RESUMEN
An ectopic pituitary adenoma (EPA) is an uncommon type of pituitary adenoma, accounting for only 2% of all pituitary adenomas. EPAs are benign tumors that can occur anywhere along the migratory embryonic path of the pituitary gland and have no relationship to intrasellar elements. They are usually hormonally active and have a minor female predominance. The clinical features of EPAs are highly dependent on its hormonal activity, anatomical location, and its local mass effect. Appropriate radiological imaging is essential for the evaluation of EPAs. Imaging investigations show a normal pituitary gland and sellar turcica, provide details on the size of the tumor, its margins, and extent, and help with surgical planning. The criteria for diagnosing an ectopic pituitary adenoma depend on detailed histopathological examination. EPA management should be individualized. We present a case of a 71-year-old male who presented with a 9-month history of left nasal obstruction, purulent nasal discharge, and intermittent anterior epistaxis. The patient was being managed by his general practitioner for chronic rhinosinusitis but failure of his symptoms to resolve prompted a visit to the otorhinolaryngologist. The patient was diagnosed with a null-cell ectopic pituitary adenoma through histological analysis of a biopsy specimen that showed adenohypophyseal cells without cell-type-specific differentiation. The patient subsequently underwent an endoscopic endonasal excision and had an uneventful hospital stay.
RESUMEN
An advanced abdominal pregnancy is defined as an extrauterine pregnancy over twenty weeks gestation with a fetus living, or showing evidence of having once lived, in the mother's abdominopelvic cavity. Our case is a 35-year-old patient with a 23-week extrauterine pregnancy, with a congenital head defect (scaphocephaly and hydrocephalus), located in the left side of the maternal abdomen with a period of gestation of 23 weeks, who underwent preoperative imaging with contrast-enhanced multidetector computed tomography (CE-MDCT). CT imaging provided significant information on the placenta and its arterial supply/venous drainage and confirmed the presence of an arteriovenous malformation of the right uterine artery. CT imaging also allowed planning of preoperative uterine artery coil embolization.
RESUMEN
Blunt popliteal vascular injury in the paediatric population is exceedingly rare and in advanced trauma centres the management can be challenging. A case of blunt popliteal artery trauma in a 5 years old requiring distal bypass using reversed saphenous vein is herein described. It is noteworthy to mention the difficulties experienced in a limited resource setting, including limitations in small rural hospitals, inefficient timely transfer to specialised centres, inadequate numbers of highly trained surgeons in subspecialities such as microvascular surgery and finally ineffective support and rehabilitative services.