The clinical and endocrine outcome to trans-sphenoidal microsurgery of nonsecreting pituitary adenomas
Article Abstract:
The majority of tumors of the pituitary gland, around 60 to 75 percent, are adenomas of the anterior pituitary. These benign tumors commonly secrete large amounts of some anterior pituitary hormone, and it is often the metabolic effects of these hormones which cause the tumor to be recognized and treated. Almost 18 percent of pituitary adenomas do not secrete a hormone. These tumors are generally recognized only after they grow past the confines of the pituitary fossa (the cavity housing the pituitary gland) and begin to push upon the base of the brain. Because the pituitary gland is located immediately beneath the optic nerves and optic tract into the brain, visual disturbances are not uncommon signs of nonsecreting pituitary adenoma. A review was conducted of 126 cases of nonsecreting pituitary adenoma. All cases were operated on by trans-sphenoidal microsurgery. The sphenoid bone is part of the base of the skull, and can be reached in the far back of the nasal cavity. It is possible to enter the skull in this fashion and remove the tumor tissue. In 94 of 126 cases, the patient suffered visual symptoms prior to treatment. In 75 percent of these cases, vision either improved or returned to normal after surgery. Abnormalities in other glands such as the thyroid and adrenal, as well as in function of the gonads, were found in many cases as a result of the damage to the pituitary. The majority of these changes were not affected by surgery, and a small fraction of patients either worsened or improved after surgery. Two patients developed diabetes insipidus after surgery. In this condition, the regulation of body water is compromised and the patient constantly excretes dilute urine rather than conserving water. Among the 71 patients who received only surgical treatment, the recurrence rate was 21 percent after an average follow-up of 6.4 years. Seven of the 15 recurrent patients has second recurrences, suggesting that some tumors are prone to recurrence. Recurrence rates may be reduced by the use of radiation therapy, but irradiation of this portion of the head is also likely to result in side effects. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1991
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Survival after pancreas transplantation in patients with diabetes and preserved kidney function
Article Abstract:
People with diabetes who receive a pancreas transplant may actually be worse off than those who do not, according to a study of 11,572 diabetes patients who were on a pancreas transplant waiting list. Those who got a transplant were 57% more likely to die from any cause over a four-year period, compared to those who did not get a transplant. All of these patients had no kidney disease at the time the study was done.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 2003
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