Dopamine agonist and tamoxifen combination therapy for a prolactin-secreting pituitary tumor resistant to dopamine agonist monotherapy: Case report and review

Publication date: September 2020Source: Interdisciplinary Neurosurgery, Volume 21Author(s): Zachary K. Christian, Kimmo J. Hatanpaa, Richard J. Auchus, Stephen R. Hammes, Ankur R. Patel, Bruce E. Mickey
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research

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AbstractPosterior pituitary tumors are rare nonneuroendocrine neoplasms originating in the neurohypophysis that lack hormonal secretory capacity. Surprisingly, these tumors are relatively frequently associated with adenohypophyseal syndromes of hormonal hypersecretion such as Cushing ’s disease and acromegaly. Fifteen cases of posterior pituitary tumor associated with hypercortisolism have been reported to date, 13 of them were pituicytomas (Pi) and 2 were granular cell tumors (GCT). Six patients with posterior pituitary tumor associated with acromegaly have been reported (4 P i and 2 GCT). The main forms of clinical...
Source: Endocrine - Category: Endocrinology Source Type: research
Overall, tumors of primary central nervous system (CNS) are quite common in adults with an incidence rate close to 30 new cases/100,000 inhabitants per year. Significant clinical and biological advances have been accomplished in the most common adult primary CNS tumors (i.e., diffuse gliomas). However, most CNS tumor subtypes are rare with an incidence rate below the threshold defining rare disease of 6.0 new cases/100,000 inhabitants per year. Close to 150 entities of primary CNS tumors have now been identified by the novel integrated histomolecular classification published by the World Health Organization (WHO) and its u...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Kunal Thakkar, Vijaya Sarathi, Nalini S ShahNeurology India 2020 68(7):13-19 Pituitary adenomas (PA) account for approximately 15% of all intracranial neoplasms. Pituitary adenomas can be of different subtypes based on the cell of origin or associated hormone hypersecretion (non-functioning pituitary adenoma, prolactinoma, somatotropinoma, corticotropinoma, thyrotropinoma, and gonadotropinoma). Functioning PAs are associated with relatively higher morbidity and mortality because of associated hormone hypersecretion syndromes. Diagnosis of functioning PA is established by biochemical confirmation of hormone hypersecret...
Source: Neurology India - Category: Neurology Authors: Source Type: research
Jugal V Gada, Prudwiraj Sanamandra, Sagar A Barasara, Yash V Chauhan, Nikhil M BhagwatNeurology India 2020 68(7):20-27 Functioning pituitary tumors contribute to significant morbidity and mortality. Proper diagnostic approach and management is essential for optimal outcomes. Prolactinomas, the commonest of these, are the only tumors which can be managed medically. Acromegaly, apart from acral enlargement, can have multiple comorbidities like diabetes, hypertension, and obstructive sleep apnea. The primary treatment is surgical and it can be supplemented by radiotherapy and medications such as somatostatin analogs, growth ...
Source: Neurology India - Category: Neurology Authors: Source Type: research
Chandrashekhar E Deopujari, Salman T ShaikhNeurology India 2020 68(7):33-38 Pituitary tumors may well be the most common brain tumors with a mean incidence of 16.7%. Even small tumors become symptomatic when they arise from functioning cells and produce devastating effects on the body. The nonfunctioning tumors may become quite large before producing symptoms due to raised intracranial pressure or mass effect on the surrounding structures, most commonly, the optic apparatus. Many of them remain asymptomatic through life. Evolution of pituitary surgery is testimony to the advances in diagnostic and surgical techniques ...
Source: Neurology India - Category: Neurology Authors: Source Type: research
Atul Goel, Sukhdeep Jhawar, Abhidha ShahNeurology India 2020 68(7):66-71 The authors review the anatomy of the pituitary gland on the basis of cadaver dissection studies and anatomy of dural relationships of pituitary tumors and its extensions on the basis of a 35-year-old experience of surgically treating pituitary tumors. Perfect understanding of anatomical correlates and nuances of pituitary tumor surgery is essential to achieve satisfactory surgical results. The pituitary gland is located in a specially enclosed cavity that is neither intracranial nor extracranial. It is covered strategically by meninges. Pituitary gl...
Source: Neurology India - Category: Neurology Authors: Source Type: research
Bhawani Shanker Sharma, Arvind Ranwa, Kanwaljeet GargNeurology India 2020 68(7):85-91 Endoscopic endonasal surgery for pituitary tumors can be performed safely with a good outcome. Complications are uncommon and relate most often to nearby structures at risk. The authors detail the nuances, tips and tricks useful in avoiding complications and their early detection and management.
Source: Neurology India - Category: Neurology Authors: Source Type: research
Jeffrey Nadel, William T CouldwellNeurology India 2020 68(7):101-105 Patients with pituitary masses who undergo transsphenoidal resection are at risk for a number of medical complications postoperatively. Among these are disturbances in fluid and sodium homeostasis, including diabetes insipidus (DI) and syndrome of inappropriate secretion of antidiuretic hormone (SIADH). It is believed that these pathologic states are a result of damage to the hypothalamic–pituitary axis from surgery, as are the downstream consequences, such as the triple phase response. The triple-phase response describes the pattern of initial acu...
Source: Neurology India - Category: Neurology Authors: Source Type: research
Ashraf Abdali, Ludmila Astaf`eva, Yuriy Trunin, Pavel Kalinin, Andrey Golanov, Badshahzar Abdali, Gennady Chmutin, Alexey Shkarubo, Bipin ChaurasiaNeurology India 2020 68(7):129-133 Cushing's disease is caused by a pituitary tumor causing increased production of adrenocorticotropic hormone, which leads to chronic hypersecretion of cortisol through adrenal cortices. Endoscopic trans-sphenoidal adenomectomy is the first choice of treatment with greatest efficiency for the treatment of the disease. However, in the absence of remission or recurrence of hypercortisolism after neurosurgical resection (adenomectomy), as ...
Source: Neurology India - Category: Neurology Authors: Source Type: research
Vikram S Karmarkar, Chandrashekhar E DeopujariNeurology India 2020 68(7):154-160 The most common sellar pathology that merits neurosurgical attention is the pituitary adenoma. However, some developmental, inflammatory, and neoplastic lesions may primarily or secondarily involve the sella, mimicking pituitary tumors. Advances in imaging and endocrinological assessment have helped in the recognition of these less common sellar, supra sellar pathologies, which may occasionally create confusion in management. The most common developmental anomaly is the Rathke's cleft cyst and an increasingly recognized inflammatory patho...
Source: Neurology India - Category: Neurology Authors: Source Type: research
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