Differential Diagnosis of Pituitary Tumors

Post, Kalmon D.; McCormick, Paul C.; Bello, Jacqueline A.

doi:10.1016/s0889-8529(18)30466-3

Cited by 44 publications

(20 citation statements)

References 138 publications

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“…Diagnostic accuracy might be a limitation of this study, because in strict sense, pituitary adenoma is a histopathological diagnosis and a number of other sellar lesions may mimic pituitary adenomas, such as germinomas, craniopharyngiomas, meningiomas, sarcoidosis, and lymphocytic infiltration (28). However, there are, in addition to the absence of hormone overproduction, arguments that in our series the vast majority of the lesions consist of NFMA.…”

Section: Non-functioning Pituitary Macroadenomasmentioning

confidence: 75%

The natural course of non-functioning pituitary macroadenomas

Dekkers¹,

Hammer²,

Keizer³

et al. 2007

eur j endocrinol

167

129

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Objective: The natural history of non-functioning pituitary macroadenomas (NFMA) has not been completely elucidated. Therefore, we evaluated pituitary function, visual fields, and tumor size during long-term follow-up of non-operated patients with NFMA. Design: Follow-up study. Patients: Twenty-eight patients (age 55G3 years) with NFMA, not operated after initial diagnosis, were included. Results: Initial presentation was pituitary insufficiency in 44%, visual field defects in 14%, apoplexy in 14%, and chronic headache in 7% of the patients. The duration of follow-up was 85G13 months. Radiological evidence of tumor growth was observed in 14 out of 28 patients (50%) after duration of follow-up of 118G24 months. Six patients (21%) were operated, because tumor growth was accompanied by visual field defects. Visual impairments improved in all the cases after transsphenoidal surgery. Spontaneous reduction in tumor volume was observed in eight patients (29%). No independent predictors for increase or decrease in tumor volume could be found by regression analysis. Conclusion: Observation alone is a safe alternative for transsphenoidal surgery in selected NFMA patients, without the risk of irreversibly compromising visual function. European Journal of Endocrinology 156 217-224

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Section: Non-functioning Pituitary Macroadenomasmentioning

confidence: 75%

The natural course of non-functioning pituitary macroadenomas

Dekkers¹,

Hammer²,

Keizer³

et al. 2007

eur j endocrinol

167

129

View full text Add to dashboard Cite

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“…Our patient presented with slowly progressing chiasmal syndrome and a hypopituitarism without posterior pituitary dysfunction. Seventy percent of patients with pituitary metastases of melanoma have multiple metastases spread throughout all organs [11,14,18,19], although it is exceptional to discover a melanoma in a patient with a unique pituitary metastasis [12,20]. In our patient an exhaustive search did not detect any metastases, and an extensive ophthalmologic and dermatologic work up failed to find evidence of any other primary site.…”

Section: Discussionmentioning

confidence: 55%

Primary sellar melanocytic tumor: report of new case and literature review

Vezzosi¹,

Capuani²,

Loubes-Lacroix

et al. 2007

Pituitary

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“…These endocrinological features conflict with those reported in the literature in that idiopathic granulomatous hypophysitis and lymphocytic hypophysitis affect primarily the anterior pituitary 12' 13, ~4, 15. The posterior pituitary and infundibulum are frequently impaired in cases of sarcoidosis, tuberculoma, and histiocytosis X, often resulting in diabetes insipidus 2' e. 6,11,13,14 Our radiological findings point to predominance of posterior pituitary or hypothalamic impairment in that the abnormally thickened pituitary stalk and infundibulum were enhanced homogeneously by the contrast material, as was the concurrent sellar lesion. Minimal sellar enlargement despite the existence of an intrasellar mass contrasts strikingly with the dilated sella due to an expanding mass such as a pituitary adenoma.…”

Section: Discussionmentioning

confidence: 65%

Pituitary granuloma and chronic inflammation of hypophysis: Clinical and immunohistochemical studies

et al. 1993

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We describe five patients with chronic inflammation of the hypophysis including three pituitary granulomas of unknown aetiology. In contrast to the previously reported cases, the involvement of neurohypophysis or hypothalamus was a distinct clinical feature in these patients. Impairment of anterior pituitary function was less prominent, while polyuria and polydipsia occurred in all cases. Enlargement of the sella turcica was absent in three and slight in two cases. CT scan and MR images demonstrated a contrast-enhanced sellar mass in all patients; abnormally thickened pituitary stalk and infundibulum with contrast-enhancement was observed in four. The fibrous tissues were removed by the transsphenoidal approach in four patients, and by the subfrontal approach in one case. In all patients, the endocrinological dysfunction was prolonged. No increase in the size of the remaining pituitary mass was demonstrated on repeated MR images in any of the patients. On histological examination, granulomatous formation was present in three samples, and multinucleated Langhans' giant cells were seen in one. The epithelioid cells and multinucleated giant cells constituting the granulomas were positive for anti-macrophage antibody. No firm laboratory or histological evidence was obtained supporting the presence of systemic disease leading to granulomas. In the other two cases, the pituitary lesions were composed of chronic inflammation tissue, and serum antipituitary antibodies were present in a patient with concurrent Hashimoto's thyroiditis. Our experiences with chronic inflammation of the hypophysis indicate that these patients are best managed by histological confirmation of the lesion followed by adequate hormonal replacement.(ABSTRACT TRUNCATED AT 250 WORDS)

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Differential Diagnosis of Pituitary Tumors

Cited by 44 publications

References 138 publications

The natural course of non-functioning pituitary macroadenomas

The natural course of non-functioning pituitary macroadenomas

Primary sellar melanocytic tumor: report of new case and literature review

Pituitary granuloma and chronic inflammation of hypophysis: Clinical and immunohistochemical studies

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