Disfunção hormonal em lesões não hipofisárias das regiões selar e periselar

Fonseca, Alexandre Brasil; Souto, André A.; Domingues, Flavio S.; Gadelha, Mônica R.; Chimelli, Leila; Santos, Marco Aurélio dos; Violante, A

doi:10.1590/s0004-282x2001000600013

Cited by 2 publications

(1 citation statement)

References 27 publications

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“…On follow up, patient presented several features inconsistent with a pituitary adenoma, such as concomitant central diabetes insipidus, high testosterone levels without exogenous steroid use and rapid tumor growth, being the latter the major clue for seeking an alternative diagnosis in this patient. Several cases have been reported of sellar GCT and the usual presenting symptoms are hypogonadism, central diabetes insipidus, visual field defects and hyperprolactinemia [17,24,27]. Of these findings, only central diabetes insipidus is inconsistent with pituitary adenoma, although not pathognomonic of GCT.…”

Section: Discussionmentioning

confidence: 99%

Sellar and suprasellar mixed germ cell tumor mimicking a pituitary adenoma

et al. 2008

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Germ cell tumors (GCT) are a heterogeneous group of lesions whose origin is not well established. Several cases of primary intrasellar germinomas have been reported, however non-germinomatous GCT have rarely been described. We report the case of a young adult male patient with a mixed GCT that presented with a sellar tumor with suprasellar extension. The patient seeked medical attention because of seizures and magnetic resonance imaging evidenced a tumor of the sellar region. Hyperprolactinemia was also present and dopamine agonist therapy was started. As there was a rapid tumor growth and the patient had concomitant central diabetes insipidus and elevated testosterone levels, a GCT was suspected and confirmed by elevated serum concentration of β-human chorionic gonadotrophin. Patient underwent surgical resection of the tumor and histopathological examination confirmed the diagnosis of a mixed GCT. Chemotherapy was initiated, followed by conventional radiotherapy. In conclusion, although pituitary adenomas respond for the vast majority of sellar tumors, concomitant symptoms such as central diabetes insipidus and rapid tumor growth should raise the suspicion of a diverse diagnosis. The present report intend not only to show a rare case of sellar and suprasellar mixed GCT but also to remind clinicians that if laboratory findings do not fit into patient's diagnosis (such as high testosterone levels in our patient), then the diagnosis should be reviewed.

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Section: Discussionmentioning

confidence: 99%

Sellar and suprasellar mixed germ cell tumor mimicking a pituitary adenoma

et al. 2008

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A Giant Internal Carotid Bifurcation Aneurysm as a Rare and Dangerous Differential Diagnosis of a Craniopharyngioma

Perret¹,

Bertani²,

Koester³

et al. 2022

Cureus

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Craniopharyngiomas are supra/parasellar lesions that often present with general, unspecific symptoms. Similarly, internal carotid artery (ICA) bifurcation giant aneurysms may also produce calcified, heterogeneous, parasellar expansive lesions, posing a relevant differential diagnosis due to their inherently different surgical strategies and risks. We report the case of a 54-year-old female presenting with progressive disorientation and apathetic behavior. CT and MRI reports described a suprasellar heterogenous mass with calcifications associated with an adjacent, laterally located fluid collection suggestive of a craniopharyngioma. During the surgical procedure, perfuse and unexplained arterial bleeding ensued, prompting the surgical team to review a previous contrast-enhanced CT scan. Careful inspection revealed an image suggestive of vascular pathology, with an area of continuous hyperdensity along the right ICA bifurcation. The Sylvian fissure was dissected, and an aneurysmal neck was encountered and successfully clipped. Giant intracranial aneurysms are rare but essential differential diagnoses to be considered during the workup and surgical approach toward parasellar mass lesions. This case illustrates the importance of performing a CT angiogram (CTA) for skull base lesions, even when the size is more suggestive of tumor pathology.

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Disfunção hormonal em lesões não hipofisárias das regiões selar e periselar

Cited by 2 publications

References 27 publications

Sellar and suprasellar mixed germ cell tumor mimicking a pituitary adenoma

Sellar and suprasellar mixed germ cell tumor mimicking a pituitary adenoma

A Giant Internal Carotid Bifurcation Aneurysm as a Rare and Dangerous Differential Diagnosis of a Craniopharyngioma

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