We report here the case of an 82-year-old woman who presented with visual disturbance. MRI demonstrated a sellar mass. The diagnosis of pituitary adenoma was made. She underwent transnasal surgery. Histologic, immunohistochemical and ultrastructural studies indicated that the tumor was a melanoma. Despite an exhaustive search for a primary lesion elsewhere, none was found. The sellar tumor was considered a primary lesion, although extrasellar primary tumor imaging cannot be excluded with 100% certainty. Reported examples of melanoma affecting the sellar region are few. They exhibit morphologic features identical to those of melanomas arising elsewhere. Although very rare, primary melanomas enter into the differential diagnosis of sellar lesions.
We report here the case of a 61-year-old woman who presented with hydrocephalus and cystic and solid lesions in sella turcica, suprasellar areas, and third ventricle. After ventriculoperitoneal shunt she developed cognitive changes and the cystic lesions enlarged. Magnetic resonance imaging (MRI) demonstrated multiple cysts and a solid lesion in the sella and around the anterior clinoid process. With diagnosis of neurocysticercosis she underwent craniotomy. Pathologic examination documented two different lesions: viable and dead cysticerci with inflaming infiltration and a left anterior clinoidal meningioma. At the second surgery, six weeks later via transnasal transsphenoidal approach a silent corticotroph pituitary adenoma was removed which was studied by histology, immunohistochemistry, and electron microscopy. To our knowledge, the occurrence of these three different lesions in the sellar area was not described before.
This chapter aims to show some concepts related to the importance of planning and strategic direction as a fundamental tool for the sustainability of Colombian SMEs for a new world economic order and present the proportionality relationship between this concept of strategic management and the organizational components. Keys that explain it and facilitate its development, considering the modernization model for managing organizations (MMOM), were developed by a group of researchers from the EAN University in Bogotá-Colombia. It was found that market management, organizational culture, organizational structure, and knowledge and innovation management are the components that a high percentage explain the strategic direction of this type of company on which priority improvement and innovation activities should be developed in such a way ways that allow strategies to develop more smoothly to achieve business objectives of effectiveness, efficiency, profitability, and sustainable development.
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