RESUMO
BACKGROUND: Pituitary adenomas are common benign tumors of the pituitary gland with an overall estimated prevalence of 16.7%. As per the revised World Health Organization (WHO) classification, these tumors are identified by their histological subtypes and are designated by their pituitary cell lineage instead of the hormone they produce. The lactotroph adenoma is the most common subtype of hormone-producing pituitary adenoma. Surgery is the mainstay of treatment, but complications are encountered. So far, there is no reported study evaluating individualized homeopathic intervention in pituitary adenoma in peer-reviewed journals. METHODS: This case study describes a case of functional lactotroph microadenoma with history of failed surgical treatment and heavy intrasellar hemorrhage occurring during the surgery. Phosphorus was prescribed as an individualized homeopathic medicine on the basis of symptoms-hemorrhagic complication during surgical procedure and aggravation of headache thereafter. RESULTS: There was a marked subjective improvement along with complete tumor regression, as evidenced by repeat magnetic resonance imaging scans. The Modified Naranjo Criteria total score was +10 out of a possible +13, providing some evidence to attribute the clinical outcome with the homeopathic intervention. CONCLUSION: This case study reconfirms the association between increased frequency of headaches and pituitary hemorrhage among cases of lactotroph adenoma. It also suggests that individualized homeopathic treatment may be helpful in pituitary adenomas with increased risk of complications such as intrasellar hemorrhage.
Assuntos
Homeopatia/métodos , Materia Medica/uso terapêutico , Fósforo/uso terapêutico , Neoplasias Hipofisárias/tratamento farmacológico , Prolactinoma/tratamento farmacológico , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/cirurgia , Prolactinoma/diagnóstico por imagem , Prolactinoma/cirurgiaRESUMO
Gynaecomastia is common and often physiological, leading to frequent dismissal as a cosmetic condition. It can however be a symptom of underlying hormone imbalance, which requires further assessment to exclude underlying sinister pathology. We discuss a rare cause of gynaecomastia that demonstrates the importance of a holistic approach to patient assessment.
Assuntos
Ginecomastia/etiologia , Neoplasias Hipofisárias/complicações , Prolactinoma/complicações , Adulto , Ginecomastia/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias Hipofisárias/diagnóstico por imagem , Prolactinoma/diagnóstico por imagem , UltrassonografiaRESUMO
BACKGROUND: Pediatric pituitary adenomas are a rare medical entity that makes up a small portion of intracranial tumors in children and adolescents. Although benign, the majority of these lesions are secreting functional tumors with the potential for physiological sequela that can profoundly affect a child's development. FOCUS OF REVIEW: In this review, we discuss the medical and surgical management of these tumors with a focus on clinical presentation, diagnostic identification, surgical approach, and associated adjuvant therapies. We will also discuss our current treatment paradigm using endoscopic, open, and combined approaches to treat these tumors. The management of pituitary tumors requires a multidisciplinary team of surgeons, endocrinologists, and neuroanesthesiologists as well as neurocritical care specialists to deliver comprehensive care.
Assuntos
Adenoma Hipofisário Secretor de ACT/cirurgia , Adenoma Hipofisário Secretor de Hormônio do Crescimento/cirurgia , Microcirurgia/métodos , Neuroendoscopia/métodos , Neoplasias Hipofisárias/terapia , Prolactinoma/terapia , Adenoma Hipofisário Secretor de ACT/diagnóstico por imagem , Adenoma Hipofisário Secretor de ACT/metabolismo , Adenoma Hipofisário Secretor de ACT/fisiopatologia , Adenoma/diagnóstico por imagem , Adenoma/metabolismo , Adenoma/fisiopatologia , Adenoma/cirurgia , Adolescente , Criança , Pré-Escolar , Craniotomia , Agonistas de Dopamina/uso terapêutico , Adenoma Hipofisário Secretor de Hormônio do Crescimento/diagnóstico por imagem , Adenoma Hipofisário Secretor de Hormônio do Crescimento/metabolismo , Adenoma Hipofisário Secretor de Hormônio do Crescimento/fisiopatologia , Humanos , Cavidade Nasal , Cirurgia Endoscópica por Orifício Natural/métodos , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/metabolismo , Neoplasias Hipofisárias/fisiopatologia , Prolactinoma/diagnóstico por imagem , Prolactinoma/fisiopatologia , Osso EsfenoideRESUMO
The case of a male patient with a macroprolactinoma is presented. Within a follow up period of six months the tumor had spontaneously shrunken without any therapy. The causes of this phenomenon are discussed in the following paper.