation.
 ...
PMID:Long-term control of a MEN1 prolactin secreting pituitary carcinoma after temozolomide treatment. 2252 Jan 46

A 7-year-old male neutered domestic short-haired cat had depression for 5 months and acute blindness. A lesion at the level of the rostral and middle cranial fossae was suspected. A large pituitary mass compressing the optic chiasm was detected in magnetic resonance images and there was also evidence of recent intratumoral hemorrhage, leading to a diagnosis of pituitary apoplexy; these findings were confirmed at postmortem examination. Pituitary apoplexy is a clinical syndrome characterized by acute neurologic signs related to hemorrhagic infarction within a pituitary tumor. Pituitary apoplexy should be considered in patients with acute onset of blindness and altered mental status.
 ...
PMID:Imaging diagnosis: pituitary apoplexy in a cat. 2254 79

Pituitary tumour apoplexy is a rare but life threatening condition. Cushing's disease usually presents with clinical features of Cushing's syndrome. We report a 30-year-old male patient with Cushing's disease who presented with severe headache and right third nerve palsy. MRI of the pituitary gland revealed a pituitary adenoma with infarction suggestive of apoplexy. After a transsphenoidal surgery he developed pan-hypopituitarism with diabetes insipidus. We also review the relevant literature.
 ...
PMID:Cushing's disease presenting with pituitary apoplexy. 2265 88

Prolactinomas are common pituitary tumors usually highly responsive to dopamine agonists. Around 70-90% of the prolactinomas exhibit decrease in tumor size, though variably with these agents. Uncommonly, there may be little or no shrinkage in pituitary tumor. In the absence of medical therapy, pituitary apoplexy may also result in tumor shrinkage, albeit rarely. We report here a case showing only modest reduction in prolactinoma with cabergoline given for a period of one and a half years. Surprisingly, this tumor showed a 40% reduction in the tumor size 3 months after cabergoline withdrawal in the absence of clinical or radiological evidence of apoplexy.
 ...
PMID:Spontaneous reduction of prolactinoma post cabergoline withdrawal. 2308 77

Prolactinoma is the most common secreting pituitary adenoma. It is typically diagnosed in women of reproductive age and is common cause of infertility. Currently the treatment of choice is pharmacotherapy with dopamine agonists, whereas surgical treatment is reserved for a selected group of patients. Pituitary-tumor apoplexy is a rare, life-threatening condition associated with significant morbidity and mortality. The authors present the case of a 25-year-old woman with prolactinoma treated with dopamine agonist. In course of such a treatment the patient became pregnant. The bromocriptine was gradually withdrawn. In the 14th week of pregnancy she was admitted for symptoms suggesting pituitary tumor apoplexy. The treatment with bromocriptine was reinitiated. In the 20th week of pregnancy further deterioration of the patient's neurological condition and visual-field abnormalities were observed. The patient was qualified for surgical treatment - selective transsphenoidal adenomectomy. The successful surgery led to improvement of neurological condition. The early postoperative PRL level decreased significantly and hormonal function of the pituitary was preserved. The pregnancy ended in 38th week with a caesarean section. Endocrinological evaluation conducted after the uneventful delivery confirmed normal function of the pituitary. Magnetic resonance imaging (MRI) did not reveal tumor re-growth. The patient is kept under constant medical care. In this case study the authors discussed therapeutic management and reviewed literature regarding gestational pituitary-tumor apoplexy with particular emphasis on surgical treatment.
 ...
PMID:Transsphenoidal surgery for a life-threatening prolactinoma apoplexy during pregnancy. 2309 Feb 64

Many researches that discourse the treatment of prolactinomas with dopamine agonists (DA) provide data about pituitary tumor apoplexy of some prolactinomas. Therefore, DA are listed as risk factors for apoplexy of prolactinomas. The authors wish to explore the percentage (frequency) of pituitary tumor apoplexy during the treatment of prolactinomas with DA. From June 2011 to February 2012, we sought electronic databases and found 2169 articles and 71 book chapters relevant to DA. Only seven articles have been included into systematic review and from 4 articles we extracted numerical data that showed percentage of pituitary tumor apoplexy. One hundred and fifty-seven patients treated with DA were included in four studies. Results showed the following percentage of apoplexy during the treatment of prolactinomas with DA (apoplexy/therapy ratio): 1/84(1,19%), 13/29(44,83%), 1/15(6,67%) and 1/29(3,45%). One result stands out from the other (13/29-44,83%) because of retrospective search for pituitary hemorrhage by MRI imaging of sellar region and some of the patients were without clinical signs of apoplexy. Median and mean age of included patients was usually over 30 years. Pituitary tumor apoplexy appeared more frequently in macroprolactinomas than in microprolactinomas and also within a year and a half since the beginning of treatment with DA. Conclusively, clinically manifested pituitary tumor apoplexy appears in relatively small percentage of prolactinomas treated with DA. We were also concluded that apoplexy appears asymptomatic and because of that and because of more frequently appearing in macroprolactinomas, there are recommendations for performing MRI imaging of sellar region more often in patients with macroprolactinomas than in patients with microprolactinomas who are treated with DA.
 ...
PMID:Frequency of pituitary tumor apoplexy during treatment of prolactinomas with dopamine agonists: a systematic review. 2324 23

Rathke cleft cysts (RCCs) are benign cystic lesions of the sellar and suprasellar region that are asymptomatic in most cases. Occasionally, compression of the optic pathway and hypothalamo-pituitary structures may cause clinical symptoms, such as headaches, visual deficits and endocrinopathies. Acute presentation caused by hemorrhage into an RCC have been described in the literature, and the term "Rathke cleft cyst apoplexy" has been coined. We present the case of a 32-year-old man with acute onset of meningitis-type symptoms and imaging findings resembling hemorrhagic pituitary tumor apoplexy. In retrospect, clinical symptoms, intraoperative appearance, and histologic examination were compatible with the diagnosis of nonhemorrhagic rupture of an RCC. Thus, the clinical presentation of "Rathke cleft cyst apoplexy" is not necessarily caused by hemorrhage.
...
PMID:Ruptured Rathke cleft cyst mimicking pituitary apoplexy. 2369 92

Cushing's disease (CD) is usually caused by secretion of ACTH by a pituitary corticotroph microadenoma. Nevertheless, 7%-20% of patients present with ACTH-secreting macroadenomas. Our aim is to report a 36-year-old female patient with CD due to solid-cystic ACTH-macroadenoma followed up during 34 months. The patient presented spontaneous remission due to presumed asymptomatic tumor apoplexy. She showed typical signs and symptoms of Cushing's syndrome (CS). Initial tests were consistent with ACTH-dependent CS: elevated urinary free cortisol, abnormal serum cortisol after low dose dexamethasone suppression test, and elevated midnight salivary cortisol, associated with high plasma ACTH levels. Pituitary magnetic resonance imaging (MRI) showed a sellar mass of 1.2 x 0.8 x 0.8 cm of diameter with supra-sellar extension leading to slight chiasmatic impingement, and showing hyperintensity on T2-weighted imaging, suggesting a cystic component. She had no visual impairment. After two months, while waiting for pituitary surgery, she presented spontaneous resolution of CS. Tests were consistent with remission of hypercortisolism: normal 24-h total urinary cortisol and normal midnight salivary cortisol. Pituitary MRI showed shrinkage of the tumor with disappearance of the chiasmatic compression. She has been free from the disease for 28 months (without hypercortisolism or hypopituitarism). The hormonal and imaging data suggested that silent apoplexy of pituitary tumor led to spontaneous remission of CS. However, recurrence of CS was described in cases following pituitary apoplexy. Therefore, careful long-term follow-up is required.
...
PMID:Spontaneous remission of hypercortisolism presumed due to asymptomatic tumor apoplexy in ACTH-producing pituitary macroadenoma. 2403 Jan 90

We present the first Asian case of a 77-year-old man who developed pituitary apoplexy (PA) soon after gonadotropin-releasing hormone agonist (GnRHa) (leuprorelin) injection to treat prostate cancer. Headache, ophthalmoplegia, visual field deficit, nausea, and vomiting are the typical characteristics of pituitary apoplexy. Though the occurrence rate is rare, the consequence of this condition can vary from mild symptoms such as headache to life-threatening scenarios like conscious change. Magnetic resonance imaging is the best imaging modality to detect PA and sublabial trans-sphenoid pituitary tumor removal can resolve most of PA symptoms and is so far the best solution in consensus. We also review 11 previous reported cases receiving GnRHa for androgen deprivation therapy of prostate cancer, and hope to alert clinicians to use GnRHa with caution.
...
PMID:Pituitary apoplexy induced by Gonadotropin-releasing hormone agonists for treating prostate cancer-report of first Asian case. 2408 91


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>