Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.343
Filtrar
1.
Medicine (Baltimore) ; 99(8): e18572, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32080071

RESUMO

Stereotactic biopsy (STB) is commonly used in the pathological diagnosis of intracranial lesions. The associated complication and mortality rates are low, but few reports with large sample sizes have assessed the complications of STB for lesions in the brain midline.To evaluate the complications of STB of lesions in the sellar region, pineal region, and brainstem.This was a retrospective analysis of patients who underwent STB of lesions in the sellar region, pineal region, and brainstem at the Neurosurgery Department, Sixth Medical Center, PLA General Hospital, China, between January 2015 and December 2017. The rates of and possible reasons for surgical complications (including bleeding) and mortality were analyzed.A total of 145 patients underwent STB of midline brain lesions, including 16 (11.0%) in the sellar region, 18 (12.4%) in the pineal region, and 111 (76.6%) in the brainstem. Successful biopsy of the sellar region, pineal region, and brainstem was achieved in 16/16 (100%), 18/18 (100%), and 107/111 (96.4%) patients, respectively. There were no complications following STB of lesion in the sellar or pineal regions. Complications occurred in 17/111 patients (15.3%) during/after brainstem biopsy, three of whom died (2.7%). The main clinical manifestations were facioplegia, facial pain, changes in blood pressure and heart rate, and difficulty breathing.STB of lesions in the sellar region, pineal region, and brainstem had a high success rate, but mortality was 2.7%. The occurrence of complications (15.3%) was closely related to the anatomical and functional characteristics of the region biopsied.


Assuntos
Neoplasias Encefálicas/patologia , Glândula Pineal/patologia , Sela Túrcica/patologia , Técnicas Estereotáxicas/efeitos adversos , Adolescente , Adulto , Biópsia/efeitos adversos , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Tronco Encefálico/diagnóstico por imagem , Tronco Encefálico/patologia , China/epidemiologia , Feminino , Hemorragia/epidemiologia , Hemorragia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Glândula Pineal/diagnóstico por imagem , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/mortalidade , Estudos Retrospectivos , Sela Túrcica/diagnóstico por imagem , Técnicas Estereotáxicas/mortalidade , Adulto Jovem
2.
Pan Afr Med J ; 34: 55, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31762921

RESUMO

Intrasellar arachnoid cysts are benign malformations. They are extremely rare (approximately 3% of cases). Their pathophysiology is still poorly elucidated. We here report a case of intrasellar arachnoid cyst with suprasellar extension whose treatment was based on endoscopic transsphenoidal fenestration. The epidemiological, clinical, pathophysiological, radiological, therapeutic and evolutionary features have been analyzed. Neuroendoscopic procedures are performed with increasing frequency in surgery. Prognosis is good and recurrences are frequent, even after several years of evolution.


Assuntos
Cistos Aracnóideos/diagnóstico , Endoscopia/métodos , Sela Túrcica/patologia , Adulto , Cistos Aracnóideos/cirurgia , Feminino , Humanos , Prognóstico , Sela Túrcica/cirurgia
3.
No Shinkei Geka ; 47(8): 901-907, 2019 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-31477634

RESUMO

OBJECTIVES: Intracranial chordomas are thought to arise from remnants of the notochord and usually occur at the parasellar region. We present a case of a primary intrasellar chondroid chordoma in a patient who was initially diagnosed with a pituitary adenoma. CASE: A 77-year-old woman had a history of two surgeries for a tumor in the sella turcica(17 months after the 1st surgery). On initial MRI, the intrasellar mass showed low signal intensity on T1WI, very high signal intensity on T2WI, and inhomogeneous enhancement. On bone reconstructive CT, the sellar floor was thin, and no abnormalities were observed at the top of the clivus. Transsphenoidal surgery was performed. The pathological diagnosis was pituitary adenoma in both cases. Seventy-two months after the 1st(31 months after the 2nd)surgery, she developed right-sided oculomotor and abducent nerve palsies again. Since recurrence occurred during the relatively short period, the surgical specimens obtained from the 1st and 2nd surgeries were reexamined. Reexamination of the previously obtained specimen demonstrated areas of chondroid tissue that were embedded in a mucoid stroma and tumor cells that were composed of round or pleomorphic nuclei with vacuolated cytoplasm(physaliphorus cells)that were compatible with chondroid chordoma. The third surgery was performed. Postoperatively, her symptoms improved, and cyber knife therapy was administered for the residual part of the tumor. CONCLUSIONS: Although intrasellar chondroid chordomas are extremely rare, they should be considered in the differential diagnosis of tumors located in the sella turcica.


Assuntos
Adenoma , Cordoma , Neoplasias Hipofisárias , Adenoma/diagnóstico , Adenoma/cirurgia , Idoso , Cordoma/diagnóstico , Cordoma/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Recidiva Local de Neoplasia , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/cirurgia , Sela Túrcica/patologia
4.
World Neurosurg ; 132: 1-3, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31442637

RESUMO

BACKGROUND: This report presents a rare presentation of a ganglioglioma in the sellar/suprasellar region. On the basis of the patient's presentation and imaging characteristics, the initial diagnosis was craniopharyngioma. While gangliogliomas are already rare brain tumors that are usually found in the frontal and temporal lobes of young patients, the presentation of this tumor in the sellar region is exceedingly rare. CASE DESCRIPTION: A 25-year-old male presented to the emergency department with headache, agitation, and combativeness. A head computed tomography scan showed a sellar/suprasellar mass with mixed solid and cystic components and peripheral calcifications. The mass compressed the third ventricle and cerebral aqueduct, resulting in obstructive hydrocephalus. The patient was intubated for decline in mental status and combativeness. A ventricular drain was placed emergently. A pituitary function panel did not show endocrine dysfunction. Magnetic resonance imaging showed a 3.6 cm × 4.2 cm solid mass in the sellar/suprasellar region with a cystic component. The mass displaced the adenohypophysis and extended into the prepontine and interpedicular cisterns. The clinical presentation and radiologic characteristics led to an initial diagnosis of craniopharyngioma. The patient underwent a right pterional craniotomy and transsylvian approach for resection of mass without complication, although a subtotal resection was achieved due to adherence of the tumor to optic nerves and carotid arteries. The resected specimen was diagnosed as ganglioglioma. CONCLUSIONS: This case is a reminder of how much the field of neurosurgery relies on imaging modalities but also emphasizes the importance of histopathology in the field of brain tumors.


Assuntos
Neoplasias Encefálicas/cirurgia , Ganglioglioma/cirurgia , Sela Túrcica/cirurgia , Adulto , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Craniofaringioma/diagnóstico , Craniotomia , Diagnóstico Diferencial , Ganglioglioma/complicações , Ganglioglioma/diagnóstico por imagem , Ganglioglioma/patologia , Humanos , Hidrocefalia/etiologia , Imagem por Ressonância Magnética , Masculino , Neoplasias Hipofisárias/diagnóstico , Sela Túrcica/diagnóstico por imagem , Sela Túrcica/patologia , Ventriculostomia
5.
World Neurosurg ; 132: e577-e584, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31442639

RESUMO

OBJECTIVE: The surgery of parasellar meningiomas is crucial. There are only a few reports of the use of intraoperative magnetic resonance imaging (iMRI) for resection of these lesions. We discuss the safety and usefulness of this technique in achieving the planned surgical goal and analyze patients' outcomes. METHODS: Nineteen cases of parasellar meningioma were treated in our institution using iMRI. We classified the tumors according to their primary location: tuberculum sellae, clinoidal, and cavernous sinus meningiomas. We evaluated the history of previous surgery, outcome, residual (if present) tumor volume, degree of resection, achievement of the surgical goal, and number of iMRI scans. RESULTS: The preoperative surgical goal was achieved in all patients. In 7 of 19 patients, (37%) further tumor resection was performed after the first iMRI scan. Regarding the cavernous sinus group, the surgical resection was continued after the first iMRI in 56% of patients, obtaining substantial additional volume reduction. No complications were found related to the use of iMRI scan. CONCLUSIONS: iMRI has been effective in safely increasing the extent of parasellar meningioma resection mainly for recurrent and invasive tumors. Its usefulness has been seen mostly in cavernous sinus lesions, in which it allowed the further safe resection in 56% of cases. Moreover, this tool was particularly useful in recurrent or residual meningiomas with extension in extracranial compartments.


Assuntos
Imagem por Ressonância Magnética/métodos , Neoplasias Meníngeas/cirurgia , Meningioma/cirurgia , Neuroimagem/métodos , Cirurgia Assistida por Computador/métodos , Adolescente , Adulto , Idoso , Feminino , Humanos , Período Intraoperatório , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Pessoa de Meia-Idade , Sela Túrcica/patologia
6.
J Craniofac Surg ; 30(5): e400-e402, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31299791

RESUMO

The study reported a case of an intrasellar arachnoid cyst with visual disturbances as the main symptom. Arachnoid cyst is a common intracranial benign space-occupying lesion, but rarely seen in intrasellar region with less than 100 cases reported available in English language literature. Therefore, it is still controversial about the diagnosis and treatment of such patients. This article reviewed previous literature and discussed the differential diagnosis and surgical strategies of intrasellar arachnoid cyst in combination with our own case.


Assuntos
Cistos Aracnóideos/diagnóstico , Diagnóstico Diferencial , Adulto , Cistos Aracnóideos/cirurgia , Feminino , Humanos , Sela Túrcica/patologia
7.
Rev. chil. endocrinol. diabetes ; 12(3): 162-164, jul. 2019. ilus
Artigo em Espanhol | LILACS | ID: biblio-1006497

RESUMO

La acromegalia, originada por un exceso de producción de Hormona de crecimiento (Gh), se caracteriza por crecimiento somático exagerado, alto riesgo cardio-metabólico, así como reducción de la expectativa de vida. Tiene una incidencia de 3-4 casos por millón de habitantes. El diagnóstico se retrasa hasta 10 años aumentando la morbi-mortalidad. Las alternativas terapéuticas incluyen medicamentos y cirugía, que van encaminados a reducir los efectos de masa tumoral, normalizar los parámetros bioquímicos y resolver las manifestaciones clínicas. En casos muy infrecuentes, el tumor hipofisario que la origina se asocia a silla turca vacía.


Acromegaly, caused by an excess production of growth hormone (Gh), it is characterized by exaggerated somatic growth, high cardio-metabolic risk, as well as reduction of life expectancy. It has an incidence of 3-4 cases per million population. The diagnosis is delayed up to 10 years increasing morbidity and mortality. The therapeutic alternatives include medications and surgery, which are aimed at reduce the effects of tumor mass, normalize biochemical parameters and resolve clinical manifestations. In very infrequent cases, the pituitary tumor that originates it is associated with empty sella syndrome. Key words: Acromegaly, Empty sella syndrome, Pituitary tumor.


Assuntos
Humanos , Feminino , Idoso , Neoplasias Hipofisárias/complicações , Acromegalia/complicações , Acromegalia/diagnóstico , Síndrome da Sela Vazia/complicações , Sela Túrcica/patologia , Fator de Crescimento Insulin-Like I/análise , Hormônio do Crescimento/análise , Imagem por Ressonância Magnética , Teste de Tolerância a Glucose
8.
World Neurosurg ; 130: e150-e159, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31203060

RESUMO

BACKGROUND: Xanthogranuloma is a chronic inflammatory mass characterized by cholesterol crystal deposition, which is rarely seen in the sellar region. The objective of this study is to identify the clinical features and cause of sellar xanthogranulomas. METHODS: We retrospectively analyzed manifestation, radiographic, and endocrinologic presentation in 9 patients (7 women and 2 men) whom we had previously treated. RESULTS: The patients were between 26 and 73 years of age (median, 56 years). The chief symptoms were visual symptoms in 3, polyuria in 3, headache in 4, and tiredness in 4 patients. Perimetry found visual field deficit in 6 patients. Anterior pituitary provocation tests disclosed impairment of ≥1 hormone in all patients: growth hormone in 8 patients and adrenocorticotropic hormone-cortisol axis in 8 patients. The lesions were suprasellar in 2 patients, intrasellar in 2 patients, and intrasuprasellar region in 5 patients. Three of the lesions were solid and 6 were single cystic to multicystic. Very low intensity area on T2-weighted magnetic resonance imaging was observed in 4 lesions. Postcontrast study performed in 7 lesions showed enhancement in solid parts or cyst walls. Surgical decompression improved visual disturbance in half of the patients but rarely improved hormonal deficits. Follow-up (median, 47 months) found no recurrence of the lesion. In addition to these 9 cases, we found 2 xanthogranulomatous lesions pathologically associated with ciliated epithelia, which also presented with severe hypopituitarism. CONCLUSIONS: Xanthogranuloma seems to be the last stage of the chronic inflammation affecting Rathke cleft cyst or craniopharyngioma presenting with severe anterior pituitary insufficiency.


Assuntos
Granuloma/complicações , Granuloma/patologia , Hipopituitarismo/complicações , Neoplasias Hipofisárias/complicações , Sela Túrcica/patologia , Xantomatose/complicações , Xantomatose/patologia , Adulto , Idoso , Feminino , Granuloma/diagnóstico por imagem , Humanos , Hipopituitarismo/diagnóstico , Hipopituitarismo/patologia , Masculino , Pessoa de Meia-Idade , Adeno-Hipófise/diagnóstico por imagem , Adeno-Hipófise/patologia , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/patologia , Estudos Retrospectivos , Sela Túrcica/diagnóstico por imagem , Xantomatose/diagnóstico por imagem
10.
Endocr Pathol ; 30(2): 81-89, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30903445

RESUMO

Although most pituitary neuroendocrine tumors (PitNETs) show benign behavior, a significant number of PitNETs exhibit an aggressive course including cavernous sinus (CS) invasion. To date, the cause of CS invasion has not been fully elucidated. In this study, we analyzed the relationship between CS invasion in PitNETs and the expression of PITX2 and SNAIL1, which are the transcription factors associated with the morphogenesis of pituitary gland. Sixty cases with non-functional PitNETs were classified into four types: type 1a, none of CS invasion and suprasellar expansion; type 1b, suprasellar expansion without CS invasion; type 2a, CS invasion without suprasellar expansion; and type 2b, CS invasion with suprasellar expansion. We analyzed the expression of PITX2 and SNAIL1 employing quantitative real-time polymerase chain reaction (qPCR) and immunohistochemistry. Other parameters such as mitotic count, Ki-67 index, and p53 expression were also analyzed, which were previously reported as potential tumor proliferative markers in PitNETs. PITX2 expression was significantly higher in PitNETs with CS invasion than PitNETs without CS invasion (P = 0.019). Expression of SNAIL1 was significantly elevated in PitNETs with suprasellar expansion compared with PitNETs without suprasellar expansion (P = 0.02). There was no apparent relationship between CS invasion and mitotic count, Ki-67 index, and p53 expression (mitotic count, P = 0.11; Ki-67 index, P = 0.61; p53, P = 0.66). High PITX2 expression was observed in non-functional PitNETs with CS invasion, suggesting that PITX2 may be involved in CS invasion of PitNETs.


Assuntos
Seio Cavernoso/patologia , Proteínas de Homeodomínio/genética , Tumores Neuroendócrinos/genética , Neoplasias Hipofisárias/genética , Fatores de Transcrição/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Biomarcadores Tumorais/genética , Feminino , Proteínas de Homeodomínio/análise , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/patologia , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/patologia , Reação em Cadeia da Polimerase , Sela Túrcica/patologia , Fatores de Transcrição da Família Snail/análise , Fatores de Transcrição da Família Snail/genética , Fatores de Transcrição/análise
12.
J Neurooncol ; 142(3): 545-555, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30796744

RESUMO

BACKGROUND: Approach selection paradigm for tuberculum sellae meningiomas (TSMs) is still a point of discussion. The trans-eyebrow supraorbital keyhole approach (TSKA) is a minimally invasive transcranial approach and has been used for the treatment of TSMs during recent years. In this study, we presented a series of 30 cases of TSMs treated via TSKA with a long-term follow-up. METHOD: Thirty patients with TSMs underwent surgery via TSKA between December 2006 and August 2018. The medical data and follow-up results were retrospectively analyzed. RESULTS: A total of 5 males and 25 females were included in this study. Three patients presented with recurrent TSMs. The mean tumor size was 25.3 ± 7.3 mm (range, 10-48 mm). The mean follow-up period was 58.0 months (interquartile range, 33.5-86.3 months). Gross total resection (GTR) was achieved in 27 patients (90.0%). One recurrence (3.3%) occurred 9 years after surgery. Out of 29 patients with preoperative visual impairment, 17 (58.6%) improved, eight (27.6%) remained stable, and four (13.8%) deteriorated. No peri-operative death, CSF rhinorrhea, or permanent endocrine dysfunction occurred. All patients exhibited satisfactory cosmetic results. At the last follow-up, the glasgow outcome scale score was five in 27 patients (90.0%). CONCLUSION: The TSKA is characterized by minimal invasion with a satisfactory cosmetic outcome. Based on the tumor characteristics and surgeon's experience, this approach can be employed as an alternative minimally invasive approach for the treatment of TSMs.


Assuntos
Testa/cirurgia , Neoplasias Meníngeas/cirurgia , Meningioma/cirurgia , Recidiva Local de Neoplasia/patologia , Sela Túrcica/cirurgia , Neoplasias da Base do Crânio/cirurgia , Acuidade Visual , Adulto , Idoso , Craniotomia , Feminino , Seguimentos , Testa/patologia , Humanos , Masculino , Neoplasias Meníngeas/patologia , Meningioma/patologia , Pessoa de Meia-Idade , Órbita , Prognóstico , Estudos Retrospectivos , Sela Túrcica/patologia , Neoplasias da Base do Crânio/patologia
13.
Curr Pain Headache Rep ; 23(1): 7, 2019 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-30712067

RESUMO

PURPOSE OF REVIEW: Sellar and parasellar lesions are numerous and varying in terms of their patholphysiology and physical and radiographic characteristics but often incite pain syndromes that are similar in semiology. The goal of this review was to familiarize the reader with a variety of sellar and parasellar lesions grouped together based on common clinical symptomatology, with a focus on important imaging characteristics that are often distinguishing features diagnostically. RECENT FINDINGS: In most cases, tissue acquisition via surgical resection or stereotactic biopsy are the mainstay for definitive diagnosis of sellar and parasellar lesions. With advances in MRI technology in particular in terms of resolution and the inclusion of new techniques including dynamic imaging with delayed contrast, imaging studies of lesions in the sellar and parasellar regions have become increasingly important for diagnostic purposes, with pituitary adenomas and schwannomas as prime examples. In the case of chordoid gliomas, molecular features of the tumor also help distinguish it from other disease processes similar in presentation, which have dramatic impacts on management. Advances in surgical approaches and radiation techniques offer more precise and targeted therapy to lesions in an area with increased risk of clinical morbidity given the high concentration of critically important structures that must be spared during treatment. Sellar and parasellar lesions have the potential to cause significant morbidity and mortality, highlighting the importance of clinical recognition of warning signs/symptoms, obtaining high-quality imaging studies in various modalities for diagnostic purposes, and prompt management which often involves a multimodal approach that includes surgical resection, radiation, and/or medical therapy. Future advanced imaging techniques will only improve presurgical diagnostic accuracy and lead to more prompt and efficient management.


Assuntos
Imagem por Ressonância Magnética , Dor/diagnóstico por imagem , Dor/patologia , Hipófise/patologia , Neoplasias Hipofisárias/patologia , Sela Túrcica/patologia , Neoplasias Cranianas/patologia , Diagnóstico Diferencial , Humanos , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Cranianas/diagnóstico por imagem , Síndrome
14.
World Neurosurg ; 122: e130-e138, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30266706

RESUMO

OBJECTIVE: Pituitary macroadenomas extend into the extrasellar space, such as the sphenoid sinus, cavernous sinuses, and suprasellar region. However, factors that regulate the direction of their extensions into the surrounding anatomical structures remain unknown. METHODS: This retrospective study included 162 patients who were treated for pituitary adenomas that had maximum diameters greater than 20 mm. According to the direction of adenoma extension, patients were divided into 4 groups: group A, inferior into the sphenoid sinus; group B, lateral into the cavernous sinus; group C, suprasellar region with enlarged sella turcica; and group D, supraellar region without enlarged sella turcica. Several anatomical structures surrounding the sella turcica were evaluated statistically, and multivariate logistic regression analysis was performed if the structures met the determining factors of adenomas extensions. RESULTS: The maximum diameter of adenomas was significantly larger in groups A and D. The maximum diameter of the diaphragmatic foramen was largest in group C (19.3 mm) and was significantly narrower in groups B (12.7 mm) and D (12.5 mm). Intrasphenoid septation, attached on the midline of the sella turcica, was observed most frequently in group D (78.6%) and was not detectable in group A (0%). Extension into the cavernous sinus, classified as dural discontinuity, was highly prevalent in group B (80.0%) and was uncommon in group C (12.3%). Erosion of the posterior clinoid process was most apparent in group B (92.0%). CONCLUSIONS: The integrity of the sella dura and the intrasphenoid septation can regulate adenoma extension by encouraging their growth towards paths of least resistance.


Assuntos
Adenoma/diagnóstico por imagem , Dura-Máter/diagnóstico por imagem , Neoplasias Hipofisárias/diagnóstico por imagem , Adenoma/patologia , Adenoma/fisiopatologia , Progressão da Doença , Dura-Máter/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/patologia , Neoplasias Hipofisárias/fisiopatologia , Estudos Retrospectivos , Sela Túrcica/diagnóstico por imagem , Sela Túrcica/patologia , Carga Tumoral
15.
Folia Morphol (Warsz) ; 78(3): 517-523, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30444524

RESUMO

BACKGROUND: The aim of the study was to assess the dimensions and volume of sella turcica in healthy Caucasian adults with normal occlusion and facial appearance from cone-beam computed tomography (CBCT) images. MATERIALS AND METHODS: CBCT images of 80 Caucasian adult patients (40 males, 40 females) with normal facial appearance and occlusion taken previously for diagnostic purposes were evaluated. Two groups were constructed in accordance to gender. The volume, length, diameter, and depth of the sella turcica were measured by Romexis software programme. Mann-Whitney U test and Independent t-tests were used for statistical analysis. RESULTS: The mean lengths of the sella were 9.9 mm and 10.2 mm, depths were 9.2 mm and 8.8 mm and diameters were 12.3 mm and 12.1 mm in female and male groups, respectively. Between the genders, no statistically significant differences were found for any of the measurements. There were significantly higher values for the volume of sella turcica in males than in females (1102 ± 285.3 mm3 and 951.3 ± 278.5 mm3, respectively). CONCLUSIONS: The dimensions of sella turcica in healthy Caucasian adults with normal occlusion and facial appearance revealed nonsignificant differences between the genders. Individual variability in dimensions and gender differences in the volume are of importance in comparison of patients with craniofacial syndromes and aberrations. Knowledge concerning the dimensions and volume of sella turcica will be clinically relevant for a guidance to consciously realize pituitary disorders.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Imagem Tridimensional , Doenças da Hipófise/patologia , Sela Túrcica/diagnóstico por imagem , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Padrões de Referência , Sela Túrcica/patologia
16.
World Neurosurg ; 122: e1181-e1194, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30447442

RESUMO

OBJECTIVE: The purpose of this study was to analyze the outcomes of cavernous sinus hemangiomas (CSHs) treated surgically, and to investigate factors that affect the gross total resection (GTR), newly developed or deteriorated cranial nerve injury (NDDCNI), and follow-up neurologic performance, and to further discuss the optimal treatment for CSHs. METHODS: Clinical data of 47 patients with CSHs treated surgically at our institution between 2012-2018 were retrospectively reviewed. RESULTS: GTR was achieved in 26 (55.3%) patients. Significant relations were identified between the invasion of the sella turcica (odds ratio [OR] = 0.012; 95% confidence interval [CI], 0.001-0.213; P = 0.002), skull base ward (OR = 27.838; 95% CI, 2.995-258.748; P = 0.003), and GTR. The preoperative Karnofsky Performance Scale (KPS) score (OR = 2.966, per 10 score increase; 95% CI, 1.136-7.743; P = 0.026) and the invasion of the sella turcica (OR = 7.137; 95% CI, 1.282-39.726; P = 0.025) were factors that significantly affected the incidence of NDDCNI. The average follow-up KPS score, which increased significantly compared with the pre (P < 0.001) and postoperative KPS scores (P < 0.001), was 89.1. Increased tumor size (OR = 0.044, per 1cm increase; 95% CI, 0.004-0.477; P = 0.010) was a risk factor for unfavorable follow-up KPS score. CONCLUSIONS: Being treated by an experienced skull base surgeon favors the total removal of CSHs, whereas the invasion of the sella turcica does just the opposite. Increased tumor size is a risk factor for unfavorable follow-up KPS score. The invasion of the sella turcica was related to NDDCNI and unfavorable follow-up KPS score.


Assuntos
Neoplasias Encefálicas/cirurgia , Seio Cavernoso/cirurgia , Hemangioma Cavernoso/cirurgia , Neoplasias Meníngeas/cirurgia , Adulto , Idoso , Seio Cavernoso/patologia , Feminino , Hemangioma Cavernoso/patologia , Humanos , Masculino , Neoplasias Meníngeas/patologia , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos , Fatores de Risco , Sela Túrcica/patologia , Base do Crânio/patologia , Resultado do Tratamento , Adulto Jovem
17.
Am J Clin Pathol ; 151(3): 241-254, 2019 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-30551183

RESUMO

Objectives: The list of tumors involving the pituitary gland has been expanded to include a variety of neuronal and paraneuronal tumors in the 2017 World Health Organization tumor classification of endocrine organs. All the entities included in this category are distinctly rare, with limited case reports in the literature. Methods: We illustrate two extraordinary sellar tumors with neuronal differentiation: a sellar paraganglioma and a sellar neurocytoma, with thorough literature review and comparison of the clinicopathologic features of these entities. Results: Both entities are exceptionally rare and tend to be misdiagnosed as pituitary adenoma preoperatively. Both entities demonstrate frequent clinical recurrence compared with pituitary adenoma, as well as the rare occurrence of metastatic disease. Conclusions: In evaluating a sellar tumor with an uncommon morphology and neuroendocrine differentiation, an increased awareness of the unusual entities that may involve the sellar region and a judicious panel of immunohistochemical studies should improve the diagnosis.


Assuntos
Adenoma/patologia , Tumores Neuroendócrinos/patologia , Paraganglioma/patologia , Neoplasias Hipofisárias/patologia , Adenoma/classificação , Adenoma/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Tumores Neuroendócrinos/classificação , Tumores Neuroendócrinos/diagnóstico por imagem , Paraganglioma/classificação , Paraganglioma/diagnóstico por imagem , Neoplasias Hipofisárias/classificação , Neoplasias Hipofisárias/diagnóstico por imagem , Sela Túrcica/diagnóstico por imagem , Sela Túrcica/patologia , Organização Mundial da Saúde
18.
J Forensic Leg Med ; 61: 89-91, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30503990

RESUMO

The incidence of sudden death caused by undiagnosed primary intracranial neoplasm in young adults is extremely low. The aim of the work is to present a case report of the sudden death of a 24-year-old woman. The autopsy has revealed enlargement of sella turcica with an intrasellar tumorous mass extending into the adjacent basal parts of the brain. A tumour was diagnosed as an extramedullary plasmacytoma. The cause of death was established as a failure of the central nervous system. Toxicological analyses of biological materials were negative. According to the case history, a woman reportedly had no serious health problems. Finding of an extensive intracranial tumour in the sella turcica was random and surprising. The presented case is an extremely rare case of sudden death caused by intracranial intrasellar extramedullary plasmacytoma without previous clinical manifestation.


Assuntos
Morte Súbita/etiologia , Neoplasias Hipofisárias/patologia , Plasmocitoma/patologia , Sela Túrcica/patologia , Feminino , Humanos , Adulto Jovem
19.
G Chir ; 34(5): 272-275, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30444475

RESUMO

We present here the hypothesis of doping in an athlete coming back from the ancient Greece, dating back to V century B.C. There are some bone alterations due to the sports that he probably practiced, and that are represented on the amphorae (prices of his victories) found near his sepulchre. The skeleton shows a considerable mass and bone density. The chemical analyses performed on the bone emphasized the presence of arsenic, while the X-ray and CAT scan examinations revealed a quite big sella turcica. These two aspects might have influenced the performances of this athlete, and in the same time might have provoked his death at the age of about 30 years.


Assuntos
Arsênico/análise , Atletas/história , Doping nos Esportes/história , Substâncias para Melhoria do Desempenho/análise , Adulto , Animais , Densidade Óssea/efeitos dos fármacos , Dieta , Fêmur/química , Grécia Antiga , História Antiga , Humanos , Itália , Masculino , Metais/análise , Mortalidade Prematura , Substâncias para Melhoria do Desempenho/efeitos adversos , Alimentos Marinhos/análise , Sela Túrcica/química , Sela Túrcica/patologia , Tíbia/química
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA