1/90. Interesting radiologic findings in suprasellar mass lesions. Report of three cases.The authors report three quite rare lesions of the sellar/parasellar region. They are namely; pituitary abscess, cystic macroadenoma and osteochondroma. In none of the cases, the preoperative diagnostic priority was not same as the final histopathologic diagnosis. The radiologic findings of these pathologies are discussed with emphasis on differential diagnosis.- - - - - - - - - - ranking = 1keywords = suprasellar (Clic here for more details about this article) |
2/90. Rosai-Dorfman disease presenting as a pituitary tumour.A 45-year-old woman had pyrexia, headaches, collapse and hyponatraemia. Intracerebral abscess, bacterial meningitis and subarachnoid haemorrhage were excluded. She was given intravenous antibiotics and gradually recovered. One month later she was readmitted with diplopia, headache and vomiting. serum sodium was low (107 mmol/l) and a diagnosis of inappropriate ADH secretion was made. MRI scan showed a suprasellar tumour arising from the posterior pituitary gland. A skin rash gradually faded. serum cortisol, prolactin, gonadotrophins and thyroid hormone levels were low. A pituitary tumour was removed trans-sphenoidally, she had external pituitary radiotherapy, and replacement hydrocortisone and thyroxine. She was well for 12 months when she developed progressive weakness and numbness of both legs. Examination suggested spinal cord compression at the level of T2 where MRI scanning showed an intradural enhancing mass. This spinal tumour was removed and her neurological symptoms disappeared. Nine months after this she developed facial pain and nasal obstruction. CT scan showed tumour growth into the sphenoid sinus and nasal cavities. A right Cauldwell-Luc operation was done and residual tumour in the nasal passages was treated by fractionated external radiotherapy and prednisolone. Histological examination of the specimens from pituitary, spinal mass, and nasal sinuses showed Rosai-Dorfman disease, a rare entity characterized by histiocytic proliferation, emperipolesis (lymphophagocytosis) and lymphadenopathy. aged 48 she developed cranial diabetes insipidus. Although Rosai-Dorfman syndrome is rare, it is being reported with increasing frequency, and should be borne in mind as a possible cause of a pituitary tumour.- - - - - - - - - - ranking = 0.25keywords = suprasellar (Clic here for more details about this article) |
3/90. A rare case of pituitary hyperplasia with suprasellar extension due to primary myxoedema: case report.The development of pituitary tumours as a consequence of primary target organ failure is rare. We report here a rare case of pituitary hyperplasia with suprasellar extension due to primary myxoedema. This case presentation suggested the importance of detailed endocrine investigation and repeated magnetic resonance imaging for the differential diagnosis of pituitary enlargement to avoid unnecessary surgery.- - - - - - - - - - ranking = 1.25keywords = suprasellar (Clic here for more details about this article) |
4/90. Symptomatic Rathke's cleft cyst coexisting with central diabetes insipidus and hypophysitis: case report.We describe a 48-year-old female with acute onset of central diabetes insipidus followed by mild anterior pituitary dysfunction. magnetic resonance imaging (MRI) revealed enlargement of the hypophysis-infundibulum accompanied by a cystic component. She underwent a transsphenoidal exploration of the sella turcica. Histological examination showed foreign body type xanthogranulomatous inflammation in the neurohypophysis which might have been caused by rupture of a Rathke's cleft cyst. The MRI abnormalities and anterior pituitary dysfunction improved after a short course of corticosteroid administration, but the diabetes insipidus persisted. The histological findings in this case indicated the site of RCC rupture and the direction of the progression of RCC induced neurohypophysitis and adenohypophysitis.- - - - - - - - - - ranking = 4.0187447608091keywords = cleft cyst, cleft (Clic here for more details about this article) |
5/90. Pituitary adenoma with neuronal choristoma: a report of two rare cases.Two rare cases of pituitary adenoma with neuronal choristoma are described. Both patients were female and presented with features of acromegaly with elevated growth hormone and prolactin levels. Radiologically, both lesions were predominantly intrasellar in location with extension into suprasellar region, but hypothalamus was not involved. Histopathological examination revealed a mixture of chromophobe pituitary adenoma cells and neuronal cells. In both cases, the adenoma component was positive for growth hormone and prolactin. Interestingly, immunopositivity for alpha-subunit, cytokeratin and prolactin was seen in the adenoma and neuronal cells in one case. Our findings support the hypothesis that the neuronal cells possibly arise from adenoma cells as a result of metaplasia.- - - - - - - - - - ranking = 0.25keywords = suprasellar (Clic here for more details about this article) |
6/90. Sinus histiocytosis (Rosai-Dorfman disease) of the suprasellar region: MR imaging findings--a case report.Sinus histiocytosis with massive lymphadenopathy (SHML) is an uncommon disorder that typically manifests as systemic symptoms and lymphadenopathy. Extranodal, intracranial disease is uncommon. The authors report on a 15-year-old adolescent girl who had a suprasellar mass at magnetic resonance imaging. biopsy results demonstrated lymphophagocytosis consistent with a diagnosis of SHML. The clinical, radiologic, and histologic aspects of the disease are discussed.- - - - - - - - - - ranking = 1.25keywords = suprasellar (Clic here for more details about this article) |
7/90. Lymphocytic adenohypophysitis mimicking a pituitary macroadenoma.A 24-year-old woman developed headache and rapidly progressive visual disturbances during the last trimester of her first pregnancy. Magnetic resonance tomography (MRI) of the brain documented an intra- and suprasellar mass lesion. For preservation of vision, transsphenoidal microsurgical decompression was performed. Immediately postoperatively, visual acuity improved and hemianopia resolved. Histological examination yielded the diagnosis of primary lymphocytic adenohypophysitis. This is a rare inflammatory pituitary disease. There are no typical clinical, laboratory, or radiological findings that allow precise preoperative diagnosis. Even though this autoimmune disorder is principally steroid-responsive, an improvement of visual disturbances under steroid therapy cannot be predicted. Therefore, surgery is justified not only to establish the diagnosis, but also to restore vision by decompression of the optic nerves and the chiasm.- - - - - - - - - - ranking = 0.25keywords = suprasellar (Clic here for more details about this article) |
8/90. Rathke's cleft cyst associated with hypophysitis: MRI.We report a symptomatic Rathke's cleft cyst associated with hypophysitis in a 61-year-old woman. We demonstrate the MRI features and discuss the pathophysiology. To the best of our knowledge this is the first description of a Rathke's cleft cyst shrinking after high-dose steroid therapy.- - - - - - - - - - ranking = 4.822493712971keywords = cleft cyst, cleft (Clic here for more details about this article) |
9/90. diabetes insipidus in neurobrucellosis.brucellosis is an infection due to brucella species and is characterized by acute febrile illness, chilly sensations, sweats, weakness, generalized malaise, body aches and headache. The involvement of the nervous system is rare. A few cases have been reported with symptoms and sign of optic neuritis, meningoencephalitis, meningomyelitis and cranial nerve palsy. We report a case with culture proven neurobrucellosis who presented with diabetes insipidus along with systemic signs. neuroimaging revealed multiple lesions in brain parenchyma, including the suprasellar region. Both diabetes and suprasellar lesions improved markedly with specific antibiotic therapy.- - - - - - - - - - ranking = 0.50027405351744keywords = suprasellar, nervous system (Clic here for more details about this article) |
10/90. Lymphocytic hypophysitis masking a suprasellar germinoma in a 12-year-old girl--a case report.Case history, light and electron microscopic findings of a case of a lymphocytic hypophysitis in coincidence with a suprasellar germinoma in a 12-year-old girl are reported. The girl presented with a long time case history of diabetes insipidus and subsequent panhypopituitarism. Two years after the diagnosis of diabetes insipidus magnetic resonance imaging (MRI) showed a tumorous enlargement of the sellar content and pituitary stalk. A transnasal exploration was initially performed and revealed a lymphocytic hypophysitis. light microscopy showed a dense infiltration of mature lymphocytes and plasma cells in the interstitium of the anterior pituitary gland. The stalk area could not be exposed to exclude a germinoma. One year later the lesion relapsed despite dexamethason therapy and a second operation by another neurosurgeon had to be performed. light microscopy showed lymphocytic infiltrates, fibrosis and necrosis. The diagnosis was a lymphocytic hypophysitis again. Though transcranially exposed only pituitary tissue was removed. No infundibular mass became visible at surgery as shown by MRI. The girl developed five months later multiple cerebral lesions, which revealed to be a germinoma. Lymphocytic hypophysitis in children is very rare and a coincidence with a germinoma has not been described from histopathological aspect until now. The origin of the pituitary infiltration is discussed.- - - - - - - - - - ranking = 1.25keywords = suprasellar (Clic here for more details about this article) |
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