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Pituitary and adrenal disease
Published in Catherine Nelson-Piercy, Handbook of Obstetric Medicine, 2020
Causes of hyperprolactinaemia include: Normal pregnancy.Pituitary adenomas (prolactinomas).Hypothalamic and pituitary stalk lesions (leading to the removal of dopaminergic suppression of prolactin secretion).Empty sella syndrome.Hypothyroidism (thyroid-stimulating hormone [TSH] stimulates lactotrophs).Chronic kidney disease.Seizures.Drugs e.g. metoclopramide.
Primary Pituitary Disease
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Christopher M. Jones, John Ayuk
Empty sella syndrome (ESS) refers to a rare condition in which the sella turcica – a saddle-shaped depression of the sphenoid bone that forms the pituitary fossa in which the pituitary gland ordinarily sits – appears on radiological imaging to be partially or completely filled with cerebrospinal fluid.31 This occurs as a consequence of the herniation of the suprasellar subarachnoid space into the intrasellar space, with resultant compression of the pituitary gland. Both primary and secondary forms of ESS have been described.
Pregnancy and Sex-Related Deaths
Published in John M. Wayne, Cynthia A. Schandl, S. Erin Presnell, Forensic Pathology Review, 2017
John M. Wayne, Cynthia A. Schandl, S. Erin Presnell
Answer B is incorrect. Empty sella syndrome describes a radiological finding in which the sella turcica appears to be empty or the pituitary appears significantly diminutive. Although pituitary necrosis as seen in the photomicrograph could be a feature due to external compression or other secondary damage to the gland, histological findings will vary depending on the cause.
Arachnoid prolapse in endoscopic transsphenoidal surgery of pituitary adenoma, technical note
Published in British Journal of Neurosurgery, 2023
Guive Sharifi, Nader Akbari Dilmaghani, Seyed Mousa Sadrhosseini, Shima Arastou
Despite the numerous advantages of TSA, cerebrospinal fluid (CSF) leaks such as an intraoperative CSF leak, which may occur in 50% of pituitary tumor cases, and postoperative CSF leak in up to 27% of pituitary adenomas [6–10], are serious complications after TSA. CSF leaks increase the chance of life-threatening bacterial meningitis. Such complications could be overcome by performing sellar reconstruction. Nonetheless, reconstruction techniques, graft materials, and the necessity of performing reconstruction in every case are important controversial issues [9]. Mechanical complications that include chiasmal herniation syndrome, empty sella syndrome, or other complications like intrasellar hematoma, intrasellar abscess, and resultant meningitis are serious complications from neglected or improperly performed sellar floor reconstruction [4].
Spontaneous preoperative pituitary adenoma resolution following apoplexy: a case presentation and literature review
Published in British Journal of Neurosurgery, 2020
Daniel G. Eichberg, Long Di, Ashish H. Shah, William A. Kaye, Ricardo J. Komotar
Twelve patients were diagnosed to have macroadenomas and one patient was diagnosed with a microadenoma. All tumors were non-hormone secreting. Six out of 13 patients (46%) showed signs of intrasellar hemorrhage on MRI and five showed compression of the optic nerve. Seven patients (54%) showed decrease concentrations of pituitary hormones on endocrine panels. Although some patients were administered analgesics for symptom relief or placed on hormone replacement therapy, none of the patients underwent surgical intervention. However, all tumors either regressed in size or completely resolved spontaneously. Eight cases (62%) resulted in complete resolution with remission of symptoms, three cases (23%) resulted in panhypopituitarism secondary to empty sella syndrome, one case resulted in a tumor that regressed in size but was still visible on MRI, and one case – the current presented case – resulted in complete spontaneous resolution, but subsequent regrowth of the tumor four years later. Twelve cases have attributed the spontaneous resolution of the tumor to necrosis following apoplexy, while the authors of one case hypothesized a viral etiology which was not explained further. Table 2 is a statistical summary and analysis of the data collected in Table 1.
Granulomatous hypophysitis in a postpartum patient: A case report
Published in Cogent Medicine, 2018
Alexey Youssef, Rahaf Ali, Maya Marouf
Autoantibodies for pituitary autoantigens APA have been described in both LH and PGH. The antigenic targets for those APAs include growth hormone, alpha-enolase, pituitary gland-specific factors 1a and 2, secretogranin II, C14orf166 and chorionic somatomammotropin. However, these APAs are not specific for hypophysitis, as an elevated level has been described in various pituitary and non-pituitary disorders like empty sella syndrome, panhypopituitarism, isolated pituitary hormone deficiencies, isolated hyperprolactinemia, eating disorders and cryptorchidism (Hunn et al., 2014; Rao et al., 2016).