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Suprasellar Tumor
Cns Suprasellar Tumor

Presentation

However, all 13 cases of the pathologically documented SCO presented as combined intra- and suprasellar lesions. Thus it is unlikely that a lesion presenting as a purely intra- or suprasellar mass on imaging is a SCO. [ajnr.org]

Though most suprasellar GCTs conform to these findings, a few reports of mixed GCTs presenting with oculomotor or abducens palsy have been reported. [4], [5], [6], [7] Our report adds two more cases to such unusual clinical presentation. [neurologyindia.com]

Eleven patients (47.8%) presenting with bifocal GCTs exhibited tumor seeding at presentation. Tumor seeding was significantly associated with bifocal lesions (p < 0.001). [neurosurgery-blog.com]

This unusual presentation is discussed and plausible hypotheses are given. [ncbi.nlm.nih.gov]

Entire Body System

  • Weakness

    Physical examination revealed decreased consciousness with the Glasgow coma scale score of 12 (E3M5V4) accompanied by weakness on left extremities with motor strength score of 4. Other physical examinations were found within normal limit. [asianjns.org]

    Primary empty sella syndrome occurs in people who have a weakness in the membrane (diaphragma sellae) that normally covers the pituitary gland. Cerebrospinal fluid is the fluid that flows around the brain. [xtarh.com]

    Pituitary tumors may damage healthy hormone-producing cells, causing a lack of certain hormones and symptoms including fatigue, weakness, growth problems, and disruption of sexual processes. [columbianeurosurgery.org]

    Depending on the meningioma’s size and location, common symptoms may include: Headaches Seizures Blurred vision Weakness in your arms or legs Numbness Other, less common symptoms include: Loss of balance Hearing loss Memory loss The Johns Hopkins Brain [hopkinsmedicine.org]

  • Fatigue

    Patient 2 – A 49-year-old woman was admitted to hospital because of intensive headache, fatigue, vertigo and visual deficit. Magnetic resonance showed an expansive process within sellar region extending to the adjacent cavernous sinus. [bib.irb.hr]

    […] surgery or trauma Past Medical History: Hypothyroidism Medications: Levothyroxine Family History: Negative for cancer or ocular disease Social History: Machinist, longtime smoker Review of Systems: Negative, including no weight change, mood change, fatigue [webeye.ophth.uiowa.edu]

    Pituitary tumors may damage healthy hormone-producing cells, causing a lack of certain hormones and symptoms including fatigue, weakness, growth problems, and disruption of sexual processes. [columbianeurosurgery.org]

    This frequently results in one or more of the following: growth failure, delayed puberty, loss of normal menstrual function or sexual desire, increased sensitivity to cold, fatigue, constipation, dry skin, nausea, low blood pressure, and depression. [pituitary.org]

    For GCT, the next most common symptoms were headache (21/64), amenorrhea (12/64), fatigue (8/64), and memory loss (7/64). Table 3: Presenting symptoms for pituicytoma, SCO, and GCT DI was especially uncommon with these tumors. [ajnr.org]

  • Swelling

    Fluid causes brain tissue to swell, limiting blood supply to the brain. As a result, oxygen deprivation and swelling occur. Custom Price Range: $1,300 - $1,600 Request a Quote [anatomicaljustice.com]

    Swelling of the pituitary stalk. 221 MRI showed swelling of the pituitary stalk and of the right side of the pituitary gland 222 MRI showed a big dumbbell shaped mass in the sellar and suprasellar regions. [pathology.jhu.edu]

    Observation over a period of time may be the appropriate course of action in patients who meet the following criteria: Patients with few symptoms and little or no swelling in the adjacent brain areas Patients with mild or minimal symptoms who have a long [aans.org]

    In rare cases, individuals with empty sella syndrome have developed increased pressure within the skull (benign intracranial pressure), leakage of cerebrospinal fluid from the nose (cerebrospinal rhinnorhea), swelling of the optic disc due to increased [rarediseases.org]

  • Disability

    Please enable JS and disable any ad blocker [cancernetwork.com]

    Chytil, 1967 [ 12 ] 46, male Visual loss, hypopituitarism Sellar/suprasellar Resection + RT No progression Bilbao et al., 1978 [ 13 ] 37, male Delayed growth Sellar Resection - Ho et al., 1982 [ 14 ] 65, male Diplopia Cavernous sinus Resection Moderate disability [nnjournal.net]

    Although the majority of meningiomas are benign, these tumors can grow slowly until they are very large, if left undiscovered, and, in some locations, can be severely disabling and life-threatening. Other forms of meningioma may be more aggressive. [aans.org]

    43% and 40% to 100%, respectively, and a worse outcome of secondary surgery. 9, 10, 12 – 16, 59 – 63 The authors advocating conservative surgery and subsequent radiotherapy stress lower incidence of endocrine deficit, hypothalamic insufficiency, major disability [clinicalgate.com]

Respiratoric

  • Hyposmia

    Neurological complaints, such as mild mental or motor dysfunction, vertigo, epileptic attack, hyposmia, were present in a much lower degree (from 2.3 to 9.3% of patients) in addition to oculomotor paresis with subjective complaints of diplopia and proptosis [go.galegroup.com]

  • Anosmia

    Anosmia after anterior communicating artery aneurysm surgery: Comparison between the anterior interhemispheric and basal interhemispheric approaches. Neurosurgery 1996;38:325-8. [ PUBMED ] 4. Suzuki J, Katakura R, Mori T. [neurologyindia.com]

Gastrointestinal

  • Failure to Thrive

    Growth failure may result from a variety of causes. [fdocuments.net]

    A JPA in the hypothalamic region may be associated with weight gain or loss, premature puberty or diencephalic syndrome, which is characterized by failure to thrive, abnormal thinness, irritability, and eye abnormalities. [rarediseases.org]

    […] to thrive, developmental delay, altered level of consciousness, vomiting, feeding difficulties, and generalized weakness. [7],[9],[11],[14] Several studies revealed patients with decreased visual field and acuity while others reported the presence of [asianjns.org]

    A child with diencephalic syndrome may present with a history of failure to thrive, vomiting, and emaciation. However, diabetes insipidus (DI) is not usually a feature of this condition, and laboratory tests are usually normal. [pubs.rsna.org]

Skin

  • Ulcer

    […] immunomodulatory or immunosuppressive medications or surgery) ≤12 months prior to randomization Uncontrolled blood pressure despite medical treatment Impaired GI function or disease that may significantly alter the absorption of encorafenib or binimetinib (e.g., ulcerative [pole-cancerologie-bretagne.fr]

    _) Rodent ulcer (C44._) Pigmented basal cell carcinoma (C44._) 8110/0 Pilomatrixoma, NOS (C44._) Calcifying epithelioma of Malherbe (C44._) Pilomatricoma, NOS (C44._) 8091/3 Multifocal superficial basal cell carcinoma (C44._) Multicentric basal cell [doczz.net]

Eyes

  • Diplopia

    The ocular manifestations included visual loss in 59 (86%), eye pain in six (9%), diplopia in three (4%), and ptosis in one (1%) patient. [jmatonline.com]

    Diplopia indicated a possible tumor mass involving the cavernous sinus. [kjim.org]

    Within months of surgery, the patient’s diplopia and movement of her right eye improved. She had no other neurologic complaints. [barrowneuro.org]

    However, this effect is seen in any condition that causes delayed optic nerve conduction such as multiple sclerosis and retinal disorders.[25] Diplopia Diplopia may be due to a paretic diplopia from ocular motor cranial nerve (e.g., III, IV, VI) paresis [eyewiki.aao.org]

    Visual symptoms and signs include vision loss, diplopia, and multiple cranial nerve palsies secondary to rapid expansion of the tumor into the adjacent cavernous sinuses, with cranial nerve III the most commonly affected. [webeye.ophth.uiowa.edu]

  • Lacrimation

    Cyst of Lacrimal Gland (UMLS (NCI) C0271323) =Finding 291. Cysteine Protease Gene [Cysteine Protease Genes encode endopeptidases, inactivated by sulfhydryl reagents, that have a cysteine residue involved in the catalytic process. [medindex.am]

    Examples include: Patients with sarcoidosis may be noted to have a variety of skin rashes, ocular inflammation, and lacrimal gland enlargement. [endocrinologyadvisor.com]

    […] duct, NOS lacrimal duct, nasal lacrimal gland lacrimal sac lens, crystalline Meibomian gland muscle, extra-ocular nasal lacrimal duct nasolacrimal duct optic nerve orbit, NOS orbit, connective tissue orbit, soft tissue outer canthus palpebra retina retrobulbar [doczz.net]

  • Vertical Gaze Palsy

    This phenomenon is caused by involvement of midbrain structures adjacent to the pineal GCT and is characterised by vertical gaze palsy, nystagmus on convergence and pupillary dilation with poor reactiveness to light. [tandfonline.com]

  • Unilateral Proptosis

    Ewing's sarcoma of the orbit with intracranial extension: A rare cause of unilateral proptosis. J Pediatr Neurosci 2011;6:36-9. [Full text] 3. Weins AL, Hattab EM. The pathological spectrum of solid CNS metastases in the pediatric population. [ruralneuropractice.com]

Neurologic

  • Headache

    With pituicytomas, the next most common presenting symptoms were headache (10/35), hypopituitarism (9/35), fatigue (8/35), and decreased libido (7/35). For SCO, hypopituitarism was the next most common symptom (6/13) followed by headache (4/13). [ajnr.org]

    A 45-year-old man was seen for urgent evaluation of worsening headaches and loss of vision. He first noticed his symptoms 6 months before the onset of recurrent headaches with blurry and blank spots in his vision. [healio.com]

    Headaches associated with Rathke′s cleft cyst. Headache 2006;46:1580-6. 6. Billeci D, Marton E, Tripodi M, Orvieto E, Longatti P. Symptomatic Rathke′s cleft cysts: A radiological, surgical and pathological review. Pituitary 2004;7:131-7. 7. [mjdrdypu.org]

    Abstract A case report of ectopic pituitary gland in the suprasellar region of a normal 39-year-old woman with persistent headaches is presented. [ncbi.nlm.nih.gov]

  • Stroke

    Methods This was a prospective observational study, which included all patients with non-traumatic hemorrhagic stroke... [read.qxmd.com]

    Patients with severe asymptomatic carotid artery stenosis do not have a higher risk of stroke and mortality after coronary artery bypass surgery. Stroke. 2011;42:2810–2815. [ncbi.nlm.nih.gov]

  • Bitemporal Hemianopsia

    An examination of her visual fields revealed bitemporal hemianopsia. Her corrected visual acuity with eye glasses was insufficient. [semanticscholar.org]

    Physical examinations were normal except bitemporal hemianopsia revealed by ophthalmic examination. Preoperative neuroendocrine examinations showed a mild hyperprolactinemia of 72.3ng/ml (normal range, 2.8 ng/ml-29.2 ng/ml). [path.upmc.edu]

    His vision postoperatively showed a persistent bitemporal hemianopsia, but with significant improvement in visual acuity to 20/40 in the right eye and 20/20 in the left eye. [healio.com]

    […] and suprasellar ND Bitemporal hemianopsia + − Transsphenoidal 5 Whee, 11) 2002 39 M Intrasellar and suprasellar ND Bitemporal hemianopsia + − Transsphenoidal 6 Maatens, 5) 2003 33 F Intrasellar and suprasellar ND Left frontal headache, diminished visual [ncbi.nlm.nih.gov]

Workup

It is crucial to have a multidisciplinary team approach with baseline and follow up endocrine workup. [abstracts.eurospe.org]

[…] massive MRI: High signal intensity on T1 weighted images Heterogeneous enhancement Fluid levels consistent with cystic components CT: Better than MRI at showing calcifications Laboratory Same for both types of craniopharyngiomas Full pituitary endocrine workup [pathologyoutlines.com]

The clinical workup for CNS germ cell tumors includes examination of cerebrospinal fluid (CSF) and blood for markers of differentiation, specifically β-hCG and α-fetoprotein (AFP). [neupsykey.com]

Initial workup, including CT and MRI of the brain is shown (Fig. 1). [jaocr.org]

Dynamic pituitary MRI has high sensitivity and specificity for the diagnosis of mild Cushing's syndrome and should be part of theinitial workup. Horm Metab Res. 2007;39(6):451-456. Simonetta AB. Imaging of suprasellar and parasellar tumors. [appliedradiology.com]

Serum

  • Hyperprolactinemia

    Suprasellar tumors in this pars tuberalis region are frequently accompanied by hyperprolactinemia. As these tumors do not immunoreact for any of the established pituitary hormones, they are classified as nonsecretory. [ncbi.nlm.nih.gov]

    2012/16/6/1052/103043 Sir, We report a case of suprasellar mass with visual compromise, hypogonadism and hyperprolactinemia, where weekly visual perimetry after dopamine agonist (cabergoline) therapy helped to differentiate between pituitary adenoma [ijem.in]

    Preoperative neuroendocrine examinations showed a mild hyperprolactinemia of 72.3ng/ml (normal range, 2.8 ng/ml-29.2 ng/ml). [path.upmc.edu]

Treatment

It also includes classic radiographic presentations and treatment considerations for each lesion. © The Author(s) 2015. [ncbi.nlm.nih.gov]

However, treatment strategies of adult ATRT may be different from that of pediatric ATRT. [btrt.org]

Though many suprasellar lesions are relatively benign in pathology, treatment may be complicated by high surgical morbidity resulting from damage to the hypothalamic-pituitary axis. [pubmed.ncbi.nlm.nih.gov]

Is surgery the best path of treatment at this time? Thank you again for your support. M. Montoya, M.D. [endotext.org]

Prognosis

Although rare, pure suprasellar germinomas carry worse prognosis than other locations. [ncbi.nlm.nih.gov]

Treatment and prognosis In general, a biopsy is required as treatment and prognosis will vary with histology (whereas it is independent of location). [radiopaedia.org]

Key words: Prognosis; Visual Acuity; Meningioma; Optic Chiasm; Neurosurgical Procedures; Treatment Outcome; Recovery of Function Uvod. [go.gale.com]

Prognosis A prognosis is an estimate of the likely progress of a disease after a diagnosis, based on an average patient group. [braintumour.ca]

Prognosis is dependent upon the tumor type, the most common of which is a germinoma which has a peak incidence during pubescence. Prognosis for germinomas is generally good with a 10-year survival rate over 90% after radiation therapy. [jaocr.org]

Etiology

In 183 short chapters, the book provides the essentials clinicians need on symptoms/signs, diagnostic tests, and neurologic disorders of all etiologies. For this edition, Timothy A. [books.google.es]

Six major sections cover all topics related to epidemiology and etiology, molecular biology, clinical features and supportive care, imaging, neuroanatomy and neurosurgery, medical oncology and targeted therapies, and radiation oncology for adult and pediatric [books.google.ro]

A malignant etiology should be suspected if osteolysis is present. The presentation may be variable between an enlargement of the pituitary stalk or sellar and suprasellar tumor. [neurochirurgica.org]

LCH is a rare disease of uncertain etiology which typically presents in children under two years of age, is more common in boys, and may involve any organ system. [jaocr.org]

Epidemiology

This is the leading international professional reference text that also serves as a bench book, describing all aspects of the pathology of brain tumours - genetics, molecular biology, epidemiology, morphology, immunohistochemistry, diagnostic criteria [books.google.ro]

Epidemiology: · Average age: 32 years. · 28 women/15 men. [posterng.netkey.at]

We compared the clinical and epidemiological characteristics of bifocal GCTs with those of GCTs located solely in the suprasellar or pineal regions. [thejns.org]

Conclusion Pediatric meningioma is an uncommon and sometimes surprising diagnosis given its epidemiologic, histologic, and clinical features. [cnjournal.biomedcentral.com]

Pathophysiology

It addresses diagnosis, pathophysiology, management and prognosis and is written in a clear, concise style for quick, easy reference in the clinic. [books.google.es]

CNS, SIAD 31 2010 Cerebral salt wasting: pathophysiology, diagnosis, and treatment. --- 32 2010 Characterization of cerebral salt wasting after subarachnoid hemorrhage model induced by endovascular puncture. [allie.dbcls.jp]

SIADH is the biochemical manifestation of a wide variety of diseases, and the pathophysiology of SIADH is sometimes… CONTINUE READING Create an AI-powered research feed to stay up to date with new papers like this posted to ArXiv Figures, Tables, and [semanticscholar.org]

Pathophysiology Hematogenous metastases to this region most frequently go to the pituitary gland, infundibulum, and tuber cinereum, because these structures lie outside the blood-brain barrier. [radiologykey.com]

PATHOPHYSIOLOGY — With respect to pathophysiology, two issues need to be addressed: the mechanism of salt wasting and the mechanism of hyponatremia. The mechanism by which cerebral disease might lead to renal salt wasting is poorly understood. [docsity.com]

Prevention

Extreme caution was taken to avoid spillage of tumor cyst fluid into subarachnoid spaces, in order to prevent chemical meningitis. [neurologyindia.com]

Orbital inflammations Methysergide for prevention of headache Pseudotumor of the orbit and retroperitoneal fibrosis Multisystem fibrosis in alphalantitrypsin deficiency [semanticscholar.org]

The cerebral aqueduct is compressed, preventing CSF circulation and causing it to accumulate in the ventricles. The CSF migrates into the brain tissue as the pressure within the ventricles rises. [anatomicaljustice.com]

It failed to prevent the recurrence or progression of residual tumor in another 5 patients, occurring from 6 to 60 months after irradiation. [clinicalgate.com]

8055-8051-9 (Print) eISBN: 978-3-318-01300-9 (Online) Abstract The principles in the surgical management of sellar and suprasellar tumors are to relieve mass effect, normalize pituitary hypersecretion, preserve or restore normal pituitary function, prevent [karger.com]

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