Cases reported "Amenorrhea"

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1/59. Large empty sella with an intrasellar herniation of an elongated third ventricle. Case report.

    A 73-year-old female presented with a large empty sella with herniation of an elongated third ventricle concomitant with herniation of the surrounding subarachnoid space into the sella, manifesting as visual impairment and amenorrhea without galactorrhea. magnetic resonance imaging and computed tomography cisternography clearly showed the large empty sella, without evidence of either hydrocephalus or benign intracranial hypertension, which is extremely rare.
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ranking = 1
keywords = sella
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2/59. Nonfunctioning pituitary macroadenoma presenting with mild hyperprolactinemia and amenorrhea.

    OBJECTIVE: To describe a patient with a clinically nonfunctioning pituitary macroadenoma who presented with mild hyperprolactinemia and amenorrhea. DESIGN: Case report. SETTING: Tertiary care medical facility. PATIENT(S): A 44-year-old woman with a 6-month history of amenorrhea. INTERVENTION(S): Pituitary testing, magnetic resonance imaging of the sella turcica, and transsphenoidal surgery. MAIN OUTCOME MEASURE(S): Pituitary function testing, magnetic resonance imaging, and return of menstrual cycles. RESULT(S): Baseline laboratory data revealed a serum prolactin level of 34 ng/mL (normal range, 3-20 ng/mL), normal thyroid function test results, and an FSH level of 6.7 mIU/mL. A second fasting prolactin level was 48 ng/mL. magnetic resonance imaging of the sella turcica revealed a pituitary macroadenoma measuring 1.4 x 3.2 cm. Further testing of baseline pituitary function revealed normal findings. The patient underwent an uncomplicated transsphenoidal resection of the pituitary tumor and maintained normal pituitary function. Pathologic evaluation revealed a pituitary adenoma that stained positive for FSH and focally for the alpha subunit. The adenoma stained negative for GH, prolactin, ACTH, LH, and TSH. CONCLUSION(S): This patient had a nonsecreting gonadotroph macroadenoma that resulted in hypogonadotropic hypogonadism along with mild hyperprolactinemia, presumably secondary to interruption of normal transport down the pituitary stalk.
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ranking = 1.5771665192854
keywords = sella turcica, turcica, sella
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3/59. Spontaneous regression of a cyst of the cavum septi pellucidi.

    A 20-year-old woman with secondary amenorrhoea and an empty sella turcica was found to have a cyst of the cavum septi pellucidi (CSP) on MRI. The cyst had regressed spontaneously on follow-up MRI.
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ranking = 0.78858325964272
keywords = sella turcica, turcica, sella
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4/59. Treatment of prolactin-secreting pituitary tumours in young women by needle implantation of radioactive yttrium.

    Twenty-one young female patients are described who presented with amenorrhoea, galactorrhoea or infertility, and were treated by 90Y pituitary implantation of 20,000 rads. There was no morbidity. In all patients serum prolactin values were elevated and radiographs of the pituitary fossa were abnormal. Observations are available for 1--76 months (mean 27) after implantation. The median fall in prolactin values was 60 per cent while there was no deterioration in pituitary function if normal pre-operatively. luteinizing hormone values, both basally and following gonadotrophin-releasing hormone, rose to normal after operation; several instances of sellar remodelling were observed radiologically, and no instance of relapse was found radiologically, biochemically or clinically. Thirteen patients desiring fertility have been observed since implantation; so far nine have become pregnant, in three instances without any additional therapy; since four patients became pregnant twice, a total of 13 pregnancies have occurred. No case of tumour expansion was observed during pregnancy. 90Y implantation can be considered as a therapeutic procedure in young female patients requiring fertility which is competitive with surgical methods, and together with a short course of bromocriptine if needed, could prove to be the treatment of choice.
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ranking = 0.090909090909091
keywords = sella
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5/59. Spontaneous remission in idiopathic hyperprolactinemia.

    In this report we describe a 37 year old lady who was demonstrated to have hyperprolactinemia causing amenorrhea-galactorrhea syndrome. Computerized tomography scan done twice did not reveal any sellar or suprasellar abnormality and there was no clinical or biochemical evidence of primary hypothyroidism. She had regression of galactorrhea, resumed regular menstrual cycles, and conceived twice on bromocriptine therapy. Following her second delivery she noticed spontaneous remission of galactorrhea and, prolactin levels estimated multiple times were normal.
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ranking = 0.18181818181818
keywords = sella
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6/59. Pituitary function testing in amenorrhea-galactorrhea-hyperprolactinemia.

    Fifteen patients, age 16 to 55, presented with amenorrhea-galactorrhea-hyperprolactinemia. Pituitary function was evaluated by bolus injections of insulin, luteinizing hormone-releasing hormone (LHRH), and thyrotropin-releasing hormone (TRH) in 13 and by LHRH and TRH in 2. Responses to growth hormone (GH), thyroid-stimulating hormone (TSH), cortisol (F), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin were measured. GH, TSH, and F responses were normal in most cases. LH responses were decreased (P less than 0.025) in patients with abnormal sellar tomography, whereas FSH responses tended to decrease with elevated prolactin levels. Prolactin responses were absent in five of the seven cases which could be evaluated. The clinical value of such testing appears to be limited to an individualized basis, although some prognosis of ovulatory response to bromocriptine therapy may be obtained from the gonadotropin response.
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ranking = 0.090909090909091
keywords = sella
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7/59. Primary empty sella syndrome and amenorrhea.

    The empty sella syndrome is defined anatomically and radiologically. A case report of an amenorrheic patient who was diagnosed as having the primary empty sella syndrome is presented. Its pathogenesis, clinical profile, and endocrine relationships are discussed. Specific reference is directed toward the capability of the empty sella syndrome to produce pituitary impairment and possibly amenorrhea.
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ranking = 0.63636363636364
keywords = sella
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8/59. Multiple intracranial seeding of craniopharyngioma after repeated surgery--case report.

    A 17-year-old woman presented with a rare case of intracranial seeding of craniopharyngioma after repeated surgery. She initially presented with secondary amenorrhea and visual impairment. magnetic resonance imaging revealed a suprasellar mass. Subtotal removal of the tumor was performed. The diagnosis was adamantinomatous craniopharyngioma. Seven months later, the patient underwent a second operation for recurrence of the craniopharyngioma. Subsequently, ventriculoperitoneal (VP) shunting and gamma knife surgery were performed. Twenty-seven months after the first operation, multiple cystic lesions were found in the right frontal and temporal lobes. Positive tumor cytology was observed in the cerebrospinal fluid obtained from the VP shunt chamber. These tumors were subtotally resected. However, the patient died from consecutive tumor recurrence 4 years after the initial diagnosis.
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ranking = 0.090909090909091
keywords = sella
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9/59. Coexistence of a cerebellopontine epidermoid cyst with a pituitary adenoma.

    We report on an 18-year-old girl with the coexistence of an epidermoid cyst in the cerebellopontine angle (CPA) with a pituitary adenoma. The clinical course and histopathological characteristics were reviewed. The patient presented with headache, vision loss and amenorea. Computerised tomographic (CT) scan and magnetic resonance imaging (MRI) examinations demonstrated a solid sellar lesion with supra-sellar extension. There was another mass lesion in the CPA with prepontine extension. The tumours were removed surgically. Histopathological examination revealed an epidermoid cyst in the prepontine area and a pituitary adenoma in the sellar region. This has been the second case to be reported in the literature with the coexistence of an epidermoid cyst and a pituitary adenoma.
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ranking = 0.27272727272727
keywords = sella
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10/59. Primary amenorrhea-galactorrhea with hyperprolactinemia and huge pituitary enlargement in juvenile primary hypothyroidism.

    We report a girl with juvenile primary hypothyroidism revealed by growth retardation and a syndrome of primary amenorrhea-galactorrhea with hyperprolactinemia and suprasellar pituitary enlargement. Resolution of the pituitary enlargement and the amenorrhea-galactorrhea syndrome occurred after thyroid hormone replacement. No similar observation has been reported earlier in juvenile hypothyroidism.
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ranking = 0.090909090909091
keywords = sella
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