Pituitary Adenoma Research Paper

Two pt verifier name/dob confirmed. Informed the pt this a f/u call to address s/p/ pituitary Adenoma. Pt states that is doing much better but he occasional have a headache and stuffy nose. Discuss dc instructions medication, and f/u appt with the pt. Discuss s/s that would warrant the pt to seek medical attention immediately. Encourage the pt f/u with his PCM. During conversation pt request refill on his Synthroid. Informed the pt a courtesy 90 day supply was ordered. Again recommend that he f/u with his provider. Pt refused appt at this time, but states that he will call CAMO to schedule an appt. Pt agrees and verbalized

There are an immense number of surgical procedures a neurosurgeon has to perform. Neurosurgeons, examine, diagnose and surgically treat disorders of the nervous system. Some of the neurological diseases neurosurgeons treat is brain tumors, neurovascular diseases, cranial base diseases, and pediatric and developmental disorders. Some of the most extensive procedures a neurosurgeon has to perform are treating patients with intracranial tumors, and awake craniotomies (conscious during brain surgery). Despite all the procedures neurosurgeons have to treat; are the surgeries they are performing effective and maintained? Are the neurosurgical procedures up to date so that patients are invulnerable to life

Chordomas are considered rare neoplasms with an incidence of 0.08/100 000.(1) chordomas arise from remnant notochord cells found mainly within the clivus and sacrococcygeal regions . But also, can be found at any site along the vertebral column (2). The presentation of clival chordomas tend to be late, associated neurological impairment due to involvement of the lower cranial nerves (3). Clival chordomas are also challenging to treat due to their site , anterior to the brainstem, and their aggressive locally invasive nature (4,5) and they are radioresistant lesions . clival chordomas have relatively poor survival of 0.9 years without treatment (6). Extended open skull base approaches to the clival region are traditionally the mainstay for achieving gross total resection in chordoma. Extended subfrontal transbasal, anterior transfacial, and lateral transtemporal or far-lateral approaches have been described, as well as staged surgical approaches. (7-9) . These approaches to the anterior midline skull base often require extensive removal of skull base bone and brain retraction, and they put critical neurovascular structures between the operating surgeon and the pathology. With the advent and incorporation of the rigid endoscope into neurosurgical practice and the active collaboration between ENT surgeons and neurosurgeons, extended endonasal endoscopic approaches have become well-accepted, minimally invasive routes to the midline and paramedian skull base. The endoscopic

In her journal article, “Ostomies: Nursing Care and Management” (2016), Mary L. Schreiber addresses the importance of assessment, care, and patient education regarding ostomies of all types and locations. She begins by providing a scenario describing the effects of an unmanaged ostomy on a patient. These effects are pain, skin breakdown, possible infection, and disturbed body image and are all elaborated on throughout the article. Schreiber begins her teaching by explaining reasons or causes for ostomy placement, the parts included in the ostomy system, and the different types of ostomies and locations in which they are placed. Type and location of the stoma determines the consistency of drainage from the stoma site. There more distal the

Carcinoid tumors are a subset of neuroendocrine tumors and overall incidence of carcinoids in the United States is estimated at 5.25 cases per 100,000 population. The majority of carcinoid tumors arise within the gastrointestinal tract (58%), with the pulmonary system as the next most common site of origin (27%). The remainder (15%) arises from other or unknown locations1.

Berkow, R., Beers, M. H., & Fletcher, A. J. (1999). The Merck Manual of Medical Information. New York: Pocket Books.

Pituicytomas are rare, non-adenomatous tumors arising from the neurohypophysis that are classically comprised of banal spindle cells arranged in short fascicles or in a storiform pattern. More recently, pituicytomas have been found to express thyroid transcription factor-1 (TTF-1), a unifying feature of uncommon tumors arising from the posterior lobe of the pituitary gland that also include spindle cell oncocytoma and granular cell tumor of the sellar region. We describe a unique example of a twice recurrent pituicytoma received in consultation which exhibited an array of uncommon histomorphologic features. A recurrent heterogeneously enhancing 3 x 2 x 2 cm sellar tumor was transsphenoidally resected from a 68-year old male, status post two

Pheochromocytoma is an adrenal gland tissue tumor. (PubMed) This growth is a result of excessive release of catecholamine’s (hormones). Norepinephrine and epinephrine are the primary hormones secreted while some can produce dopamine. (Medscape) These increased chemicals in the body can influence the persons “heart rate, blood pressure and metabolism”. (PubMed) If not treated these tumors affect the cardiovascular system and can lead to the development of “life threatening hypertension”. (Medscape) These tumors can be seen as a single mass or multiple tumors and can appear unilateral or bilateral in the body. (PubMed) Thirty percent of pheochromocytoma cases are found to be heredity where ten genes have been linked to the condition. Ten percent of pheochromocytomas are malignant and the most common sites of metastasis include “liver, bone and lymph nodes”. (Medscape)

It is difficult to use term cure for these tumors. Even in long term follow-up late recurrences occur after initial remission with surgery (1). In fact, we should have been able to achieve cure after surgery for microadenomas.

Pheochromocytoma is a rare, usually benign tumor, that arises from certain cells known as chromaffin cells. Chromaffin cells produce hormones that are necessary for the body to function properly. In most cases, pheochromocytomas originate in the central portion of the adrenal gland, otherwise referred to as the adrenal medulla. The adrenal medulla is responsible for the normal production of adrenaline. Our body requires adrenaline in order to maintain blood pressure. In patients with pheochromocytoma, the adrenal gland releases hormones that can potentially cause persistent or episodic high blood pressure. Unfortunately, this can lead to severe or life-threatening damage to other body systems, especially the cardiovascular system if left untreated.

A pituitary tumor can cause loss of vision in one or both eyes depending on its size and shape. The pituitary gland sits in the pituitary sella, which is almost directly behind the eye. If the pituitary tumor gets large enough and grows laterally, it can push against the optic nerve and stop the message for getting to the cerebral cortex. An individual with a pituitary tumor will first notice notice dark, blurry, or dim vision. Sometimes it will only affect vision on one side, when it affects both sides of vision, it's pressing against the optic chiasm.

Pheochromocytoma is a term used to refer to rare and mostly benign catecholamine-secreting tumors arising from the chromaffin cells found in the adrenal medulla or in the paraganglia (i.e. extra-adrenal pheochromocytoma). Clinical presentation can be highly variable and can mimic other diseases, but the condition typically presents with hypertension, palpitations, severe headaches and sweating.

It is cancer that occurs in the adrenal glands when abnormal cells form in the gland or travel from another part of the body. It normally happens in the outer layer called the adrenal cortex. It forms as a tumor and can be either benign, which is not cancerous, or it can be cancerous. When it's a benign tumor, it is called benign adenomas. A cancerous tumor of the adrenal glands would be called an adrenal cortical carcinom. in 1886 Felix Frankel was the first person to say that someone had an adrenal tumor

Irradiation is indicated as treatment for a pituitary adenoma when the tumor is not reduced and hormone levels remain high even when surgery is performed and patients undergo medical treatment. Therefore irradiation is somewhat of a last resort and is only used when the tumor does not respond to the other forms of

Surgery on the pituitary gland and around the sellar region is of special interest to the neurosurgeon. The approach to the gland has evolved over the past 50 years and so has the role of steroids in the perioperative management of these patients. Being one of the organs that play a key role in the hormonal balance of an individual, the neurosurgeon should be particularly careful that all steps must be taken to optimise the hormonal status and also ensure there is no disruption in that balance postoperatively. For more than half a decade the meticulous administration of steroid perioperatively has become common place. Today, however, the old philosophies are being challenged and new philosophies pioneered creating a paradigm shift in the way we manage patient requiring an operation around the sellar region, in particular pituitary surgery.