High-Grade Atypical Teratoid/Rhabdoid Tumor in the Pituitary Region.

Atypical teratoid/rhabdoid tumors (AT/RTs) are embryological tumors of the central nervous system (CNS). They are typically found in children, with rare presentations in adults. We describe the presentation of an AT/RT in the pituitary region of a 37-year-old female. The patient presented with a two-week history of intractable cephalgia with sudden onset of monocular diplopia and left-sided cranial nerve VI palsy. The patient underwent transsphenoidal resection of their mass, which revealed the diagnosis. She then underwent systemic therapy with chemotherapy as well as radiation. She ultimately died 14 months after treatment completion due to unrelated events. The case highlights the rarity of AT/RT in adults, emphasizing the challenge of establishing standardized treatment protocols due to its rarity in adult presentations.

Secondary pulmonary hypertension due to pulmonary Langerhans cell histiocytosis accompanied with panhypopituitarism.

A 65-year-old man presented to our hospital with complaint of acute dyspnoea. He smoked 30 cigarettes per day from age 20 to 52 years. Immunocytochemical findings revealed 6.3% of positive CD1a cells in the cell fraction of bronchoalveolar lavage, thus suggesting a diagnosis of pulmonary Langerhans cell histiocytosis (PLCH), after nine years since the first suspicion of PLCH. Furthermore, he was diagnosed with secondary pulmonary hypertension (PH) caused by progressed PLCH by right heart catheterization. At 59 years of age, he was diagnosed with panhypopituitarism, and persistent hormone replacement therapy was subsequently started by an endocrinologist. After the initiation of oxygen therapy and treatment with a combination of sildenafil and warfarin, an estimated pulmonary artery systolic pressure reduced 97.9 to 64.0 mmHg. We believed this is a rare case of PLCH with irreversible central nervous system (CNS) disorder in whom severe PH developed due to a long-term burden of PLCH in a middle-aged male.

Prolonged ovarian acyclicity is associated with a higher likelihood of developing hyperprolactinemia in zoo female African elephants.

Hyperprolactinemia is a common disorder of the hypothalamic-pituitary axis, and a cause of ovarian dysfunction in women. Currently, over half of non-cycling African elephant females in North America also are hyperprolactinemic, suggesting a similar link between these two conditions may exist. The objective of this study was to determine the relationship between acyclicity and prolactin status by comparing mean prolactin concentrations of bi-weekly samples collected over a 1-year period in 2012 with 20 years of historical weekly progestagen data to assess cyclicity. Females were categorized as: 1) non-cycling with an average prolactin concentration of 15 ng/ml or greater (HIGH; n = 17); 2) non-cycling with an average prolactin concentration below 15 ng/ml (LOW; n = 16); and 3) typical temporal patterns of progestagen and prolactin secretion (NORMAL; n = 45), and evaluated based on length of time (in years) they had experienced ovarian inactivity. Results showed that the majority of HIGH prolactin elephants had been acyclic for at least 5 years, and in a number of cases (n = 9) for over 10 years. By contrast, most of the LOW prolactin elephants had experienced acyclicity for less than 5 years. Finally, there was a positive association between duration of acyclicity and mean prolactin concentrations, with an increase in the likelihood of having higher prolactin concentrations the longer an individual was acyclic. This study highlights the importance of longitudinal hormonal datasets to examine temporal changes in biological functioning and better understand the etiology of infertility problems.