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Sample records for adenoma pleomorfo gigante

  1. Gigantism caused by growth hormone secreting pituitary adenoma.

    Rhee, Noorisaem; Jeong, Kumi; Yang, Eun Mi; Kim, Chan Jong

    2014-06-01

    Gigantism indicates excessive secretion of growth hormones (GH) during childhood when open epiphyseal growth plates allow for excessive linear growth. Case one involved a 14.7-year-old boy presented with extreme tall stature. His random serum GH level was 38.4 ng/mL, and failure of GH suppression was noted during an oral glucose tolerance test (OGTT; nadir serum GH, 22.7 ng/mL). Magnetic resonance imaging (MRI) of the brain revealed a 12-mm-sized pituitary adenoma. Transsphenoidal surgery was performed and a pituitary adenoma displaying positive immunohistochemical staining for GH was reported. Pituitary MRI scan was performed 4 months after surgery and showed recurrence/residual tumor. Medical treatment with a long-acting somatostatin analogue for six months was unsuccessful. As a result, secondary surgery was performed. Three months after reoperation, the GH level was 0.2 ng/mL and insulin-like growth factor 1 was 205 ng/mL. Case two involved a 14.9-year-old boy, who was referred to our department for his tall stature. His basal GH level was 9.3 ng/mL, and failure of GH suppression was reported during OGTT (nadir GH, 9.0 ng/mL). Pituitary MRI showed a 6-mm-sized pituitary adenoma. Surgery was done and histopathological examination demonstrated a pituitary adenoma with positive staining for GH. Three months after surgery, the GH level was 0.2 ng/mL and nadir GH during OGTT was less than 0.1 ng/mL. Pituitary MRI scans showed no residual tumor. We present two cases of gigantism caused by a GH-secreting pituitary adenoma with clinical and microscopic findings.

  2. Spontaneous remission of acromegaly or gigantism due to subclinical apoplexy of pituitary growth hormone adenoma

    WANG Xian-ling; DOU Jing-tao; L(U) Zhao-hui; ZHONG Wen-wen; BA Jian-ming; JIN Du; LU Ju-ming; PAN Chang-yu; MU Yi-ming

    2011-01-01

    Background Subclinical apoplexy of pituitary functional adenoma can cause spontaneous remission of hormone hypersecretion.The typical presence of pituitary growth hormone (GH) adenoma is gigantism and/or acromegaly.We investigated the clinical characteristics of patients with spontaneous partial remission of acromegaly or gigantism due to subclinical apoplexy of GH adenoma.Methods Six patients with spontaneous remission of acromegaly or gigantism were enrolled.The clinical characteristics,endocrinological evaluation and imageological characteristics were retrospectively analyzed.Results In these cases,the initial clinical presences were diabetes mellitus or hypogonadism.No abrupt headache,vomiting,visual function impairment,or conscious disturbance had ever been complained of.The base levels of GH and insulin growth factor-1 (IGF-1) were normal or higher,but nadir GH levels were all still >1 μg/L in 75 g oral glucose tolerance test.Magnetic resonance imaging detected enlarged sella,partial empty sella and compressed pituitary.The transsphenoidal surgery was performed in 2 cases,and the other patients were conservatively managed.All the patients were in clinical remission.Conclusions When the clinical presences,endocrine evaluation,biochemical examination and imageology indicate spontaneous remission of GH hypersecretion in patients with gigantism or acromegaly,the diagnosis of subclinical apoplexy of pituitary GH adenoma should be presumed.To these patients,conservative therapy may be appropriate.

  3. Seesaw nystagmus caused by giant pituitary adenoma: case report Nistagmo em gangorra causado por adenoma pituitário gigante: relato de caso

    Frederico Castelo Moura

    2006-03-01

    Full Text Available Giant pituitary adenomas are uncommonly large tumors, greater than 4 cm in size that can produces endocrine symptoms, visual loss and cranial nerve palsies. We report the rare occurrence of seesaw nystagmus as the presenting sign of giant pituitary adenoma. A 50-year-old man presented with headache associated with visual loss and seesaw nystagmus. Perimetry revealed bitemporal hemianopia and magnetic resonance imaging showed a giant pituitary adenoma. After surgery, nystagmus disappeared. Our case is relevant in understanding its pathogenesis since it documents seesaw nystagmus in a patient bitemporal hemianopia due to a large tumor but without mesencephalic compression.Adenoma pituitário gigante é um tumor incomum, maior que 4 cm que produz sintomas endócrinos, perda visual e paralisia de nervos cranianos. Relatamos um caso de nistagmo em gangorra como sinal de apresentação de adenoma pituitário gigante. Um paciente de 50 anos, masculino, apresentava cefaléia, perda visual e nistagmo em gangorra. A perimetria revelou hemianopsia bitemporal e a imagem por ressonância magnética demonstrou um adenoma pituitário gigante. Após a cirurgia, o nistagmo desapareceu. Nosso caso é importante na compreensão da fisiopatogenia do nistagmo em gangorra, pois documenta sua ocorrência em paciente com hemianopsia bitemporal decorrente de tumor hipofisário sem compressão mesencefálica.

  4. Proptose causada por adenoma pituitário gigante: relato de caso

    Pereira Andréa

    2003-01-01

    Full Text Available OBJETIVO: Relatar um caso raro de proptose unilateral associada à paralisia oculomotora e cegueira causados por adenoma pituitário gigante. MÉTODOS: A paciente foi submetida a exame clínico e oftalmológico completo, campimetria, exame de imagem por ressonância magnética e estudo histopatológico do tumor após intervenção cirúrgica. RESULTADOS: Paciente de 21 anos apresentou perda visual progressiva bilateral associada à proptose e limitação da motilidade ocular do olho esquerdo. A campimetria revelou hemianopsia temporal completa no olho direito e havia ausência de percepção luminosa no olho esquerdo. O exame de imagem por ressonância magnética mostrou extenso tumor infiltrando o terceiro ventrículo, seio cavernoso e ápice da órbita à esquerda. O estudo histopatológico revelou se tratar de adenoma hipofisário produtor de hormônio de crescimento e prolactina sem sinais de malignidade. CONCLUSÃO: Este caso é de interesse não apenas pelo fato do envolvimento orbitário pelos adenomas ser extremamente raro, mas também para salientar a importância de diagnóstico precoce uma vez que apesar da histologia benigna, os adenomas invasivos nem sempre seguem curso clínico favorável.

  5. Change in the immunophenotype of a somatotroph adenoma resulting in gigantism

    Jayesh P Thawani

    2014-01-01

    Full Text Available Background: Examining the pathologic progression of a pituitary adenoma from the point of a prepubescent child to an adult with gigantism affords us an opportunity to consider why patients may develop secretory or functioning tumors and raises questions about whether therapeutic interventions and surveillance strategies could be made to avoid irreversible phenotypic changes. Case Description: A patient underwent a sublabial transsphenoidal resection for a clinically non-functioning macroadenoma in 1999. He underwent radiation treatment and was transiently given growth hormone (GH supplementation as an adolescent. His growth rapidly traversed several percentiles and he was found to have elevated GH levels. The patient became symptomatic and was taken for a second neurosurgical procedure. Pathology and immunohistochemical staining demonstrated a significantly higher proportion of somatotroph cells and dense granularity; he was diagnosed with a functional somatotroph adenoma. Conclusions: While it is likely that the described observations reflect the manifestations of a functional somatotroph adenoma in development, it is possible that pubertal growth, GH supplementation, its removal, or radiation therapy contributed to the described endocrine and pathologic changes.

  6. Seesaw nystagmus caused by giant pituitary adenoma: case report Nistagmo em gangorra causado por adenoma pituitário gigante: relato de caso

    Frederico Castelo Moura; Allan Christian Pieroni Gonçalves; Mário Luiz Ribeiro Monteiro

    2006-01-01

    Giant pituitary adenomas are uncommonly large tumors, greater than 4 cm in size that can produces endocrine symptoms, visual loss and cranial nerve palsies. We report the rare occurrence of seesaw nystagmus as the presenting sign of giant pituitary adenoma. A 50-year-old man presented with headache associated with visual loss and seesaw nystagmus. Perimetry revealed bitemporal hemianopia and magnetic resonance imaging showed a giant pituitary adenoma. After surgery, nystagmus disappeared. Our...

  7. Pituitary gigantism: Causes and clinical characteristics.

    Rostomyan, Liliya; Daly, Adrian F; Beckers, Albert

    2015-12-01

    Acromegaly and pituitary gigantism are very rare conditions resulting from excessive secretion of growth hormone (GH), usually by a pituitary adenoma. Pituitary gigantism occurs when GH excess overlaps with the period of rapid linear growth during childhood and adolescence. Until recently, its etiology and clinical characteristics have been poorly understood. Genetic and genomic causes have been identified in recent years that explain about half of cases of pituitary gigantism. We describe these recent discoveries and focus on some important settings in which gigantism can occur, including familial isolated pituitary adenomas (FIPA) and the newly described X-linked acrogigantism (X-LAG) syndrome.

  8. Familial gigantism

    Wouter W. de Herder

    2012-01-01

    Full Text Available Familial GH-secreting tumors are seen in association with three separate hereditary clinical syndromes: multiple endocrine neoplasia type 1, Carney complex, and familial isolated pituitary adenomas.

  9. Gigantism in sibling unrelated to multiple endocrine neoplasia: case report.

    Matsuno, A; Teramoto, A; Yamada, S; Kitanaka, S; Tanaka, T; Sanno, N; Osamura, R Y; Kirino, T

    1994-11-01

    The cases of gigantism sisters with somatotroph adenomas unrelated to multiple endocrine neoplasia (MEN) Type 1 are reported. The sisters grew rapidly since they were 5 or 6 years old and were diagnosed to have gigantism with pituitary adenoma by computed tomographic scan and magnetic resonance imaging. A serum endocrinological examination showed the elevated growth hormone values. After thyroxine-releasing hormone stimulation, growth hormone values exhibited a paradoxical rise. They were supposed to be unrelated to MEN Type 1, because analysis of the 11th chromosomes and the other endocrine functions were normal. They were operated on by the transphenoidal method. Immunohistochemical staining of both tumor specimens confirmed somatotroph adenomas. Pituitary adenoma associated with MEN Type 1 is a well-recognized entity. However, the sporadic occurrence of pituitary adenoma unrelated to MEN Type 1, especially in siblings, is extremely rare. Fifteen cases of pituitary adenomas in siblings were described in the literature. As for gigantism, only two brothers were reported. Our case of gigantism sisters is the second sporadic case. In our review of the isolated cases of pituitary adenoma in siblings described in the literature, 12 (70%) of 17 cases including ours are acromegaly or gigantism. This incidence is much higher than that of MEN Type 1 patients with pituitary adenomas. The cause of the familial occurrence of pituitary adenomas is still unclear, although autosomal recessive inheritance has been suggested. It has been stated that point mutations in codon 201 or 227 of the Gs alpha gene located in chromosome 20 were found in about 35 to 40% of somatotroph adenomas.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Condiloma gigante

    Brunno Cezar Framil Sanches

    2011-09-01

    Full Text Available O condiloma gigante está altamente associado à infecção pelo Papiloma Vírus Humano (HPV, uma das doenças sexualmente transmissíveis mais prevalentes no mundo. Paciente de 54 anos, com aparecimento de lesão vegetante em região suprapúbica de crescimento progressivo há 20 anos. Realizou tratamento prévio de condiloma peniano com cauterização com sucesso. A lesão teve crescimento significativo e foi, então, submetido à biópsia com diagnóstico histológico de condiloma acuminado. A terapia eleita foi a exérese completa da lesão. A terapia invasiva se torna opção terapêutica de eleição, indicada por todos os estudos analisados. No caso em questão, a opção terapêutica foi a retirada completa da lesão devido à recorrência do quadro após terapias de cauterização química e térmica. Apesar de a abordagem cirúrgica ser uma conduta mais agressiva, no paciente em questão foi adequada por conta do tamanho e da falha de terapias anteriores.

  11. [Old phenotype and new genotypes. Pituitary adenomas].

    Gérard, C; Jedidi, H; Petrossians, P; Krzesinski, F; Daly, A; Beckers, A

    2015-11-01

    Gigantism and acromegaly, usually caused by a pituitary adenoma linked inappropriate secretion of growth hormone (GH), are generally considered as very rare diseases, even if, according to some authors, their cumulative prevalence is about 1/5000. Starting from the historical case of a giant from Liège we shall describe the different types of GH pituitary adenomas and their pathophysiology. We shall particularly discuss rare forms of inherited GH secreting pituitary adenomas like the FIPA (familial inherited isolated pituitary adenomas) and the X-LAG (X linked acrogigantism), both described for the first time in Liège, in 2000 and 2014, respectively.

  12. Parathyroid adenoma

    Hyperparathyroidism - parathryoid adenoma; Overactive parathyroid gland - parathyroid adenoma ... The parathyroid glands in the neck help control calcium use and removal by the body. They do this by ...

  13. Pulsars: Gigantic Nuclei

    Xu, Renxin

    2011-01-01

    What is the real nature of pulsars? This is essentially a question of the fundamental strong interaction between quarks at low-energy scale and hence of the non-perturbative quantum chromo-dynamics, the solution of which would certainly be meaningful for us to understand one of the seven millennium prize problems (i.e., "Yang-Mills Theory") named by the Clay Mathematical Institute. After a historical note, it is argued here that a pulsar is very similar to an extremely big nucleus, but is a little bit different from the {\\em gigantic nucleus} speculated 80 years ago by L. Landau. The paper demonstrates the similarity between pulsars and gigantic nuclei from both points of view: the different manifestations of compact stars and the general behavior of the strong interaction.

  14. Quiste gigante de ovario

    Dagoberto Calderón Rodríguez

    2014-08-01

    Full Text Available Un crecimiento quístico del ovario debe medir por lo menos 2,5 cm de diámetro para denominarse quiste. Se presenta el caso de una paciente de 36 años, femenina, perteneciente a la etnia Wayú, con un quiste gigante en ovario derecho, de aproximadamente 10 cm de diámetro, un peso de 3,6 Kg y torcido sobre su pedículo, que le provoca dolor intenso de más de un mes de evolución. Se practicó intervención quirúrgica y se comprobaron signos macroscópicos de necrobiosis de ovario, siendo el resultado de la biopsia un teratoma maduro. Su resultado final fue satisfactorio

  15. Linfedema escrotal gigante

    C. Carrasco López

    2013-06-01

    Full Text Available La elefantiasis escrotal es una condición que ha sido historicamente descrita en áreas endémicas de filariasis, siendo menos frecuente su presentación idiopática o asociada a otras entidades. Presentamos un caso de elefantiasis escrotal gigante de causa adquirida al que se le practicó exéresis de estructura linfadematosa con reconstrucción con colgajo local y autoinjerto cutáneo. El caso clínico presentado es raro, ya sea por la baja frecuencia o por su etiología, así como por la importante magnitud del problema. Por esta razón hemos decidido presentarlo para dar a conocer posibilidades terapéuticas y realizar una revisión del tema.

  16. Acromegaly and gigantism in the medical literature. Case descriptions in the era before and the early years after the initial publication of Pierre Marie (1886).

    de Herder, Wouter W

    2009-01-01

    In 1886 Pierre Marie used the term "acromegaly" for the first time and gave a full description of the characteristic clinical picture. However several others had already given clear clinical descriptions before him and sometimes had given the disease other names. After 1886, it gradually became clear that pituitary enlargement (caused by a pituitary adenoma) was the cause and not the consequence of acromegaly, as initially thought. Pituitary adenomas could be found in the great majority of cases. It also became clear that acromegaly and gigantism were the same disease but occurring at different stages of life and not different diseases as initially thought. At the end of the 19th and beginning of the 20th century most information was derived from case descriptions and post-mortem examinations of patients with acromegaly or (famous) patients with gigantism. The stage was set for further research into the pathogenesis, diagnosis and therapy of acromegaly and gigantism.

  17. Familial isolated pituitary adenomas (FIPA) and the pituitary adenoma predisposition due to mutations in the aryl hydrocarbon receptor interacting protein (AIP) gene.

    Beckers, Albert; Aaltonen, Lauri A; Daly, Adrian F; Karhu, Auli

    2013-04-01

    Pituitary adenomas are one of the most frequent intracranial tumors and occur with a prevalence of approximately 1:1000 in the developed world. Pituitary adenomas have a serious disease burden, and their management involves neurosurgery, biological therapies, and radiotherapy. Early diagnosis of pituitary tumors while they are smaller may help increase cure rates. Few genetic predictors of pituitary adenoma development exist. Recent years have seen two separate, complimentary advances in inherited pituitary tumor research. The clinical condition of familial isolated pituitary adenomas (FIPA) has been described, which encompasses the familial occurrence of isolated pituitary adenomas outside of the setting of syndromic conditions like multiple endocrine neoplasia type 1 and Carney complex. FIPA families comprise approximately 2% of pituitary adenomas and represent a clinical entity with homogeneous or heterogeneous pituitary adenoma types occurring within the same kindred. The aryl hydrocarbon receptor interacting protein (AIP) gene has been identified as causing a pituitary adenoma predisposition of variable penetrance that accounts for 20% of FIPA families. Germline AIP mutations have been shown to associate with the occurrence of large pituitary adenomas that occur at a young age, predominantly in children/adolescents and young adults. AIP mutations are usually associated with somatotropinomas, but prolactinomas, nonfunctioning pituitary adenomas, Cushing disease, and other infrequent clinical adenoma types can also occur. Gigantism is a particular feature of AIP mutations and occurs in more than one third of affected somatotropinoma patients. Study of pituitary adenoma patients with AIP mutations has demonstrated that these cases raise clinical challenges to successful treatment. Extensive research on the biology of AIP and new advances in mouse Aip knockout models demonstrate multiple pathways by which AIP may contribute to tumorigenesis. This review assesses

  18. Clinical and genetic characterization of pituitary gigantism: an international collaborative study in 208 patients.

    Rostomyan, Liliya; Daly, Adrian F; Petrossians, Patrick; Nachev, Emil; Lila, Anurag R; Lecoq, Anne-Lise; Lecumberri, Beatriz; Trivellin, Giampaolo; Salvatori, Roberto; Moraitis, Andreas G; Holdaway, Ian; Kranenburg-van Klaveren, Dianne J; Chiara Zatelli, Maria; Palacios, Nuria; Nozieres, Cecile; Zacharin, Margaret; Ebeling, Tapani; Ojaniemi, Marja; Rozhinskaya, Liudmila; Verrua, Elisa; Jaffrain-Rea, Marie-Lise; Filipponi, Silvia; Gusakova, Daria; Pronin, Vyacheslav; Bertherat, Jerome; Belaya, Zhanna; Ilovayskaya, Irena; Sahnoun-Fathallah, Mona; Sievers, Caroline; Stalla, Gunter K; Castermans, Emilie; Caberg, Jean-Hubert; Sorkina, Ekaterina; Auriemma, Renata Simona; Mittal, Sachin; Kareva, Maria; Lysy, Philippe A; Emy, Philippe; De Menis, Ernesto; Choong, Catherine S; Mantovani, Giovanna; Bours, Vincent; De Herder, Wouter; Brue, Thierry; Barlier, Anne; Neggers, Sebastian J C M M; Zacharieva, Sabina; Chanson, Philippe; Shah, Nalini Samir; Stratakis, Constantine A; Naves, Luciana A; Beckers, Albert

    2015-10-01

    Despite being a classical growth disorder, pituitary gigantism has not been studied previously in a standardized way. We performed a retrospective, multicenter, international study to characterize a large series of pituitary gigantism patients. We included 208 patients (163 males; 78.4%) with growth hormone excess and a current/previous abnormal growth velocity for age or final height >2 s.d. above country normal means. The median onset of rapid growth was 13 years and occurred significantly earlier in females than in males; pituitary adenomas were diagnosed earlier in females than males (15.8 vs 21.5 years respectively). Adenomas were ≥10 mm (i.e., macroadenomas) in 84%, of which extrasellar extension occurred in 77% and invasion in 54%. GH/IGF1 control was achieved in 39% during long-term follow-up. Final height was greater in younger onset patients, with larger tumors and higher GH levels. Later disease control was associated with a greater difference from mid-parental height (r=0.23, P=0.02). AIP mutations occurred in 29%; microduplication at Xq26.3 - X-linked acrogigantism (X-LAG) - occurred in two familial isolated pituitary adenoma kindreds and in ten sporadic patients. Tumor size was not different in X-LAG, AIP mutated and genetically negative patient groups. AIP-mutated and X-LAG patients were significantly younger at onset and diagnosis, but disease control was worse in genetically negative cases. Pituitary gigantism patients are characterized by male predominance and large tumors that are difficult to control. Treatment delay increases final height and symptom burden. AIP mutations and X-LAG explain many cases, but no genetic etiology is seen in >50% of cases.

  19. Current Opinion in Endocrinology, Diabetes, and Obesity “Pituitary gigantism: Update on Molecular Biology and Management”

    Lodish, Maya B.; Trivellin, Giampaolo; Stratakis, Constantine A.

    2016-01-01

    Purpose of review To provide an update on the mechanisms leading to pituitary gigantism, as well as to familiarize the practitioner with the implication of these genetic findings on treatment decisions. Recent findings Prior studies have identified gigantism as a feature of a number of monogenic disorders, including mutations in the aryl hydrocarbon receptor interacting protein (AIP) gene, multiple endocrine neoplasia types 1 and 4, McCune Albright Syndrome, Carney Complex, and the paraganglioma, pheochromocytoma and pituitary adenoma association (3PA) due to succinate dehydrogenase defects. We recently described a previously uncharacterized form of early-onset pediatric gigantism caused by microduplications on chromosome Xq26.3 and we termed it X-LAG (X-linked acrogigantism). The age of onset of increased growth in X-LAG is significantly younger than other pituitary gigantism cases, and control of growth hormone excess is particularly challenging. Summary Knowledge of the molecular defects that underlie pituitary tumorigenesis is crucial for patient care as they guide early intervention, screening for associated conditions, genetic counseling, surgical approach (partial or total hypophysectomy), and choice of medical management. Recently described microduplications of Xq26.3 account for more than 80% of the cases of early-onset pediatric gigantism. Early recognition of X-LAG may improve outcomes, as successful control of growth hormone excess requires extensive anterior pituitary resection and are difficult to manage with medical therapy alone. PMID:26574647

  20. Cardiac and metabolic effects of chronic growth hormone and insulin-like growth factor I excess in young adults with pituitary gigantism.

    Bondanelli, Marta; Bonadonna, Stefania; Ambrosio, Maria Rosaria; Doga, Mauro; Gola, Monica; Onofri, Alessandro; Zatelli, Maria Chiara; Giustina, Andrea; degli Uberti, Ettore C

    2005-09-01

    Chronic growth hormone (GH)/insulin-like growth factor I (IGF-I) excess is associated with considerable mortality in acromegaly, but no data are available in pituitary gigantism. The aim of the study was to evaluate the long-term effects of early exposure to GH and IGF-I excess on cardiovascular and metabolic parameters in adult patients with pituitary gigantism. Six adult male patients with newly diagnosed gigantism due to GH secreting pituitary adenoma were studied and compared with 6 age- and sex-matched patients with acromegaly and 10 healthy subjects. Morphologic and functional cardiac parameters were evaluated by Doppler echocardiography. Glucose metabolism was assessed by evaluating glucose tolerance and homeostasis model assessment index. Disease duration was significantly longer (Pgigantism than in patients with acromegaly, whereas GH and IGF-I concentrations were comparable. Left ventricular mass was increased both in patients with gigantism and in patients with acromegaly, as compared with controls. Left ventricular hypertrophy was detected in 2 of 6 of both patients with gigantism and patients with acromegaly, and isolated intraventricular septum thickening in 1 patient with gigantism. Inadequate diastolic filling (ratio between early and late transmitral flow velocitygigantism and 1 of 6 patients with acromegaly. Impaired glucose metabolism occurrence was higher in patients with acromegaly (66%) compared with patients with gigantism (16%). Concentrations of IGF-I were significantly (Pgigantism who have cardiac abnormalities than in those without cardiac abnormalities. In conclusion, our data suggest that GH/IGF-I excess in young adult patients is associated with morphologic and functional cardiac abnormalities that are similar in patients with gigantism and in patients with acromegaly, whereas occurrence of impaired glucose metabolism appears to be higher in patients with acromegaly, although patients with gigantism are exposed to GH excess for a

  1. Gigantism

    ... Prognosis) Pituitary surgery is usually successful in limiting growth hormone production. Early treatment can reverse many of the changes caused by growth hormone excess. Possible Complications Surgery may lead to low ...

  2. Hidrocele gigante en paciente anciano

    Ada Arleny Pérez Mayo; Yordania Velázquez Avila

    2014-01-01

    Se presenta el caso de un paciente de 87 años, intervenido por primera vez en el Hospital Nacional “San Pedro Necta” del Departamento de Huehuetenango en Guatemala, por presentar hidrocele gigante de más de veinte años de evolución. El examen físico mostró tumoración translúcida dolorosa en la bolsa escrotal izquierda, con el posible diagnóstico de hidrocele tabicado o no comunicante. El preoperatorio consistió en la canalización de vena periférica, administración de profilaxis antibiótica co...

  3. Pituitary Gigantism: A Case Report

    Rana Bhattacharjee

    2012-01-01

    Full Text Available Objective: To present a rare case of gigantism. Case Report: A 25-year-old lady presented with increased statural growth and enlarged body parts noticed since the age of 14 years, primary amenorrhea, and frontal headache for the last 2 years.She has also been suffering from non-inflammatory low back pain with progressive kyphosis and pain in the knees, ankles, and elbows for the last 5 years. There was no history of visual disturbance, vomiting, galactorrhoea, cold intolerance. She had no siblings. Family history was non-contributory.Blood pressure was normal. Height 221 cm, weight 138 kg,body mass index (BMI28. There was coarsening of facial features along with frontal bossing and prognathism, large hands and feet, and small goitre. Patient had severe kyphosis and osteoarthritis of knees. Confrontation perimetry suggested bitemporal hemianopia. Breast and pubic hair were of Tanner stage 1. Serum insulin like growth factor-1 (IGF1 was 703 ng/ml with all glucose suppressedgrowth hormone (GHvalues of >40 ng/ml. Prolactin was 174 ng/ml. Basal serum Lutenising Hormone (LH, follicle stimulating Hormone (FSH was low. Oral glucose tolerance test (OGTT, liver and renal function tests, basal cortisol and thyroid profile, Calcium, phosphorus and Intact Parathyroid hormone (iPTH were normal.Computed tomographyscan of brain showed large pituitary macroadenoma. Automated perimetry confirmed bitemporal hemianopia. A diagnosis of gigantism due to GH secreting pituitary macroadenoma with hypogonadotrophichypogonadism was made. Debulking pituitary surgery followed by somatostatin analogue therapy with gonadal steroid replacement had been planned, but the patient refused further treatment.

  4. Hidrocele gigante en paciente anciano

    Ada Arleny Pérez Mayo

    2014-09-01

    Full Text Available Se presenta el caso de un paciente de 87 años, intervenido por primera vez en el Hospital Nacional “San Pedro Necta” del Departamento de Huehuetenango en Guatemala, por presentar hidrocele gigante de más de veinte años de evolución. El examen físico mostró tumoración translúcida dolorosa en la bolsa escrotal izquierda, con el posible diagnóstico de hidrocele tabicado o no comunicante. El preoperatorio consistió en la canalización de vena periférica, administración de profilaxis antibiótica con ceftriaxona y rasurado de la piel. Durante el acto operatorio se constató hidrocele izquierdo, con acumulación de líquido acuoso de la túnica vaginal que rodeaba el testículo, cuantificable alrededor de los 500 ml. La técnica quirúrgica consistió en la eversión o plicatura de la vaginal. No se presentaron entidades asociadas, como quiste del cordón, hernia inguinal o fimosis. No existieron complicaciones. Se reportó una estadía hospitalaria de cuatro días y el paciente evolucionó favorablemente. No ocurrió recidiva durante el año de seguimiento

  5. Pituitary Adenoma Segmentation

    Egger, Jan; Kuhnt, Daniela; Freisleben, Bernd; Nimsky, Christopher

    2011-01-01

    Sellar tumors are approximately 10-15% among all intracranial neoplasms. The most common sellar lesion is the pituitary adenoma. Manual segmentation is a time-consuming process that can be shortened by using adequate algorithms. In this contribution, we present a segmentation method for pituitary adenoma. The method is based on an algorithm we developed recently in previous work where the novel segmentation scheme was successfully used for segmentation of glioblastoma multiforme and provided an average Dice Similarity Coefficient (DSC) of 77%. This scheme is used for automatic adenoma segmentation. In our experimental evaluation, neurosurgeons with strong experiences in the treatment of pituitary adenoma performed manual slice-by-slice segmentation of 10 magnetic resonance imaging (MRI) cases. Afterwards, the segmentations were compared with the segmentation results of the proposed method via the DSC. The average DSC for all data sets was 77.49% +/- 4.52%. Compared with a manual segmentation that took, on the...

  6. Tubular apocrine adenoma.

    Toribio, J; Zulaica, A; Peteiro, C

    1987-04-01

    We report a case of tubular apocrine adenoma located on the scalp, with characteristics of syringocystadenoma papilliferum in the superior part of the lesion. An interesting feature of the growth is its connective tissue involvement.

  7. Pituitary adenoma: a radiotherapeutic perspective.

    Platta, Christopher S; Mackay, Christopher; Welsh, James S

    2010-08-01

    Pituitary adenomas comprise approximately 10% to 20% of all central nervous system neoplasms whereas autopsy series have suggested that the incidence of pituitary adenoma in the general population may approach 25%. Several treatment modalities are used in the treatment of pituitary adenomas, including observation, surgery, medical intervention, and radiotherapy. The treatment modality employed depends greatly on the type of pituitary adenoma and presenting symptoms. This review will discuss the biology of pituitary adenomas and the current management principles for the treatment of prolactinomas, Cushing disease, acromegaly, and nonsecretory adenomas, with an emphasis on the published radiotherapeutic literature.

  8. Clinical and morphological features of undifferentiated monomorphous GH/TSH-secreting pituitary adenoma.

    Skorić, T; Korsić, M; Zarković, K; Plavsić, V; Besenski, N; Breskovac, L; Giljević, Z; Paladino, J

    1999-06-01

    A 41-year-old male presented with progressive visual defects, acromegaly and hyperthyroidism. After clinical evaluation a giant GH/TSH-secreting pituitary adenoma was diagnosed. Administration of the somatostatin analog octreotide at doses of 150 microg s.c. per day inhibited the secretion of both GH and TSH. A three-week treatment with octreotide prior to surgery led to slight visual improvement and CT scan showed some new necrotic areas within the tumor mass. Transcranial surgery was performed. By immunohistochemical analyses of the adenoma tissue GH, prolactin and beta-chorionic gonadotropin were detected; TSH was negative. Electron microscopy revealed an undifferentiated, monomorphous adenoma with morphological features of an acidophil stem cell adenoma such as the presence of misplaced exocytoses, fibrous bodies and mitochondrial gigantism. However, the tumor cells contained small secretory granules (up to 250 nm) accumulated along the cell membrane characteristic of thyrotrope cells. Furthermore, some adenoma cells were fusiform with long cytoplasmic processes resembling thyrotropes. Two months after the operation CT scan revealed a large residual tumor. Serum GH and TSH levels had increased again and the TSH level was even higher than before the treatment. The patient died suddenly, most probably of lethal arrhythmia. Specimens of the adenoma tissue obtained at autopsy confirmed the previous findings with the exception of positive immunostaining for TSH which was found in less than 1% of the adenoma cells. This undifferentiated, monomorphous GH/TSH-secreting pituitary adenoma represents an entity that is unusual both in its ultrastructural features and clinical manifestations suggesting a cytogenesis from an early, undifferentiated stem cell.

  9. Triangulation of the Gigantic Jets in 20 August 2014

    Kang-Ming, P.; Hsu, R. R.; Su, H. T.; Chen, A. B. C.; Chou, J. K.; Chang, S. C.; Wu, Y. J.; Chien-Lun, H.; Yang, I. C.; Tsai, S. H.

    2015-12-01

    Coordinate optical observation campaigns on TLEs near Taiwan are held since 2011 with the aim to triangulate TLEs. Currently, there are four stations with baseline varying from 100 to 400 km between them. Our optical observation systems recorded 48 various types of TLEs on the night of 20 August 2014, with eight of them being gigantic jets that were recorded by at least two stations. Due to the length of baselines and the TLE occurring locations, the earth curvature needed to be taken into account by means of spherical trigonometry method. The preliminary results shows the gigantic jets occurred over the northern Taiwan and the accuracy of geolocation is less than 1 km and the accuracy of the retrieval height on the key structures is less than 0.5 km. The triangulation results of the eight events indicate most of these gigantic jets terminated at 80-90km, but one of the gigantic jets is likely extend to 100 km. Three of the eight gigantic jets occurred consequently after previous one with time interval of 500ms to more than 100s. The previous gigantic jet is likely to influence the consequent gigantic jet for usually the consequent gigantic jet has more beads structures in high altitude and one of the streamer column of a consequent gigantic jets at 55 -60 km is identified to re-bright, which is more than 100s after the previous gigantic jet.

  10. Familial pituitary adenomas.

    Vandeva, S; Vasilev, V; Vroonen, L; Naves, L; Jaffrain-Rea, M-L; Daly, A F; Zacharieva, S; Beckers, A

    2010-12-01

    Pituitary adenomas are benign intracranial neoplasms that present a major clinical concern because of hormonal overproduction or compression symptoms of adjacent structures. Most arise in a sporadic setting with a small percentage developing as a part of familial syndromes such as multiple endocrine neoplasia type 1 (MEN1), Carney complex (CNC), and the recently described familial isolated pituitary adenomas (FIPA) and MEN-4. While the genetic alterations responsible for the formation of sporadic adenomas remain largely unknown, considerable advances have been made in defining culprit genes in these familial syndromes. Mutations in MEN1 and PRKAR1A genes are found in the majority of MEN1 and CNC patients, respectively. About 15% of FIPA kindreds present with mutations of the aryl hydrocarbon receptor-interacting protein (AIP) gene. Mutations in the CDKN1B gene, encoding p27(Kip)¹ were identified in MEN4 cases. Familial tumours appear to differ from their sporadic counterparts not only in genetic basis but also in clinical characteristics. Evidence suggests that, especially in MEN1 and FIPA, they are more aggressive and affect patients at younger age, therefore justifying the importance of early diagnosis. In this review, we summarize the genetic and clinical characteristics of these familial pituitary adenomas.

  11. Hepatocarcinoma gigante unifocal en mujer con ingesta prolongada de anticonceptivos hormonales: ¿casualidad o causalidad?

    VICTOR MANUEL LOPEZ MOURIÑO

    2016-12-01

    Full Text Available Presentamos un caso de una paciente de mediana edad con ingesta mantenida de anticonceptivos hormonales (AH que desarrolla múltiples adenomas hepáticos (asociación bien documentada y un carcinoma hepatocelular (CHC unifocal gigante sin encontrar otros factores de riesgo para el mismo (enolismo, tabaquismo, cirrosis, hemocromatosis,..... Si bien en la literatura no hay unanimidad respecto a la asociación del consumo de AH con el CHC, algunos autores ya contemplaron esa posibilidad, excluyendo también otras etiologías reconocidas de CHC, por lo que debería reevaluarse si su asociación es aleatoria o por el contrario existe nexo causal.

  12. Pituitary gigantism presenting with depressive mood disorder and diabetic ketoacidosis in an Asian adolescent.

    Kuo, Sheng-Fong; Chuang, Wen-Yu; Ng, Sohching; Chen, Chih-Hung; Chang, Chen-Nen; Chou, Chi-Hsiang; Weng, Wei-Chieh; Yeh, Chih-Hua; Lin, Jen-Der

    2013-01-01

    Hyperglycemia is seldom described in young patients with pituitary gigantism. Here, we describe the case of a 17-year-old Taiwanese boy who developed depressive mood disorder and diabetic ketoacidosis (DKA) at the presentation of pituitary gigantism. The boy complained of lethargy and dysphoric mood in June 2008. He presented at the emergency department with epigastralgia and dyspnea in January 2009. Results of laboratory tests suggested type 1 diabetes mellitus with DKA. However, serum C-peptide level was normal on follow-up. Although he had no obvious features of acral enlargement, a high level of insulin-like growth factor 1 was detected, and a 75 g oral glucose suppression test showed no suppression of serum growth hormone levels. A pituitary macroadenoma was found on subsequent magnetic resonance imaging. The pituitary adenoma was surgically removed, followed by gamma-knife radiosurgery, and Sandostatin long-acting release treatment. He was then administered metformin, 500 mg twice daily, and to date, his serum glycohemoglobin has been <7%.

  13. Evolution of gigantism in amphiumid salamanders.

    Bonett, Ronald M; Chippindale, Paul T; Moler, Paul E; Van Devender, R Wayne; Wake, David B

    2009-05-20

    The Amphiumidae contains three species of elongate, permanently aquatic salamanders with four diminutive limbs that append one, two, or three toes. Two of the species, Amphiuma means and A. tridactylum, are among the largest salamanders in the world, reaching lengths of more than one meter, whereas the third species (A. pholeter), extinct amphiumids, and closely related salamander families are relatively small. Amphiuma means and A. tridactylum are widespread species and live in a wide range of lowland aquatic habitats on the Coastal Plain of the southeastern United States, whereas A. pholeter is restricted to very specialized organic muck habitats and is syntopic with A. means. Here we present analyses of sequences of mitochondrial and nuclear loci from across the distribution of the three taxa to assess lineage diversity, relationships, and relative timing of divergence in amphiumid salamanders. In addition we analyze the evolution of gigantism in the clade. Our analyses indicate three lineages that have diverged since the late Miocene, that correspond to the three currently recognized species, but the two gigantic species are not each other's closest relatives. Given that the most closely related salamander families and fossil amphiumids from the Upper Cretaceous and Paleocene are relatively small, our results suggest at least two extreme changes in body size within the Amphuimidae. Gigantic body size either evolved once as the ancestral condition of modern amphiumas, with a subsequent strong size reduction in A. pholeter, or gigantism independently evolved twice in the modern species, A. means and A. tridactylum. These patterns are concordant with differences in habitat breadth and range size among lineages, and have implications for reproductive isolation and diversification of amphiumid salamanders.

  14. Evolution of gigantism in amphiumid salamanders.

    Ronald M Bonett

    Full Text Available The Amphiumidae contains three species of elongate, permanently aquatic salamanders with four diminutive limbs that append one, two, or three toes. Two of the species, Amphiuma means and A. tridactylum, are among the largest salamanders in the world, reaching lengths of more than one meter, whereas the third species (A. pholeter, extinct amphiumids, and closely related salamander families are relatively small. Amphiuma means and A. tridactylum are widespread species and live in a wide range of lowland aquatic habitats on the Coastal Plain of the southeastern United States, whereas A. pholeter is restricted to very specialized organic muck habitats and is syntopic with A. means. Here we present analyses of sequences of mitochondrial and nuclear loci from across the distribution of the three taxa to assess lineage diversity, relationships, and relative timing of divergence in amphiumid salamanders. In addition we analyze the evolution of gigantism in the clade. Our analyses indicate three lineages that have diverged since the late Miocene, that correspond to the three currently recognized species, but the two gigantic species are not each other's closest relatives. Given that the most closely related salamander families and fossil amphiumids from the Upper Cretaceous and Paleocene are relatively small, our results suggest at least two extreme changes in body size within the Amphuimidae. Gigantic body size either evolved once as the ancestral condition of modern amphiumas, with a subsequent strong size reduction in A. pholeter, or gigantism independently evolved twice in the modern species, A. means and A. tridactylum. These patterns are concordant with differences in habitat breadth and range size among lineages, and have implications for reproductive isolation and diversification of amphiumid salamanders.

  15. Gigantic Suprapubic Lymphedema: A Case Study

    Tanhaeivash, Roozbeh; Franiel, Tobias; Grimm, Marc-Oliver

    2016-01-01

    We present the first case study of idiopathic gigantic suprapubic lymphedema and buried penis treated with puboscrotal reconstruction in a patient with initial extreme obesity after an extensive weight reduction (120 kg). Massive localized lymphedema of the suprapubic region should be differentiated from the scrotal type. Severe lymphedema could not resolve on its own and weight reduction does not seem to be helpful in such cases. PMID:27574599

  16. Giant basal cell carcinoma Carcinoma basocelular gigante

    Nilton Nasser

    2012-06-01

    Full Text Available The basal cell carcinoma is the most common skin cancer but the giant vegetating basal cell carcinoma reaches less than 0.5 % of all basal cell carcinoma types. The Giant BCC, defined as a lesion with more than 5 cm at its largest diameter, is a rare form of BCC and commonly occurs on the trunk. This patient, male, 42 years old presents a Giant Basal Cell Carcinoma which reaches 180 cm2 on the right shoulder and was negligent in looking for treatment. Surgical treatment was performed and no signs of dissemination or local recurrence have been detected after follow up of five years.O carcinoma basocelular é o tipo mais comum de câncer de pele, mas o carcinoma basocelular gigante vegetante não atinge 0,5% de todos os tipos de carcinomas basocelulares. O Carcinoma Basocelular Gigante, definido como lesão maior que 5 cm no maior diâmetro, é uma forma rara de carcinoma basocelular e comumente ocorre no tronco. Este paciente apresenta um Carcinoma Basocelular Gigante com 180cm² no ombro direito e foi negligente em procurar tratamento. Foi realizado tratamento cirúrgico e nenhum sinal de disseminação ou recorrência local foi detectada após 5 anos.

  17. Parathyroid adenoma. Case presentation

    Daniel Olivera Fajardo

    2016-10-01

    Full Text Available Parathyroid Adenoma is a non-malignant tumor of the thyroid glands, which increases the levels of parathormone. This hormone regulates blood and bone levels of calcium, phosphorus and Vitamin D. Its classic triad is characterized by the increase of the levels of parathormone, hyperkalimia and Hipophosphatemia. This entity affects between 500-1000 inhabitants and is the main cause of primary Hyperparathyroidism in about 80-85% of the patients. It is presented a case of a 69 year old female patient, admitted due to pathologic fractures of hip, clavicle, and fingers, caused by primary hyperparathyroidism originated by parathyroid adenoma. For the low incidence of this entity, its publication is considered of interest for the scientific staff.

  18. Ceruminous gland adenoma

    Himanshu Varshney

    2014-01-01

    Full Text Available Ceruminous adenoma is a rare neoplasm of the external auditory meatus (EAM with benign clinical behavior. They demonstrate a dual cell population of basal myoepithelial-type cells and luminal ceruminous cells. Cerumen pigment, cytokeratin 7 (CK7 and p63 can help to distinguish this tumor from other neoplasms that occur in the region. Complete surgical excision results in an excellent long-term clinical outcome. We present a case of histologically confirmed ceruminous adenoma of the EAM in a surgically treated 38-year-old female. She presented with recurrent serosanguineous discharge along with flakes from the right ear along with hearing impairment. She is doing well in last 8 months follow-up.

  19. Lacrimal Gland Pleomorphic Adenoma and Carcinoma ex Pleomorphic Adenoma

    von Holstein, Sarah L; Fehr, André; Persson, Marta;

    2014-01-01

    To study genetic alterations in lacrimal gland pleomorphic adenoma (PA) and carcinoma ex pleomorphic adenoma (Ca-ex-PA) with focus on copy number changes and expression patterns of the translocation target genes PLAG1, HMGA2, and CRTC1-MAML2 in relation to clinical data....

  20. Gigantism and Its Implications for the History of Life.

    Vermeij, Geerat J

    2016-01-01

    Gigantism-very large body size-is an ecologically important trait associated with competitive superiority. Although it has been studied in particular cases, the general conditions for the evolution and maintenance of gigantism remain obscure. I compiled sizes and dates for the largest species in 3 terrestrial and 7 marine trophic and habitat categories of animals from throughout the Phanerozoic. The largest species (global giants) in all categories are of post-Paleozoic age. Gigantism at this level appeared tens to hundreds of millions of years after mass extinctions and long after the origins of clades in which it evolved. Marine gigantism correlates with high planktic or seafloor productivity, but on land the correspondence between productivity and gigantism is weak at best. All global giants are aerobically active animals, not gentle giants with low metabolic demands. Oxygen concentration in the atmosphere correlates with gigantism in the Paleozoic but not thereafter, likely because of the elaboration of efficient gas-exchange systems in clades containing giants. Although temperature and habitat size are important in the evolution of very large size in some cases, the most important (and rare) enabling circumstance is a highly developed ecological infrastructure in which essential resources are abundant and effectively recycled and reused, permitting activity levels to increase and setting the stage for gigantic animals to evolve. Gigantism as a hallmark of competitive superiority appears to have lost its luster on land after the Mesozoic in favor of alternative means of achieving dominance, especially including social organization and coordinated food-gathering.

  1. Fungal cell gigantism during mammalian infection.

    Oscar Zaragoza

    Full Text Available The interaction between fungal pathogens with the host frequently results in morphological changes, such as hyphae formation. The encapsulated pathogenic fungus Cryptococcus neoformans is not considered a dimorphic fungus, and is predominantly found in host tissues as round yeast cells. However, there is a specific morphological change associated with cryptococcal infection that involves an increase in capsule volume. We now report another morphological change whereby gigantic cells are formed in tissue. The paper reports the phenotypic characterization of giant cells isolated from infected mice and the cellular changes associated with giant cell formation. C. neoformans infection in mice resulted in the appearance of giant cells with cell bodies up to 30 microm in diameter and capsules resistant to stripping with gamma-radiation and organic solvents. The proportion of giant cells ranged from 10 to 80% of the total lung fungal burden, depending on infection time, individual mice, and correlated with the type of immune response. When placed on agar, giant cells budded to produce small daughter cells that traversed the capsule of the mother cell at the speed of 20-50 m/h. Giant cells with dimensions that approximated those in vivo were observed in vitro after prolonged culture in minimal media, and were the oldest in the culture, suggesting that giant cell formation is an aging-dependent phenomenon. Giant cells recovered from mice displayed polyploidy, suggesting a mechanism by which gigantism results from cell cycle progression without cell fission. Giant cell formation was dependent on cAMP, but not on Ras1. Real-time imaging showed that giant cells were engaged, but not engulfed by phagocytic cells. We describe a remarkable new strategy for C. neoformans to evade the immune response by enlarging cell size, and suggest that gigantism results from replication without fission, a phenomenon that may also occur with other fungal pathogens.

  2. Fungal cell gigantism during mammalian infection.

    Zaragoza, Oscar; García-Rodas, Rocío; Nosanchuk, Joshua D; Cuenca-Estrella, Manuel; Rodríguez-Tudela, Juan Luis; Casadevall, Arturo

    2010-01-01

    The interaction between fungal pathogens with the host frequently results in morphological changes, such as hyphae formation. The encapsulated pathogenic fungus Cryptococcus neoformans is not considered a dimorphic fungus, and is predominantly found in host tissues as round yeast cells. However, there is a specific morphological change associated with cryptococcal infection that involves an increase in capsule volume. We now report another morphological change whereby gigantic cells are formed in tissue. The paper reports the phenotypic characterization of giant cells isolated from infected mice and the cellular changes associated with giant cell formation. C. neoformans infection in mice resulted in the appearance of giant cells with cell bodies up to 30 microm in diameter and capsules resistant to stripping with gamma-radiation and organic solvents. The proportion of giant cells ranged from 10 to 80% of the total lung fungal burden, depending on infection time, individual mice, and correlated with the type of immune response. When placed on agar, giant cells budded to produce small daughter cells that traversed the capsule of the mother cell at the speed of 20-50 m/h. Giant cells with dimensions that approximated those in vivo were observed in vitro after prolonged culture in minimal media, and were the oldest in the culture, suggesting that giant cell formation is an aging-dependent phenomenon. Giant cells recovered from mice displayed polyploidy, suggesting a mechanism by which gigantism results from cell cycle progression without cell fission. Giant cell formation was dependent on cAMP, but not on Ras1. Real-time imaging showed that giant cells were engaged, but not engulfed by phagocytic cells. We describe a remarkable new strategy for C. neoformans to evade the immune response by enlarging cell size, and suggest that gigantism results from replication without fission, a phenomenon that may also occur with other fungal pathogens.

  3. Sotos syndrome: An interesting disorder with gigantism

    Nalini A

    2008-01-01

    Full Text Available We report the case of a 16-year-old boy diagnosed to have Sotos syndrome, with rare association of bilateral primary optic atrophy and epilepsy. He presented with accelerated linear growth, facial gestalt, distinctive facial features, seizures and progressive diminution of vision in both eyes. He had features of gigantism from early childhood. An MRI showed that brain and endocrine functions were normal. This case is of interest, as we have to be aware of this not so rare disorder. In addition to the classic features, there were two unusual associations with Sotos syndrome in the patient.

  4. Papillary eccrine adenoma

    Laxmisha Chandrashekar

    2004-01-01

    Full Text Available A 28-year-old man came to us with a solitary skin colored, mildly tender nodule of 6 months duration on the dorsum of the right hand. On histological examination, multiple dilated ducts without apparent continuity with the surface were found in the dermis. These dilated ducts had branching tubules with eosinophilic amorphous material filling most of the lumina. The peripheral cells of the tubules resembled myoepithelial cells, whereas the luminal border cells were cuboidal or low columnar. Papillary projections arising from the inner cells were seen extending into the lumen. These features were diagnostic of a rare tumor, papillary eccrine adenoma.

  5. Aneurisma gigante da arteria cerebral media: relato de um caso

    Geraldo Pianetti Filho

    1978-06-01

    Full Text Available É relatado um caso de aneurisma gigante da artéria cerebral média com as dimensões de 12,0 x 8,0 x 6,0 cm, tratado cirurgicamente mediante craniotomia e ressecção. É feita breve análise da conduta diante dos aneurismas gigantes. Os autores acreditam ser este o maior aneurisma cerebral já descrito até o presente momento.

  6. Gigantism and Its Implications for the History of Life.

    Geerat J Vermeij

    Full Text Available Gigantism-very large body size-is an ecologically important trait associated with competitive superiority. Although it has been studied in particular cases, the general conditions for the evolution and maintenance of gigantism remain obscure. I compiled sizes and dates for the largest species in 3 terrestrial and 7 marine trophic and habitat categories of animals from throughout the Phanerozoic. The largest species (global giants in all categories are of post-Paleozoic age. Gigantism at this level appeared tens to hundreds of millions of years after mass extinctions and long after the origins of clades in which it evolved. Marine gigantism correlates with high planktic or seafloor productivity, but on land the correspondence between productivity and gigantism is weak at best. All global giants are aerobically active animals, not gentle giants with low metabolic demands. Oxygen concentration in the atmosphere correlates with gigantism in the Paleozoic but not thereafter, likely because of the elaboration of efficient gas-exchange systems in clades containing giants. Although temperature and habitat size are important in the evolution of very large size in some cases, the most important (and rare enabling circumstance is a highly developed ecological infrastructure in which essential resources are abundant and effectively recycled and reused, permitting activity levels to increase and setting the stage for gigantic animals to evolve. Gigantism as a hallmark of competitive superiority appears to have lost its luster on land after the Mesozoic in favor of alternative means of achieving dominance, especially including social organization and coordinated food-gathering.

  7. CT scan in diagnosis of pituitary adenomas, 5. CT findings of GH secreting adenomas

    Sakoda, K.; Yonezawa, M.; Gen, M. (Hiroshima Univ. (Japan). School of Medicine)

    1981-10-01

    Clinical findings and radiological findings in 19 cases of GH secreting adenoma were reported. In diagnosis of GH secreting adenoma, conventional radiography and computed tomography of the sella turcica are useful. The CT of this kind of adenomas shows a characteristically higher x-ray absorption coefficient than other adenomas.

  8. Radiosurgery for pituitary adenomas; Radiocirurgia nos adenomas hipofisarios

    Castro, Douglas Guedes de; Salvajoli, Joao Victor; Canteras, Miguel Montes; Cecilio, Soraya A. Jorge [Instituto de Radiocirurgia Neurologica, Sao Paulo, SP (Brazil)]. E-mail: dougguedes@uol.com.br

    2006-12-15

    Pituitary adenomas represent nearly 15% of all intracranial tumors. Multimodal treatment includes microsurgery, medical management and radiotherapy. Microsurgery is the primary recommendation for nonfunctioning and most of functioning adenomas, except for prolactinomas that are usually managed with dopamine agonist drugs. However, about 30% of patients require additional treatment after microsurgery for recurrent or residual tumors. In these cases, fractionated radiation therapy has been the traditional treatment. More recently, radiosurgery has been established as a treatment option. Radiosurgery allows the delivery of prescribed dose with high precision strictly to the target and spares the surrounding tissues. Therefore, the risks of hypopituitarism, visual damage and vasculopathy are significantly lower. Furthermore, the latency of the radiation response after radiosurgery is substantially shorter than that of fractionated radiotherapy. The goal of this review is to define the efficacy, safety and role of radiosurgery for treatment of pituitary adenomas and to present the preliminary results of our institution. (author)

  9. Villous adenoma of the distal appendix.

    Taylor, J V; Thomas, M G; Kelly, S; Sutton, R

    1997-04-01

    Villous adenoma confined to the distal appendix has not been previously reported in conjunction with acute apendicitis. The presence of an adenoma indicates a need for further investigation due to an association with neoplasia elsewhere.

  10. Serrated adenoma of stomach: A premalignancy?

    Divya Achutha Ail

    2015-01-01

    Full Text Available Serrated adenoma is a newly described entity in the group of gastric adenomas. Until date only 20 cases of gastric serrated adenoma have been reported. It is an important entity to be diagnosed accurately as it has a very high-risk of malignant transformation, especially those located in the cardia of stomach. Serrated adenoma associated with adenocarcinoma is more frequent in the elderly, but pure serrated adenoma is common in the young, in whom follow-up is mandatory. Gastric serrated adenoma has distinct location, definite histomorphology and characteristic Ki-67 immunohistochemical staining. Ki-67 staining helps to differentiated pure serrated adenoma from those associated with adenocarcinoma. We present a young adult male, incidentally detected to have gastric serrated adenoma.

  11. Double pituitary adenomas: six surgical cases.

    Sano, T; Horiguchi, H; Xu, B; Li, C; Hino, A; Sakaki, M; Kannuki, S; Yamada, S

    1999-05-01

    While double pituitary adenomas have been found in approximately 1% of autopsy pituitaries, those in surgically resected material have been only rarely reported. We report herein 6 cases of double pituitary adenomas, which consisted of two histologically and/or immunohistochemically different areas among approximately 450 surgical specimens. Five out of 6 patients were men and the age was ranged between 18 and 61 years old. All these 6 patients presented acromegaly or acrogigantism and hyperprolactinemia was noted in 3 patients. In 2 patients (cases 1 and 2) the two adenomas belonged to different adenoma groups (GH-PRL-TSH group and FSH/LH group), while in the remaining 4 patients (cases 3-6) the two adenomas belonged to the same group (GH-PRL-TSH group). Thus, in all patients at least one of the two adenomas was GH-producing adenoma. Reasons for a high incidence of GH-producing adenomas in surgically resected double pituitary adenomas may include the presence of a variety of histologic subtypes among GH-producing adenomas and the advantage of cytokeratin immunostaining to distinguish these subtypes. In regard to pathogenesis of double pituitary adenomas, adenomas in cases 1 and 2 may be of multicentric occurrence, while those in cases 3-6 may occur through different clonal proliferation within originally one adenoma, resulting in diverse phenotypic expressions. Since there were patients with familial MEN 1 (case 2) and familial pituitary adenoma unrelated MEN 1 (case 3), genetic background should be also considered. Double pituitary adenomas in surgically resected material may not be so infrequent. Further molecular analysis will provide new insights into understanding the pathogenesis of pituitary adenomas and their mechanisms of multidirectional phenotypic diffrentiation.

  12. Clear cell myoepithelial carcinoma ex pleomorphic adenoma

    Nikhil R Rabade

    2014-01-01

    Full Text Available Pleomorphic adenoma is the most common epithelial neoplasm of lacrimal gland. A clear cell myoepithelial carcinoma arising in the background of pleomorphic adenoma is common in the salivary glands but very rare in the lacrimal glands. We report the case of a 27 year old man whose lacrimal gland pleomorphic adenoma recurred several times over a period of four years and ultimately evolved into a clear cell myoepithelial carcinoma ex pleomorphic adenoma.

  13. [Prostatilen treatment of prostatic adenoma].

    Al'-Shukri, S Kh; Gorbachev, A G; Borovets, S Iu; Belousov, V Ia; Kuz'min, I V; Chushkin, K A

    2006-01-01

    We studied efficacy of repeated courses of prostatilen in suppositories with dimexide in prostatic adenoma patients with normal micturition. Rectal suppositories contain 30 mg prostatilen and 90 mg dimexide. The course consisted of 15 suppositories. The treatment reduced clinical symptoms of infravesical obstruction, residual urine volume in administration of prostatilen in 15-day courses each 3 months. This suggests possibility of suppository prostatilen use not only as an alternative for expensive drugs but also in combination with them in treatment of initial prostatic adenoma.

  14. Late paleozoic fusulinoidean gigantism driven by atmospheric hyperoxia.

    Payne, Jonathan L; Groves, John R; Jost, Adam B; Nguyen, Thienan; Moffitt, Sarah E; Hill, Tessa M; Skotheim, Jan M

    2012-09-01

    Atmospheric hyperoxia, with pO(2) in excess of 30%, has long been hypothesized to account for late Paleozoic (360-250 million years ago) gigantism in numerous higher taxa. However, this hypothesis has not been evaluated statistically because comprehensive size data have not been compiled previously at sufficient temporal resolution to permit quantitative analysis. In this study, we test the hyperoxia-gigantism hypothesis by examining the fossil record of fusulinoidean foraminifers, a dramatic example of protistan gigantism with some individuals exceeding 10 cm in length and exceeding their relatives by six orders of magnitude in biovolume. We assembled and examined comprehensive regional and global, species-level datasets containing 270 and 1823 species, respectively. A statistical model of size evolution forced by atmospheric pO(2) is conclusively favored over alternative models based on random walks or a constant tendency toward size increase. Moreover, the ratios of volume to surface area in the largest fusulinoideans are consistent in magnitude and trend with a mathematical model based on oxygen transport limitation. We further validate the hyperoxia-gigantism model through an examination of modern foraminiferal species living along a measured gradient in oxygen concentration. These findings provide the first quantitative confirmation of a direct connection between Paleozoic gigantism and atmospheric hyperoxia.

  15. Ependimoma myxopapilar sacro gigante con osteolisis

    Ajler, Pablo; Landriel, Federico; Goldschmidt, Ezequiel; Campero, Álvaro; Yampolsky, Claudio

    2014-01-01

    Objetivo: la presentación de un caso de una paciente con un ependimoma sacro con extensa infiltración y destrucción ósea local. Descripción del caso: una mujer de 53 años acudió a la consulta por dolor lumbosacro y alteraciones sensitivas perineales y esfinterianas. La imágenes por Resonancia Magnética (IRM) y la Tomografía Axial Computada (TAC) mostraron una lesión expansiva gigante a nivel S2-S4 con extensa osteólisis e invasión de tejidos adyacentes. Se realizó una exéresis tumoral completa con mejoría del estatus funcional. La anatomía patológica informó ependimoma mixopapilar. Discusión: la extensión de la resección quirúrgica es el mejor predictor de buen pronóstico. El tratamiento radiante se reserva como opción adyuvante para las resecciones incompletas y recidiva tumoral. La quimioterapia sólo debería utilizarse en casos en que la cirugía y la radioterapia estén contraindicadas. Conclusión: Los ependimomas mixopapilares sacros con destrucción ósea y presentación intra y extradural son muy infrecuentes y deben ser tenidos en cuenta entre los diagnósticos diferenciales preoperatorios. Su resección total, siempre que sea posible, es la mejor alternativa terapéutica. PMID:25165615

  16. Transcranial surgery for pituitary adenomas.

    Youssef, A Samy; Agazzi, Siviero; van Loveren, Harry R

    2005-07-01

    Although the transsphenoidal approach is the preferred approach to the vast majority of pituitary tumors with or without suprasellar extension, the transcranial approach remains a vital part of the neurosurgical armamentarium for 1 to 4% of these tumors. The transcranial approach is effective when resection becomes necessary for a portion of a pituitary macroadenoma that is judged to be inaccessible from the transsphenoidal route because of isolation by a narrow waist at the diaphragma sellae, containment within the cavernous sinus lateral to the carotid artery, projection anteriorly onto the planum sphenoidale, or projection laterally into the middle fossa. The application of a transcranial approach in these circumstances may still be mitigated by response to prolactin inhibition of prolactinomas, the frequent lack of necessity to remove asymptomatic nonsecretory adenomas from the cavernous sinus, and the lack of evidence that sustained chemical cures can be reliably achieved by removal of secretory adenomas (adrenocorticotropic hormone, growth hormone) from the cavernous sinus. Cranial base surgical techniques have refined the surgical approach to pituitary adenomas but have had less effect on actual surgical indications than anticipated. Because application of the transcranial approach to pituitary adenomas is and should be rare in clinical practice, it is useful to standardize the technique to a default mode with which the surgical team is most experienced and, therefore, most comfortable. Our default mode for transcranial pituitary surgery is the frontotemporal-orbitozygomatic approach.

  17. Macrodystrophia lipomatosa: An unusual cause of localized gigantism

    S Uma Maheswari

    2016-01-01

    Full Text Available Macrodystrophia lipomatosa (MDL is a rare congenital form of localized gigantism characterized by progressive overgrowth of all mesenchymal elements with a disproportionate increase in fibro adipose tissue. Here we report a case of 20 years old male who presented with history of painless gradual enlargement of entire left upper limb since childhood. Magnetic resonance imaging and histopathology confirmed the diagnosis of macrodystrophia lipomatosa. This condition has to be differentiated from other causes of localized gigantism, since these conditions differ in their course, prognosis, complications and treatment.

  18. Macrodystrophia Lipomatosa: An Unusual Cause of Localized Gigantism.

    Maheswari, S Uma; Sampath, V; Ramesh, A; Manoharan, K

    2016-01-01

    Macrodystrophia lipomatosa (MDL) is a rare congenital form of localized gigantism characterized by progressive overgrowth of all mesenchymal elements with a disproportionate increase in fibro adipose tissue. Here we report a case of 20 years old male who presented with history of painless gradual enlargement of entire left upper limb since childhood. Magnetic resonance imaging and histopathology confirmed the diagnosis of macrodystrophia lipomatosa. This condition has to be differentiated from other causes of localized gigantism, since these conditions differ in their course, prognosis, complications and treatment.

  19. First observations of Gigantic Jets from Monsoon Thunderstorms over India

    Singh, Rajesh; Maurya, Ajeet; Chanrion, Olivier; Neubert, Torsten; Cummer, Steven; Mlynarczyk, Janusz; Bór, József; Siingh, Devendraa; Cohen, Morris; Kumar, Sushil

    2016-04-01

    Gigantic Jets are electric discharges from thunderstorm cloud tops to the bottom of the ionosphere at ~80 km altitude. After their first discovery in 2001, relatively few observations have been reported. Most of these are from satellites at large distances and a few tens from the ground at higher spatial resolution. Here we report the first Gigantic Jets observed in India from two thunderstorm systems that developed over the land surface from monsoon activity, each storm producing two Gigantic Jets. The jets were recorded by a video camera system at standard video rate (20 ms exposure) at a few hundred km distance. ELF measurements suggest that the jets are of the usual negative polarity and that they develop in less than 40 ms, which is faster than most jets reported in the past. The jets originate from the leading edge of a slowly drifting convective cloud complex close to the highest regions of the clouds and carry ~25 Coulomb of charge to the ionosphere. One jet has a markedly horizontal displacement that we suggest is caused by a combination of close-range cloud electric fields at inception, and longer-range cloud fields at larger distances during full development. The Gigantic Jets are amongst the few that have been observed over land.

  20. Surgery of gigantic infrarenal aneurysm of abdominal aorta

    N. Rustempašić

    2005-08-01

    Full Text Available The case shows gigantic aneurysm of abdominal aorta, localized infrarenally, as well as aneurysms of bilateral iliac arteries, which were solved successfully by resection of aneurism of abdominal aorta, closure of iliac arteries near aortic bifurcation, and interposition of aorta-bifemural vascular graft. There were no postoperative complications,and final outcome was fully satisfactory.

  1. Octreotide Uptake in Parathyroid Adenoma

    Karaçavuş, Seyhan; Kula, Mustafa; Cihan Karaca, Züleyha; Ünlühızarcı, Kürşad; Tutuş, Ahmet; Bayram, Fahri; Çoban, Ganime

    2012-01-01

    The patient with a history of bone pain and muscle weakness, was thought to have oncogenic osteomalacia as a result of biochemical investigations and directed to Nuclear Medicine Department for a whole-body bone scintigraphy and 111In-octreotide scintigraphy. There was no focal pathologic tracer uptake, but generalized marked increase in skeletal uptake on bone scintigraphy. Octreotide scintigraphy showed accumulation of octreotide in the region of the left lobe of the thyroid gland in the neck. Thereafter, parathyroid scintigraphy was performed with technetium-99m labeled metroxy-isobutyl-isonitryl (99mTc-MIB) and MIBI scan demonstrated radiotracer uptake at the same location with octreotide scintigraphy. The patient underwent left inferior parathyroidectomy and histopathology confirmed a parathyroid adenoma. Somatostatin receptor positive parathyroid adenoma may show octreotide uptake. Octreotide scintigraphy may be promising and indicate a possibility of using somatostatin analogues for the medical treatment of somatostatin receptor positive Conflict of interest:None declared. PMID:23487397

  2. MRI of pituitary adenomas in acromegaly

    Marro, B. [Service de Neuroradiologie, Batiment Babinsky, Hopital Salpetriere, 47, Bd de l`Hopital, F-75013 Paris (France); Zouaoui, A. [Service de Neuroradiologie, Batiment Babinsky, Hopital Salpetriere, 47, Bd de l`Hopital, F-75013 Paris (France); Sahel, M. [Service de Neuroradiologie, Batiment Babinsky, Hopital Salpetriere, 47, Bd de l`Hopital, F-75013 Paris (France); Crozat, N. [Service de Neuroradiologie, Batiment Babinsky, Hopital Salpetriere, 47, Bd de l`Hopital, F-75013 Paris (France); Gerber, S. [Service de Neuroradiologie, Batiment Babinsky, Hopital Salpetriere, 47, Bd de l`Hopital, F-75013 Paris (France); Sourour, N. [Service de Neuroradiologie, Batiment Babinsky, Hopital Salpetriere, 47, Bd de l`Hopital, F-75013 Paris (France); Sag, K. [Service de Neuroradiologie, Batiment Babinsky, Hopital Salpetriere, 47, Bd de l`Hopital, F-75013 Paris (France); Marsault, C. [Service de Neuroradiologie, Batiment Babinsky, Hopital Salpetriere, 47, Bd de l`Hopital, F-75013 Paris (France)

    1997-06-01

    Adenomas causing acromegaly represent at least a quarter of pituitary adenomas. We studied 12 patients presenting with active acromegaly due to a pituitary adenoma with a 1.5 T superconductive MRI unit. All had T1-weighted sagittal and coronal sections before and after Gd-DTPA; six had coronal T2-weighted images. Surgical correlation was obtained in seven patients. Histologically, there were eight growth hormone (GH)-secreting and three mixed [GH and prolactin (PRL) secreting] adenomas, and one secreting GH, PRL and follicle-stimulating hormone. Macroadenomas (10) were more frequent than microadenomas (2). No correlation was found between serum GH and tumour size. There were nine adenomas in the lateral part of the pituitary gland; seven showed lateral or infrasellar invasion. Homogeneous, isointense signal on T1- and T2-weighted images was observed in six cases. Heterogeneous adenomas had cystic or necrotic components. (orig.). With 5 figs., 3 tabs.

  3. Gene mutations in hepatocellular adenomas

    Raft, Marie B; Jørgensen, Ernö N; Vainer, Ben

    2015-01-01

    is associated with bi-allelic mutations in the TCF1 gene and morphologically has marked steatosis. β-catenin activating HCA has increased activity of the Wnt/β-catenin pathway and is associated with possible malignant transformation. Inflammatory HCA is characterized by an oncogene-induced inflammation due....... This review offers an overview of the reported gene mutations associated with hepatocellular adenomas together with a discussion of the diagnostic and prognostic value....

  4. Pleomorphic Adenoma of the Upper Lip

    Ülkü KÜÇÜK

    2011-01-01

    Full Text Available Pleomorphic adenoma is the most common neoplasm of the salivary glands and is most commonly located in the parotis followed by the submandibular glands. Its localization in the minor salivary glands is mostly reported in the palate. Few publications report pleomorphic adenoma cases located in the lip.We present a 35-year-old male patient with a pleomorphic adenoma located in the upper lip.

  5. Adenoma Malignum Detected on a Trauma CT

    McEachern, James; Butcher, Matthew; Burbridge, Brent; Zhu, Yu

    2013-01-01

    Adenoma malignum is a rare subtype of cervical adenocarcinoma. Clinical presentation is variable with watery vaginal discharge being the most commonly associated finding. We report a case of adenoma malignum incidentally detected on pelvic computed tomography (CT) performed for a trauma patient. The cervical mass was further characterized by magnetic resonance (MR) imaging and remained compatible with adenoma malignum. Local cervical biopsy was suggestive of the diagnosis which was subsequent...

  6. Giant hepatocellular adenoma; case report

    Pitella, F.A.; Coutinho, A.M.N.; Coura Filho, G.B.; Costa, P.L.A.; Ono, C.R.; Watanabe, T.; Sapienza, M.T.; Hironaka, F.; Cerri, G.G.; Buchpiguel, C.A. [Universidade de Sao Paulo (FM/USP), SP (Brazil). Inst. de Radiologia. Servico de Medicina Nuclear

    2008-07-01

    Full text: Introduction: Hepatocellular adenoma is a benign hepatic tumor identified mainly in women during fertility age, with estimated incidence of 4/1000 inhabitants. It is usually unique, well circumscribed, with or without a capsule, size varying from 1 to 30 cm, with possible central areas of necrosis and hemorrhage. Case Report: A 37-year-old female patient presenting with no comorbities, use of hormonal birth control pills for 18 years, a condition of reduction in the consistency of feces, increase in number of daily defecations, abdominal cramps, and a stuffed sensation after meals for two years. A palpable abdominal mass extending from the right hypochondriac to the right iliac fossa was noticed four months ago. A computerized tomography (CT) showed an extensive hepatic mass on the right which was considered, within the diagnostic hypotheses, hepatic adenomatosis, without ruling out secondary lesions. A hepatic scintillography with {sup 99m}Tc-DISIDA showed an extensive exophytic area from segment V to the right iliac fossa with arterialized blood flow and hepatocytic activity, as well as a hepatic nodule in segment VII with hepatocytic activity consistent with the hepatic adenomas hypothesis. The biopsy confirmed the hepatic adenoma diagnosis and the patient was submitted to a partial hepatectomy and cholecystectomy with good clinical evolution. Conclusion: Nuclear Medicine may supplement the assessment of hepatic nodules, including giant masses, thus suggesting new hypotheses and direction to therapeutic conduct. (author)

  7. Piecemeal Versus En Bloc Resection of Large Rectal Adenomas

    2016-05-10

    Colorectal Adenoma With Mild Dysplasia; Colorectal Adenoma With Severe Dysplasia; Colorectal Adenomatous Polyp; Colorectal Low Grade Intraepithelial Neoplasia; Colorectal High Grade Intraepithelial Neoplasia

  8. Nevo melanocítico congênito gigante

    Guilherme Lippi Ciantelli

    2014-06-01

    Full Text Available Os nevos melanocíticos congênitos (NMC são lesões pigmentadas formadas a partir do acúmulo anormal de melanócitos neuroectodérmicos em uma localização ectópica e estão presentes em 1% dos recém-nascidos. Contudo, os NMC gigantes ocorrem em apenas 1:20.000 nascidos vivos, enquanto os com a típica distribuição em “calção de banho” são muito raros, estando presentes em apenas 1:500.000 nascidos vivos. Neste artigo os autores relatam um caso de NMC gigante em “calção de banho” devido a sua raridade, revisando os aspectos diagnósticos e terapêuticos desta afecção.

  9. A gigantic feathered dinosaur from the lower cretaceous of China.

    Xu, Xing; Wang, Kebai; Zhang, Ke; Ma, Qingyu; Xing, Lida; Sullivan, Corwin; Hu, Dongyu; Cheng, Shuqing; Wang, Shuo

    2012-04-04

    Numerous feathered dinosaur specimens have recently been recovered from the Middle-Upper Jurassic and Lower Cretaceous deposits of northeastern China, but most of them represent small animals. Here we report the discovery of a gigantic new basal tyrannosauroid, Yutyrannus huali gen. et sp. nov., based on three nearly complete skeletons representing two distinct ontogenetic stages from the Lower Cretaceous Yixian Formation of Liaoning Province, China. Y. huali shares some features, particularly of the cranium, with derived tyrannosauroids, but is similar to other basal tyrannosauroids in possessing a three-fingered manus and a typical theropod pes. Morphometric analysis suggests that Y. huali differed from tyrannosaurids in its growth strategy. Most significantly, Y. huali bears long filamentous feathers, thus providing direct evidence for the presence of extensively feathered gigantic dinosaurs and offering new insights into early feather evolution.

  10. Hamartoma mamario gigante: dos casos de una entidad rara

    T.A. Gomes-Rodrigues

    2014-09-01

    Full Text Available El hamartoma gigante de la mama es una entidad clínico-patológica inusual que tiende a confundirse con otros tumores. A pesar del avance en las técnicas diagnósticas, su diagnóstico clínico es difícil y normalmente solo se confirma cuando se analiza toda la pieza de resección. El diagnóstico diferencial debe incluir entidades como el fibroadenoma, lipoma, tumor phyllodes y diversos tipos de carcinomas. Presentamos 2 casos de hamartoma gigante de mama en mujeres de edad media, de los cuales uno fue tratado mediante mastectomía conservadora de complejo pezónareola y reconstrucción con prótesis y el otro con biopsia escisional y remodelación con patrón de pexia mamaria.

  11. Proton therapy of hypophyseal adenomas

    Mirakova, E.I.; Kirpatovskaya, L.E.; Lyass, F.M.; Snigireva, R.Ya.; Krymskij, V.A. (Akademiya Meditsinskikh Nauk SSSR, Moscow. Inst. Nejrokhirurgii; Akademiya Meditsinskikh Nauk SSSR, Moscow. Inst. Ehksperimental' noj Ehndokrinologii i Khimii Gormonov)

    1983-10-01

    The authors present the results of proton therapy in 59 patients with different hypophyseal adenomas. The period of observation lasted from 6 mos. to 5 yrs. Irradiation was done using a multifield-convergent method and a proton beam of the ITEF synchrotron. The beam energy was 200 MeV, the beam diameter 7-15 mm. Radiation response and immediate results were evaluated for all the patients. The least favorable results were noted in the patients with prolactinomas, for which, in addition to irradiation, parlodel therapy is needed. No marked radiation reactions, neurological complications and manifestations of hypopituitarism were observed with the chosen doses and schemes of irradiation.

  12. Magnetic resonance imaging of pituitary adenomas

    Bonneville, Jean-Francois; Bonneville, Fabrice; Cattin, Francoise [University Hospital, Department of Neuroradiology, Besancon (France)

    2005-03-01

    Today, MR is the only method needed for the morphological investigation of endocrine-active pituitary adenomas. In acromegaly and Cushing's syndrome, the therapeutic attitude is directly dictated by MR data. We present the MR aspect of pituitary adenomas according to size, sex, age, endocrine activity and a few particular conditions such as hemorrhagic pituitary adenomas, pituitary adenomas during pregnancy, cavernous sinus invasion and postsurgical changes. When an intrasellar mass extending out of the sella turcica is detected, the goal of the MR examination is to indicate precisely the origin of the tumor, its extension in relation to the various surrounding structures, its structure and its enhancement in order to help in the differential diagnosis. Demonstration of very small pituitary adenomas remains a challenge. When SE T1- and Turbo SE T2-weighted sequences are non-diagnostic, enhanced imaging becomes mandatory; half-dose gadolinium injection, delayed sequence, dynamic imaging can be of some help. (orig.)

  13. Multiple origins of gigantism in stem baleen whales

    Tsai, Cheng-Hsiu; Kohno, Naoki

    2016-12-01

    Living baleen whales (Mysticeti) include the world's largest animals to have ever lived—blue whales ( Balaenoptera musculus) can reach more than 30 m. However, the gigantism in baleen whales remains little explored. Here, we compiled all published stem mysticetes from the Eocene and Oligocene and then mapped the estimated body size onto different phylogenies that suggest distinct evolutionary histories of baleen whales. By assembling all known stem baleen whales, we present three novel findings in early mysticete evolution. Results show that, regardless of different phylogenetic scenarios, large body size (more than 5-m long) evolved multiple times independently in their early evolutionary history. For example, the earliest known aetiocetid ( Fucaia buelli, 33-31 Ma) was small in size, about 2 m, and a later aetiocetid ( Morawanocetus-like animal, 26-23 Ma) can reach 8-m long—almost four times the size of Fucaia buelli—suggesting an independent gigantism in the aetiocetid lineage. In addition, our reconstruction of ancestral state demonstrates that the baleen whales originated from small body size (less than 5 m) rather than large body size as previously acknowledged. Moreover, reconstructing the evolution of body size in stem baleen whales suggests that the initial pulse of mysticete gigantism started at least back to the Paleogene and in turn should help to understand the origin, pattern, and process of the extreme gigantism in the crown baleen whales. This study illustrates that Cope's rule is insufficient to explain the evolution of body size in a group that comprises the largest animals in the history of life, although currently the lack of exact ancestor-descendant relationships remains to fully reveal the evolutionary history of body size.

  14. Breast gigantism induced by D-penicillamine: case report

    Cha, Ji Hyeon; Kim, Hak Hee; Kim, Sun Mi; Seo, Myung Hee; Yoon, Hoi Soo [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)

    2004-03-01

    D-penicillamine, a chelating agent of copper, is the drug of choice for the treatment of Wilson's disease. Breast enlargement is a rare complication arising from its use, and we report a case of breast gigantism which developed after it had been used for ten months to treat this condition. Mammography demonstrated bilaterally enlarged dense breasts; ultrasonography, similarly, demonstrated enlargement, revealing the presence of a mass, shown at biopsy to be benign, in the left one.

  15. Teratoma gigante de mediastino anterior con taponamiento cardiaco.

    López-Carranza, Mario; Cirujano de tórax y cardiovascular. Servicio de Cirugía Torácica y Cardiovascular. Hospital Víctor Lazarte Echegaray EsSalud. Trujillo.; Silva-Rodríguez, Oswaldo; Anátomo-Patólogo. Servicio de Anatomía Patológica. Hospital Víctor Lazarte Echegaray EsSalud. Trujillo.; Carbajal-Vásquez, Américo; Médico Anátomo-Patólogo. Hospital Víctor Lazarte Echegaray EsSalud. Trujillo.

    2012-01-01

    Los teratomas de mediastino, se adhieren y comprimen las estructuras adyacentes y rara vez producen taponamientocardiaco; cuando ocurren se deben a la perforación del pericardio. Se presenta un paciente adulto, con teratomamediastinal gigante, que presentó taponamiento cardiaco sin tener perforación pericárdica, siendo intervenidoquirúrgicamente mediante incisión de Clamshell. Probablemente, constituya el teratoma mediastinal más grandecon taponamiento cardiaco reportado.

  16. Diagnóstico del consumidor de calamar gigante en México y en Sonora

    Ma. Consepción Luna Raya

    2006-01-01

    con gustos y preferencias del consumidor del calamar gigante, se utilizaron resultados de 1,799 encuestas aplicadas en 14 ciudades del país. Los resultados de las encuestas indican que el consumo del calamar gigante, en frecuencia y cantidad, es bajo; no obstante, se encontró una tendencia hacia el consumo del calamar gigante con valor agregado. En términos generales, existen oportunidades para fomentar el consumo del calamar gigante en los ámbitos nacional y regional.

  17. Octreotide Uptake in Parathyroid Adenoma

    Seyhan Karaçavuş

    2012-08-01

    Full Text Available The patient with a history of bone pain and muscle weakness, was thought to have oncogenic osteomalacia as a result of biochemical investigations and directed to Nuclear Medicine Department for a whole-body bone scintigraphy and 111In-octreotide scintigraphy. There was no focal pathologic tracer uptake, but generalized marked increase in skeletal uptake on bone scintigraphy. Octreotide scintigraphy showed accumulation of octreotide in the region of the left lobe of the thyroid gland in the neck. Thereafter, parathyroid scintigraphy was performed with technetium-99m labeled metroxy-isobutyl-isonitryl (99mTc-MIB and MIBI scan demonstrated radiotracer uptake at the same location with octreotide scintigraphy. The patient underwent left inferior parathyroidectomy and histopathology confirmed a parathyroid adenoma. Somatostatin receptor positive parathyroid adenoma may show octreotide uptake. Octreotide scintigraphy may be promising and indicate a possibility of using somatostatin analogues for the medical treatment of somatostatin receptor positive parathyroid tumors. (MIRT 2012;21:77-79

  18. Giant Parotid Pleomorphic Adenoma Involving Parapharyngeal Space

    Sukri Rahman

    2013-09-01

    Full Text Available AbstrakLatar belakang: Pleomorfik adenoma parotis merupakan tumor jinak kelenjar liur yang paling sering ditemukan, namun pleomorfik adenoma parotis yang sangat besar sehingga melibatkan ruang parafaring (RPF sangat jarang. Diagnosis ini sulit ditegakkan karena gejala klinisnya tidak khas. Penatalaksanaanya harus hati-hati mengingat banyak struktur vital yang beresiko mengalami trauma. Tujuan: Bagaimana menegakkan diagnosis dan penatalaksanaan pleomorfik adenoma parotis yang melibatkan RPF. Kasus: Seorang pasien perempuan 27 tahun ditegakkan diagnosis pleomorfik adenoma parotis kanan dengan melibatkan RPF. Terdapat pembengkakan pada leher yang bersifat asimtomatis dan gejala pendorongan faring dan laring yang menyebabkan disfonia, disfagia, dan defisit saraf kranial IX,X,XII. Penatalaksanaan: Pasien telah dilakukan operasi parotidektomi pendekatan transervikal–transparotid dengan preservasi arteri karotis eksterna dan saraf fasialis. Kesimpulan: Biopsi Aspirasi Jarum Halus (BAJAH dan radiologi merupakan pemeriksaan yang penting untuk menegakkan diagnosis. Penatalaksanaan pleomorfik adenoma parotis yang melibatkan RPF adalah bedah ekstirpasi komplit dengan beberapa pendekatan. .Kata kunci: tumor jinak kelenjar liur, pleomorfik adenoma, ruang parafaringAbstractBackground: Parotid pleomorphic adenoma is the most common benign salivary gland tumor, while giant parotid pleomorphic adenoma involving the parapharyngeal space (PPS is rare. It was difficult to diagnose because the clinical presentation of this tumor can be subtle. The management must be performed carefully due to anatomy relation to complex vital structure lead to traumatic injury highrisk. Purposes: How to make diagnosis and management parotid pleomorphic adenoma involving PPS. Case: A female 27 years old with diagnosis was giant parotid pleomorphic adenoma involving PPS. There was asymptomatic swelling of the neck and presence of pushing the pharynx and larynx medially causes

  19. The pathophysiology of pituitary adenomas.

    Dworakowska, Dorota; Grossman, Ashley B

    2009-10-01

    The pathogenesis of tumour formation in the anterior pituitary has been intensively studied, but the causative mechanisms involved in pituitary cell transformation and tumourigenesis remain elusive. Most pituitary tumours are sporadic, but some arise as a component of genetic syndromes such as the McCune-Albright syndrome, multiple endocrine neoplasia type 1, Carney complex and, the most recently described, a MEN1-like phenotype (MEN4) and pituitary adenoma predisposition syndromes. Some specific genes have been identified that predispose to pituitary neoplasia (GNAS, MEN1, PRKAR1A, CDKN1B and AIP), but these are rarely involved in the pathogenesis of sporadic tumours. Mutations of tumour suppressor genes or oncogenes, as seen in more common cancers, do not seem to play an important role in the great majority of pituitary adenomas. The pituitary tumour transforming gene (PTTG; securin) was the first transforming gene found to be highly expressed in pituitary tumour cells, and seems to play an important role in the process of oncogenesis. Many tumour suppressor genes, especially those involved in the regulation of the cell cycle, are under-expressed, most often by epigenetic modulation - usually promoter hypermethylation - but the regulator of these co-ordinated series of methylations is also unclear. Cell signalling abnormalities have been identified in pituitary tumours, but their genetic basis is unknown. Both Raf/MEK/ERK and PI3K/Akt/mTOR pathways are over-expressed and/or over-activated in pituitary tumours: these pathways share a common root, including initial activation related to the tyrosine kinase receptor, and we speculate that a change to these receptors or their relationship to membrane matrix-related proteins may be an early event in pituitary tumourigenesis.

  20. MicroRNAs in Human Pituitary Adenomas

    Xu-Hui Li

    2014-01-01

    Full Text Available MicroRNAs (miRNAs are a class of recently identified noncoding RNAs that regulate gene expression at posttranscriptional level. Due to the large number of genes regulated by miRNAs, miRNAs play important roles in many cellular processes. Emerging evidence indicates that miRNAs are dysregulated in pituitary adenomas, a class of intracranial neoplasms which account for 10–15% of diagnosed brain tumors. Deregulated miRNAs and their targets contribute to pituitary adenomas progression and are associated with cell cycle control, apoptosis, invasion, and pharmacological treatment of pituitary adenomas. To provide an overview of miRNAs dysregulation and functions of these miRNAs in pituitary adenoma progression, we summarize the deregulated miRNAs and their targets to shed more light on their potential as therapeutic targets and novel biomarkers.

  1. Pituitary prolactin adenoma with Toxoplasma gondii infection

    张晓晖; 李青; 程虹; 阎庆国; 黄高昇

    2003-01-01

    Objective: To report two recent cases of pituitary adenoma associated with Toxoplasma gondii (T.Gondii) infection.Methods: Histological changes were observed in H & E and PAS staining sections microscopically.Immunohistochemistry was performed to classify the pituitary tumors and to confirm the diagnosis of T.gondii.Results: The cases were 43- and 19-year-old females, in which the latter one was a recurring case, and radiology examination showed that tumors existed in sellar region.Microscopically, the tumors consisted of small homogenous polygonal or round cells with abundant eosinophilic granular cytoplasm.Immunohistochemistry revealed they were prolactin-producing adenomas.Interestingly, we found toxoplasma infection in the tumor tissues, being confirmed by T.gondii sepicific antibody immunohistochemistry.Conclusion: The association of pituitary adenoma with toxoplasma raises the possibility that T.gondii may be involved in the development of certain cases of pituitary adenoma.

  2. [Pleomorphic adenoma with bilateral pulmonary metastasis].

    De Kerangal, X; Poirrier, P; Soulard, R; Dot, J M; Ségneuric, J B; L'Her, P; Jancovici, R; Saint-Blancart, P

    2001-11-01

    We report a new case of pleomorphous adenoma of the submaxillary glands with multiple lung metastases. Histological proof was obtained on the thoracoscopic surgical specimen. Clinically, this benign tumor presents as a malignant tumor. Diagnosis has been a subject of debate; surgical resection is indicated. Diagnosis is achieved by elimination in a patient with one or several nodules occurring in a context of recurrent pleomorphous adenoma.

  3. The Oldest Recorded Case of Acromegaly and Gigantism in Iran.

    Najjari, Mohsen

    2015-10-01

    Here we commemorate the character and academic authority of Prof. Zabiholah Gorban (1903-2006), the founder of Shiraz medical school. No doubt, in the scope of history of contemporary medicine, he has been efficient and effective. With respect to this fact, his article on a rare case described in Acta anatomica published in Iran in 1966, entitled (Observations on a giant skeleton) is browsed and reviewed. A case named Siah Khan with combined acromegaly and gigantism that appears to have letters to say still after nearly half a century.

  4. Hereditary Gigantism-the biblical giant Goliath and his brothers.

    Donnelly, Deirdre E; Morrison, Patrick J

    2014-05-01

    The biblical giant Goliath has an identifiable family tree suggestive of autosomal dominant inheritance. We suggest that he had a hereditary pituitary disorder possibly due to the AIP gene, causing early onset and familial acromegaly or gigantism. We comment on the evidence within the scriptures for his other relatives including a relative with six digits and speculate on possible causes of the six digits. Recognition of a hereditary pituitary disorder in the biblical Goliath and his family sheds additional information on his and other family members' battles with David and his relatives.

  5. Proteus syndrome: A rare cause of gigantic limb

    Nandini Chakrabarti

    2014-01-01

    Full Text Available A congenital disorder with variable manifestations, including partial gigantism of the hands and feet with hypertrophy of soles, nevi, hemihypertrophy, gynecomastia, macrocephaly and other skull abnormalities, and abdominal lipomatosis. The cause is unknown, although a genetic origin, generally of autosomal-dominant transmission, has been conjectured. Symptoms can be treated, but there is no known cure. We present the case of a young male with grotesque overgrowth of the right lower limb, splenomegaly and multiple nevi. Angiography revealed venous malformation within the limb. The findings are in conformity to the criteria for the Proteus syndrome.

  6. Osteoma gigante en mandíbula. Reporte de Caso.

    Licéaga-Escalera, Carlos; Hospital Juárez de México. México D. F.; Del Bosque-Méndez, Jorge; Hospital Juárez de México. México D. F.; Aldape-Barrios, Beatriz; Facultad de Odontología, Universidad Nacional Autónoma de México. México D. F.; Montoya-Pérez, Luis; Hospital Juárez de México. México D. F., México; Morelos-Patiño, Ethien; Facultad de Odontología, Universidad Nacional Autónoma de México. México D. F.; González-Olmedo, Víctor; Facultad de Odontología, Universidad Nacional Autónoma de México. México D. F.

    2014-01-01

    El osteoma es una neoplasia benigna poco común, que se caracteriza por presentar un crecimiento óseo progresivo, el cual está compuesto por la proliferación bien diferenciada de hueso compacto y/o esponjoso. En el área maxilofacial se presenta con mayor frecuencia en la cara lingual posterior de la mandíbula. Se caracteriza por crecimiento lento y asintomático. El caso describe una paciente de 45 años con un osteoma gigante mandibular de 4 años de evolución tratado quirúrgicamente.

  7. The association between location, age and advanced colorectal adenoma characteristics

    Pommergaard, Hans-Christian; Burcharth, Jakob; Rosenberg, Jacob

    2016-01-01

    PURPOSE: Evidence supports an association between certain colorectal adenoma characteristics and predisposition to cancer. The association between anatomical location of colorectal adenoma, age and advanced adenomas needs attention. The objective of this study was to evaluate the possible...... association between occurrence of sporadic advanced adenomas with location and age. MATERIALS AND METHODS: A cross-sectional study using baseline data from index colonoscopy from a randomized controlled trial evaluating chemopreventive treatment against recurrence of colorectal adenomas was performed....... Inclusion criteria for patients were one adenoma of >1 cm in diameter or multiple adenomas of any size, or an adenoma of any size and familial disposition for colorectal cancer. Multivariate regression and propensity score-matched analyses were used to correlate location of adenomas and age with advanced...

  8. Cytogenetic analysis of colorectal adenomas: karyotypic comparisons of synchronous tumors

    Bomme, L; Bardi, G; Pandis, N

    1998-01-01

    adenomas. Twenty-four colorectal adenomas from 11 patients were subjected to chromosome banding analysis. Clonal chromosome abnormalities were found in 20 tumors. Recurrent structural rearrangements involved chromosomes 1, 13, 17, and 18. The most common numerical changes were gain of chromosomes 7, 13, 20......, and 3 and loss of chromosome 18. Eight adenomas had subclones as evidence of clonal evolution. Similar clones in separate polyps were seen in tumors from 6 patients; these adenomas were always located in the same part of the large bowel. In 2 patients, both with one rectal adenoma and one adenoma...

  9. Clinical applications of somatostatin analogs for growth hormone-secreting pituitary adenomas

    Wang JW

    2014-01-01

    Full Text Available Ji-wen Wang,1,2 Ying Li,3 Zhi-gang Mao,1,2 Bin Hu,1,2 Xiao-bing Jiang,1,2 Bing-bing Song,4 Xin Wang,4 Yong-hong Zhu,4 Hai-jun Wang1,21Department of Neurosurgery and Pituitary Tumor Center, The First Affiliated Hospital, Sun Yat-sen University, 2Key Laboratory of Pituitary Adenoma in Guangdong Province, 3State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 4Department of Histology and Embryology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, People's Republic of ChinaAbstract: Excessive growth hormone (GH is usually secreted by GH-secreting pituitary adenomas and causes gigantism in juveniles or acromegaly in adults. The clinical complications involving cardiovascular, respiratory, and metabolic systems lead to elevated morbidity in acromegaly. Control of serum GH and insulin-like growth factor (IGF 1 hypersecretion by surgery or pharmacotherapy can decrease morbidity. Current pharmacotherapy includes somatostatin analogs (SAs and GH receptor antagonist; the former consists of lanreotide Autogel (ATG and octreotide long-acting release (LAR, and the latter refers to pegvisomant. As primary medical therapy, lanreotide ATG and octreotide LAR can be supplied in a long-lasting formulation to achieve biochemical control of GH and IGF-1 by subcutaneous injection every 4–6 weeks. Lanreotide ATG and octreotide LAR provide an effective medical treatment, whether as a primary or secondary therapy, for the treatment of GH-secreting pituitary adenoma; however, to maximize benefits with the least cost, several points should be emphasized before the application of SAs. A comprehensive assessment, especially of the observation of clinical predictors and preselection of SA treatment, should be completed in advance. A treatment process lasting at least 3 months should be implemented to achieve a long-term stable blood concentration. More satisfactory surgical outcomes for noninvasive macroadenomas treated

  10. Giant serous microcystic pancreas adenoma

    Mustafa Kerem

    2012-10-01

    Full Text Available Serous cystadenomas are rare tumors comprising 1-2% of exocrine pancreas tumors. They are mostly known as benign conditions but malign transformation as serous cystadenocarcinoma is also reported. It is usually seen in females. Non-specific symptoms, such as abdominal pain or symptoms due to mass affect, are usually seen. A 64-year old female patient was investigated for abdominal pain. Physical and laboratory findings were normal. Abdomen ultrasonography confirmed an 11x9.5 cm solid cystic lesion and abdomen computed tomography scan confirmed a 12x11 cm lobulated cystic solid lesion which had central cystic necrotic areas extending from liver hilus inferiorly. Fine needle biopsy confirmed benign cytology and trucut biopsy of the pan creatic mass reported chronic inflamation. Nevertheless, this mass could have malignant contents and transformation potential. A laparatomy was decided due to patient’s symptoms and mass effect. Due to vascular invasion of the tumor, Whipple procedure was performed. The pathology report confirmed serous microcystic adenoma. These rare tumors are usually benign but pre-operative malignity criterias are not identified. There are few differential diagnostic tools for excluding malignity. We suggest surgical resection as best treatment approach for selected cases.

  11. Radiotherapy for pituitary adenomas: an endocrinologist`s perspective

    O`Halloran, D.J.; Shalet, S.M. [Christie Hospital and Holt Radium Inst., Manchester (United Kingdom)

    1996-10-01

    A brief review is given of the clinical management of patients with pituitary adenomas such as prolactinomas, adenomasin acromegoly and Leushin`s disease, and non-functioning pituitary adenomas. In particular the complications of radiotherapy are explored. (UK).

  12. Growth hormone receptor expression and function in pituitary adenomas

    Clausen, Lene R; Kristiansen, Mikkel T; Rasmussen, Lars M

    2004-01-01

    OBJECTIVE AND DESIGN: Hypopituitarism, in particular GH deficiency, is prevalent in patients with clinically nonfunctioning pituitary adenomas (NFPAs) both before and after surgery. The factors regulating the growth of pituitary adenomas in general and residual tumour tissue in particular...

  13. HYPONATREMIA AFTER TRANSSPHENIODAL SURGERY OF PITUITARY ADENOMA

    陶蔚; 任祖渊; 苏长保; 王任直; 杨义; 马文斌

    2003-01-01

    Objective. To clarify the frequency, presentation, associated factors, treatment and outcome of hy-ponatremia after transsphenoidal surgery of pituitary adenomas.Methods. Retrospectively reviewed the database of 183 patients who underwent transsphenoidal surgeryof pituitary adenomas between January 1999 and June 2000 in our department.Result.s. 38.8% (71/183) had postoperative hyponatremia. Among them, 59.2% (42/71) appeared onthe 4th to 7th day postoperatively. 59.2% (42/71) presented with nausea, vomiting, headache, dizzi-ness, confusion and weakness. Hyponatremia was related to age, tumor size and adenoma type, but notrelated to sex and degree of resection. Treatment consisted of salt replacement and mild fluid restrictionin 4 patients and salt and fluid replacement in 67 patients. Hyponatremia resolved within 16 days in allthe patients.Conclusions. Hyponatremia often appeared about 7 days after transsphenoidal surgery of pituitary ade-nomas, especially in elderly and patients with macroadenomas and huge pituitary adenomas. The principleof treatment was salt and fluid replacement.

  14. Temozolomide in aggressive pituitary adenomas and carcinomas

    Leon D. Ortiz

    2012-01-01

    Full Text Available Temozolomide is an alkylating agent used in the treatment of gliomas and, more recently, aggressive pituitary adenomas and carcinomas. Temozolomide methylates DNA and, thereby, has antitumor effects. O6-methylguanine-DNA methyltransferase, a DNA repair enzyme, removes the alkylating adducts that are induced by temozolomide, thereby counteracting its effects. A Medline search for all of the available publications regarding the use of temozolomide for the treatment of pituitary tumors was performed. To date, 46 cases of adenohypophysial tumors that were treated with temozolomide, including 30 adenomas and 16 carcinomas, have been reported. Eighteen of the 30 (60% adenomas and 11 of the 16 (69% carcinomas responded favorably to treatment. One patient with multiple endocrine neoplasia type 1 and an aggressive prolactin-producing adenoma was also treated and demonstrated a good response. No significant complications have been attributed to temozolomide therapy. Thus, temozolomide is an effective treatment for the majority of aggressive adenomas and carcinomas. Evidence indicates that there is an inverse correlation between levels of O6-methylguanine-DNA methyltransferase immunoexpression and therapeutic response. Alternatively, high-level O6-methylguanine-DNA methyltransferase immunoexpression correlates with an unfavorable response. Here, we review the use of temozolomide for treating pituitary neoplasms.

  15. Surgical management of spontaneous ruptured hepatocellular adenoma

    Marcelo Augusto Fontenelle Ribeiro Junior

    2009-01-01

    Full Text Available AIMS: Spontaneous ruptured hepatocellular adenoma (SRHA is a rare life-threatening condition that may require surgical treatment to control hemorrhaging and also stabilize the patient. We report a series of emergency surgeries performed at our institution for this condition. METHODS: We reviewed medical records and radiology files of 28 patients (from 1989 to 2006 with a proven diagnosis of hepatocellular adenoma (HA. Three (10.7% of 28 patients had spontaneous ruptured hepatocellular adenoma, two of which were associated with intrahepatic hemorrhage while one had intraperitoneal bleeding. Two patients were female and one was male. Both female patients had a background history of oral contraceptive use. Sudden abdominal pain associated with hemodynamic instability occurred in all patients who suffered from spontaneous ruptured hepatocellular adenoma. The mean age was 41.6 years old. The preoperative assessment included liver function tests, ultrasonography and computed tomography. RESULTS: The surgical approaches were as follows: right hemihepatectomy for controlling intraperitoneal bleeding, and right extended hepatectomy and non-anatomic resection of the liver for intrahepatic hemorrhage. There were no deaths, and the postoperative complications were bile leakage and wound infection (re-operation, as well as intraperitoneal abscess (re-operation and pleural effusion. CONCLUSION: Spontaneous ruptured hepatocellular adenoma may be treated by surgery for controlling hemorrhages and stabilizing the patient, and the decision to operate depends upon both the patient's condition and the expertise of the surgical team.

  16. Case-report: metastasizing pleomorphic adenoma of the parotid gland.

    Schroeff, M.P. van der; Ru, J.A. de; Slootweg, P.J.

    2007-01-01

    CASE-REPORT: Metastasizing pleomorphic adenoma of the parotid gland. We present a case of metastasizing pleomorphic adenoma (MPA). The patient died in 2002 at the age of 64 years, following on an initial diagnosis of a pleomorphic adenoma of the right parotid gland at the age of nineteen, multiple l

  17. Relationship Between Histopathology and Clinical Prognosis of Invasive Pituitary Adenoma

    LIYong; SHUKai; DONGFangyong; WANFeng; LEITing; LILing

    2005-01-01

    Objective: To study the relationship between histopathology and clinical prognosis of invasive pituitary adenoma subjected to transsphenoidal surgery. Methods: The enrolled were 82 patients with invasive pituitary adenomas undergoing transsphenoidal surgery during Jan. 2000 May 2003 in our department with full MR imaging findings, pathology data and follow-up information. The follow-up duration was 5-30 months. Results: MR imaging findings of invasive pituitary adenoma included: depression of the sellar floor, involvement of sphenoid sinus and cavernous sinus, breakthrough of diaphragma sellae,encasement of internal carotid artery, etc. Pathological examination revealed that the invasion rate of dura in sella turcica was the highest among the structures around tumor. Pituitary adenoma apoplexy was found in 20 cases (24.4%). The total removal rate for PRL-secreting adenomas was significantly lower than that for non-secreting adenomas (P<0.01), but non-, GH-, ACTH-secreting adenomas had no significant differences. The recurrence rate of PRL-secreting adenornas was higher than that of non- and GH-secreting adenomas (P<0.05). Conclusion: Among invasive pituitary adenomas, the therapeutic effects of nonand GH-secreting pituitary adenomas are better than that of PRL-secreting adenomas. Invasive biological behaviors of invasive pituitary adenomas result in radical operation failure and postoperative recurrence.

  18. Advanced methods of treatment of hypophysis adenoma

    Kan Ya.A.

    2011-03-01

    Full Text Available Hypophysis adenomas are mostly spread in the chiasmatic cellular area. They account 18% of all new brain formations, the structure of pituitary adenomas includes prolactinomas in a large number of cases which are manifested by the syndrome of hyperprolactinemia and hormone inactive hypophysis tumours (35%. Somatotropins (13-15% are lower in frequency, the main clinical feature is acromegalia. One can rarely reveal corticotropins (8-10%, gonadotro-pins (7-9% and thyrotropins (1% and their mixed forms. Transsphenoidal surgical interventions are considered to be methods of choice treatment of hypophysis adenomas and other formations in the chiasmatic cellular area. Alternative methods of treatment are conservative. They can be as an addition to microsurgery (radiotherapy

  19. Light bodies in human pituitary adenomas

    Holck, S; Wewer, U M; Albrechtsen, R

    1987-01-01

    by transmission electron microscopy. Double membrane bound bodies with filamentous internal structure identical to rodent light bodies were identified in 10 hormone-producing adenomas: 5 PRL, 1 PRL-GH, 2 GH, and 2 ACTH-producing tumours. No light bodies were found in the remaining 79 tumours nor in the pituitary......Light bodies are large cytoplasmic granules originally described in the gonadotrophic cells of the rat pituitary gland. In order to determine whether similar bodies occur in the human anterior pituitary gland, 89 pituitary adenomas and periadenomatous tissue from 20 cases were examined...... cells in periadenomatous tissue from 20 cases. These results show that some human pituitary adenomas may contain light bodies identical to those seen in gonadotrophs of rat pituitary....

  20. Hyalinising trabecular adenoma of the thyroid.

    Sara NINAN

    2011-12-01

    Full Text Available Hyalinising trebecular adenoma (HTA of the thyroid is rare and controversies remain regarding the diagnosis and management. It is an uncommon benign thyroid tumour that can present as a solitary thyroid nodule, a prominent nodule in a multinodular goitre, or as an incidental finding in a thyroidectomy specimen. Some considered HTA a unique entity, while others have proved it to be a variant of papillary carcinoma or have considered it a nonspecific pattern that may be seen with a variety of thyroid lesions. We report the case of a 31-year-old Chinese lady who presented with four years history of right sided goitre that was gradually increasing in size. Fine needle aspiration cytology showed appearances of follicular adenoma. Intra-operative frozen section histology of the excised right thyroid lobe was reported as trabecular adenoma which was confirmed with histopathological examination.

  1. Quistes gigantes infectados en el hígado

    Dagoberto Calderón Rodríguez

    2015-06-01

    Full Text Available Los quistes hepáticos, tanto en cirugía de adulto como en pediatría, son entidades infrecuentes. Se presenta el caso de una paciente femenina, de 51 años de edad con múltiples quistes gigantes infectados en el hígado, el mayor de ellos de aproximadamente unos 15 - 20 cm. Se le practicó laparotomía de urgencia con exéresis casi total del lóbulo izquierdo del hígado y destechamiento del gran quiste del lóbulo derecho. La paciente ha sido reingresada en dos ocasiones por infección de los quistes hepáticos teniendo resolutividad con tratamiento farmacológico.

  2. Avian-style respiration allowed gigantism in pterosaurs.

    Ruxton, Graeme

    2014-08-01

    Powered flight has evolved three times in the vertebrates: in the birds, the bats and the extinct pterosaurs. The largest bats ever known are at least an order of magnitude smaller than the largest members of the other two groups. Recently, it was argued that different scaling of wingbeat frequencies to body mass in birds and bats can help explain why the largest birds are larger than the largest bats. Here, I extend this argument in two ways. Firstly, I suggest that different respiratory physiologies are key to understanding the restriction on bat maximum size compared with birds. Secondly, I argue that a respiratory physiology similar to birds would have been a prerequisite for the gigantism seen in pterosaurs.

  3. Model of UV flashes due to gigantic blue jets

    Milikh, G M [University of Maryland, College Park, MD, 20742 (United States); Shneider, M N [Princeton University, Princeton, NJ (United States)], E-mail: milikh@astro.umd.edu, E-mail: shneyder@princeton.edu

    2008-12-07

    Analysis of UV flashes observed by the UV detector on board the 'Tatiana' microsatellite suggests, based on their location, pulse width and energy of the source of the photons, that the flashes were generated by gigantic blue jets (GBJs). Presented in this paper is a numerical model of UV flashes due to a bunch of long streamers which form a leader, a prong such as that observed in a GBJ. Using a previously developed model of upward propagation of a long streamer in the exponential atmosphere the paper describes temporal evolution of the UV flux generated by a bunch of long streamers, in the given spectral range 300-400 nm used by the UV detector on board 'Tatiana'. The model is in agreement with the observations.0.

  4. Granuloma central de células gigantes

    Cava-Vergiú, Carlos-Enrique; Flores Cueto, Walter; Cáceres La Torre, Andreé

    2006-01-01

    Este artículo presenta el caso de una paciente que acudió a la Clínica Especializada en Odontología de la Universidad de San Martín de Porres. La paciente requería la exodoncia de las terceras molares inferiores. Mediante el examen radiológico se observó una imagen radiolúcida con bordes definidos a nivel apical de las piezas 4.7 y 4.8. El diagnóstico presuntivo planteado fue granuloma central de células gigantes. La presentación de esta lesión es muy rara y puede ser de crecimiento ...

  5. Tubulovillous Adenoma in a Urethral Neobladder Anastomosis

    Bradley A. Morganstern

    2015-11-01

    Full Text Available We present a case of a tubulovillous adenoma arising in a neobladder that was managed by cystoscopic resection. A 64 year-old male underwent a cystectomy with creation of an ileocolic neobladder urinary diversion for T2 urothelial carcinoma of the bladder. Nine years following his surgery, the patient noted several episodes of gross hematuria. Cystoscopic evaluation revealed the rare occurrence of a 3 cm tubulovillous adenoma with high-grade dysplasia at the neck of the neobladder.

  6. Angioscan exploration of morphology of pituitary adenoma

    Tabarin, A.; David, J.P.; Drouillard, J. and others

    1987-01-01

    Considerable progress has been made in the morphologic study of pituitary due to the availability of angioscan programs. An exceptional case is presented of a persistent intrasellar trigeminal artery associated with prolactinoma. Based on technological progress in CT scan imaging the place of angiographic explorations in the investigation of pituitary adenoma is reconsidered.

  7. Genotype phenotype classification of hepatocellular adenoma

    Paulette Bioulac-Sage; Jean Frédéric Blanc; Sandra Rebouissou; Charles Balabaud; Jessica Zucman-Rossi

    2007-01-01

    Studies that compare tumor genotype with phenotype have provided the basis of a new histological/molecular classification of hepatocellular adenomas. Based on two molecular criteria (presence of a TCF1/HNF1α or β-catenin mutation), and an additional histological criterion (presence or absence of an inflammatory infiltrate), subgroups of hepatocellular adenoma can be defined and distinguished from focal nodular hyperplasia. Analysis of 96 hepatocellular adenomas performed by a French collaborative network showed that they can be divided into four broad subgroups: the first one is defined by the presence of mutations in TCF1 gene inactivating the hepatocyte nuclear factor 1 (HNF1α); the second by the presence of β-catenin activating mutations; the category without mutations of HNF1α or β-catenin is further divided into 2 subgroups depending on the presence or absence of inflammation. Therefore, the approach to the diagnosis of problematic benign hepatocytic nodules may be entering a new era directed by new molecular information. It is hoped that immunohistological tools will improve significantly diagnosis of liver biopsy in our ability to distinguish hepatocellular adenoma from focal nodular hyperplasia (FNH), and to delineate clinically meaningful entities within each group to define the best clinical management. The optimal care of patients with a liver nodule will benefit from the recent knowledge coming from molecular biology and the combined expertise of hepatologists, pathologists, radiologists, and surgeons.

  8. Nephrogenic adenoma. Reports of two cases

    Osther, P J; Starklint, H

    1989-01-01

    Nephrogenic adenoma is a rare lesion of the urinary tract. Two cases in the urinary bladder are described. Histologically the tumor consists of cystic and tubular structures resembling the distal part of the nephron. The etiology and pathogenesis are discussed and a new etiologic theory...

  9. Thyroid Adenomas After Solid Cancer in Childhood

    Haddy, Nadia; El-Fayech, Chiraz; Guibout, Catherine; Adjadj, Elisabeth [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Thomas-Teinturier, Cecile [Radiation Epidemiology Group, INSERM, Villejuif (France); Hopital Bicetre, Bicetre (France); Oberlin, Odile [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Veres, Cristina [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Pacquement, Helene [Institut Curie, Paris (France); Jackson, Angela [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Munzer, Martine; N' Guyen, Tan Dat [Institut Jean Godinot, Reims (France); Bondiau, Pierre-Yves [Centre Antoine Lacassagne, Nice (France); Berchery, Delphine; Laprie, Anne [Centre Claudius Regaud, Toulouse (France); Bridier, Andre; Lefkopoulos, Dimitri [Institut Gustave Roussy, Villejuif (France); Schlumberger, Martin [Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Rubino, Carole; Diallo, Ibrahima [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Vathaire, Florent de, E-mail: florent.devathaire@igr.fr [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France)

    2012-10-01

    Purpose: Very few childhood cancer survivor studies have been devoted to thyroid adenomas. We assessed the role of chemotherapy and the radiation dose to the thyroid in the risk of thyroid adenoma after childhood cancer. Methods and Materials: A cohort of 3254 2-year survivors of a solid childhood cancer treated in 5 French centers before 1986 was established. The dose received by the isthmus and the 2 lobes of the thyroid gland during each course of radiation therapy was estimated after reconstruction of the actual radiation therapy conditions in which each child was treated as well as the dose received at other anatomical sites of interest. Results: After a median follow-up of 25 years, 71 patients had developed a thyroid adenoma. The risk strongly increased with the radiation dose to the thyroid up to a few Gray, plateaued, and declined for high doses. Chemotherapy slightly increased the risk when administered alone but also lowered the slope of the dose-response curve for the radiation dose to the thyroid. Overall, for doses up to a few Gray, the excess relative risk of thyroid adenoma per Gray was 2.8 (90% CI: 1.2-6.9), but it was 5.5 (90% CI: 1.9-25.9) in patients who had not received chemotherapy or who had received only 1 drug, and 1.1 (90% CI: 0.4-3.4) in the children who had received more than 1 drug (P=.06, for the difference). The excess relative risk per Gray was also higher for younger children at the time of radiation therapy than for their older counterparts and was higher before attaining 40 years of age than subsequently. Conclusions: The overall pattern of thyroid adenoma after radiation therapy for a childhood cancer appears to be similar to that observed for thyroid carcinoma.

  10. Diagnostic criteria in invasive pituitary adenomas

    Moldovan Ioana-Maria

    2016-09-01

    Full Text Available Pituitary adenomas are benign pituitary primary tumors, the most frequent type of tumor in the pituitary fossa. An important part, around 1/3 of the pituitary adenomas manifests an aggressive behavior, growing faster and invading into parasellar areas (cavernous sinus, neural tissues and bones. Objectives: the first aim of this paper is to review the last findings about invasiveness diagnostic criteria, imagistic and biomarkers, which can be used in the classification of pituitary tumors and also to predict the probability of invasiveness, tumor recurrence and suspicion of malignancy. The second aim is to highlight the morphological and clinic types of invasive pituitary adenomas. Materials and methods: we performed a systematic review and analysis of the published articles, searching PubMed between January 1985 and December 2015. There were selected articles published in English, reviews and abstracts. During the advanced search type in PubMed, combinations of the following keywords were used: “pituitary adenoma”, “invasive”, “aggressive”, “biomarkers”, “classification”, “histological subtypes”, ‘”immunohistochemical markers”. Results: 215 articles were selected, regarding diagnostic, prognostic and therapeutic aspects. There were some histological subtypes of pituitary adenomas known as having an aggressive clinical behavior. Several biomarkers were identified as being associated with the invasive feature: proliferation markers (Ki-67 index, number of mitoses, p53 & p27 expression, microvascularization density, telomerase, topoisomerase 2 Alpha, matrix metalloproteinases, protein kinase C, cyclooxygenase-2, E-cadherin, transcription Factors, genetic alterations (PTTG gene, Galectin-3 protein/ LGALS3 gene, apoptosis markers. Based on their invasion and proliferation characteristics, pituitary tumors are proposed to be classified into five grades (1a, 1b, 2a, 2b, 3, the grade 2b tumor with high risk of recurrence

  11. Gigantic Surface Lifetime of an Intrinsic Topological Insulator

    Neupane, Madhab; Xu, Su-Yang; Ishida, Yukiaki; Jia, Shuang; Fregoso, Benjamin M.; Liu, Chang; Belopolski, Ilya; Bian, Guang; Alidoust, Nasser; Durakiewicz, Tomasz; Galitski, Victor; Shin, Shik; Cava, Robert J.; Hasan, M. Zahid

    2015-09-01

    The interaction between light and novel two-dimensional electronic states holds promise to realize new fundamental physics and optical devices. Here, we use pump-probe photoemission spectroscopy to study the optically excited Dirac surface states in the bulk-insulating topological insulator Bi2Te2Se and reveal optical properties that are in sharp contrast to those of bulk-metallic topological insulators. We observe a gigantic optical lifetime exceeding 4 μ s (1 μ s =10-6 s ) for the surface states in Bi2Te2Se , whereas the lifetime in most topological insulators, such as Bi2Se3 , has been limited to a few picoseconds (1 ps =10-12 s ). Moreover, we discover a surface photovoltage, a shift of the chemical potential of the Dirac surface states, as large as 100 mV. Our results demonstrate a rare platform to study charge excitation and relaxation in energy and momentum space in a two-dimensional system.

  12. Onfalocele gigante roto. Presentación de un caso

    Víctor Manuel González Valdez

    2013-10-01

    Full Text Available El onfalocele es uno de los defectos de la pared abdominal. Puede asociarse a otras malformaciones como el ano imperforado, agenesia del colon, extrofia vesical y afecciones cardiovasculares, que a menudo devienen fetos no viables. Se presenta el caso de una recién nacida en Belize, de parto pretérmino (35,3 semanas, con bajo peso (1860 g y primogénita, que requirió cirugía de urgencia a las diez horas de vida por onfalocele gigante roto, asociado a tetralogía de Fallot, hipoglucemia y gran toma del estado general. El objetivo del informe es exponer los procederes diagnósticos y terapéuticos en este tipo de casos. Dado el adecuado diagnóstico prenatal que existe en Cuba, es inusual que los médicos cubanos, salvo aquellos que colaboran en el extranjero, asistan a estos pacientes; por ello, este trabajo puede ser útil en el contexto docente.

  13. LTR retrotransposons contribute to genomic gigantism in plethodontid salamanders.

    Sun, Cheng; Shepard, Donald B; Chong, Rebecca A; López Arriaza, José; Hall, Kathryn; Castoe, Todd A; Feschotte, Cédric; Pollock, David D; Mueller, Rachel Lockridge

    2012-01-01

    Among vertebrates, most of the largest genomes are found within the salamanders, a clade of amphibians that includes 613 species. Salamander genome sizes range from ~14 to ~120 Gb. Because genome size is correlated with nucleus and cell sizes, as well as other traits, morphological evolution in salamanders has been profoundly affected by genomic gigantism. However, the molecular mechanisms driving genomic expansion in this clade remain largely unknown. Here, we present the first comparative analysis of transposable element (TE) content in salamanders. Using high-throughput sequencing, we generated genomic shotgun data for six species from the Plethodontidae, the largest family of salamanders. We then developed a pipeline to mine TE sequences from shotgun data in taxa with limited genomic resources, such as salamanders. Our summaries of overall TE abundance and diversity for each species demonstrate that TEs make up a substantial portion of salamander genomes, and that all of the major known types of TEs are represented in salamanders. The most abundant TE superfamilies found in the genomes of our six focal species are similar, despite substantial variation in genome size. However, our results demonstrate a major difference between salamanders and other vertebrates: salamander genomes contain much larger amounts of long terminal repeat (LTR) retrotransposons, primarily Ty3/gypsy elements. Thus, the extreme increase in genome size that occurred in salamanders was likely accompanied by a shift in TE landscape. These results suggest that increased proliferation of LTR retrotransposons was a major molecular mechanism contributing to genomic expansion in salamanders.

  14. Atmospheric oxygen and the evolution of insect gigantism

    Dudley, R.

    2003-04-01

    Geophysical analyses suggest the presence of a late Paleozoic oxygen pulse beginning in the late Devonian and continuing through to the late Carboniferous. During this time, atmospheric oxygen levels increased to values potentially as high as 35% relative to the contemporary value of 21%. Widespread gigantism in late Paleozoic insects and other arthropods is consistent with enhanced oxygen flux within diffusion-limited tracheal systems, and thus with relaxation of constraints on maximum insect body size. Because total atmospheric pressure increases with increased oxygen partial pressure, concurrently hyperdense conditions would have augmented aerodynamic force production in early forms of flying insects. Hyperoxia of the late Paleozoic atmosphere may also have physiologically facilitated the initial evolution of insect flight metabolism. By the late Permian, evolution of decompositional microbial and fungal communities together with disequilibrium in rates of carbon deposition gradually reduced oxygen concentrations to values possibly as low as 15%. The disappearance of giant insects by the end of the Permian is consistent with extinction of these taxa for reasons of asphyxiation on a geological time scale. In modern selection experiments with Drosophila flies, substantial plasticity in body size can be evoked under conditions of variable oxygen. In particular, moderate hyperbaria (and thus hyperoxia) evokes a 20% increase in adult body size over merely five generations, suggesting ready capacity for evolutionary responses by insects to fluctuating atmospheric oxygen.

  15. Gigantism treated by pure endoscopic endonasal approach in a case of McCune-Albright syndrome with sphenoid fibrous dysplasia: a case report.

    Sharifi, Guive; Jalessi, Maryam; Sarvghadi, Farzaneh; Farhadi, Mohammad

    2013-12-01

    McCune-Albright syndrome (MAS) is an uncommon polyostotic manifestation of fibrous dysplasia in association with at least one endocrinopathy that is mostly associated with precocious puberty and hyperpigmented skin macules named café-au-lait spots. We present an atypical manifestation of McCune-Albright syndrome in a 19-year-old man with the uncommon association of polyostotic fibrous dysplasia and gigantism in the absence of café-au-lait spots and precocious puberty. He presented with a height increase to 202 cm in the previous 3 years, which had become more progressive in the few months prior. Physical examination revealed only a mild facial asymmetry; however, a computed tomography (CT) scan discovered vast areas of voluminous bones with ground-glass density and thickening involving the craniofacial bones and skull base. Magnetic resonance imaging (MRI) found a right stalk shift of the pituitary with a 20 mm pituitary adenoma. We describe the diagnostic and endoscopic endonasal transsphenoidal approach for excision of the tumor.

  16. Pleomorphic Adenomas of the Parapharyngeal Space

    İstemihan Akın

    2014-01-01

    Full Text Available Background. Parapharyngeal space is one of potential facial planes for neoplasms and infections and represents less than 1% of all head and neck tumours. Occurrence of the pleomorphic adenoma in the parapharyngeal space is a rarity. Case Presentation. Here, three giant pleomorphic adenomas of different sizes occupying the parapharyngeal space in three patients are reported. Extensive preoperative diagnostic workup was done in order to verify the nature and size of the tumour and the proximity to the large vessels. Review of the literature, clinical features, pathology, radiological findings, and treatment of these tumours are discussed. Conclusion. The excision of the tumor through submandibular transcervical approach, without cutting the mandible, turned out to be a safe and radical approach in all three cases.

  17. Orbital Lymphoma Mimicking Lacrimal Gland Pleomorphic Adenoma

    Diego Strianese

    2013-09-01

    Full Text Available Purpose: To describe the case of a patient affected by orbital lymphoma mimicking pleomorphic adenoma of the lacrimal gland. Methods: This was a retrospective case report. Results: We present the case of a patient with 15-year history of slowly progressive left proptosis and inferomedial bulbar dislocation who had the presumptive diagnosis of lacrimal gland pleomorphic adenoma based on clinical and radiological features. The patient underwent lateral orbitotomy and lacrimal gland excision. Postoperative histological features were consistent with low-grade B-cell non-Hodgkin lymphoma. Conclusion: The accepted clinico-radiological criteria used for the diagnosis of lacrimal gland fossa lesions might have a certain false-positive rate, even in recent years. The initial surgical approach with the appropriate choice between fine-needle aspiration biopsies, intraoperative biopsies and lacrimal gland excisions might be a challenge.

  18. Heterogeneity of secretory granules of silent pituitary adenomas

    Holck, S; Wewer, U M; Albrechtsen, R

    1988-01-01

    Silent pituitary adenomas were compared with hormonally active tumors taking into account the size, number, and ultrastructural characteristics of secretory granules (SG). The study group (a total of 79 primary pituitary adenomas) comprised 27 silent, 21 growth hormone (GH)-producing-, 16 prolactin...... (PRL)-producing-, 5 GH-PRL-producing- and 10 adrenocorticotropic hormone (ACTH)-producing adenomas. The SG of silent adenomas were significantly smaller than SG in endocrine active adenomas. All hormonally inactive tumors also contained small (mean, 94 nm) specific cytoplasmic granules, designated...... approximately 10 to 50% of the granules in each cell. These granules were not seen in hormonally active tumors and considered therefore diagnostic of silent pituitary adenomas....

  19. ROLE OF RADIOFREQUENCY ABLATION IN ADENOMA SEBACEUM

    Ch. Madh

    2016-03-01

    Full Text Available Adenoma sebaceum, pathognomonic of tuberous sclerosis, are tiny angiofibromas which commonly occur over central part of face. Recurrence after treatment is common and hence a need for inexpensive, safe and efficient treatment is required. Radiofrequency ablation is a safe and an economical procedure and has been known to cause less scarring with good aesthetic results compared to other ablative methods such as electrocautery.

  20. Temozolomide in aggressive pituitary adenomas and carcinomas

    Leon D. Ortiz; Luis V. Syro; Scheithauer, Bernd W.; Fabio Rotondo; Humberto Uribe; Camilo E Fadul; Eva Horvath; Kalman Kovacs

    2012-01-01

    Temozolomide is an alkylating agent used in the treatment of gliomas and, more recently, aggressive pituitary adenomas and carcinomas. Temozolomide methylates DNA and, thereby, has antitumor effects. O 6-methylguanine-DNA methyltransferase, a DNA repair enzyme, removes the alkylating adducts that are induced by temozolomide, thereby counteracting its effects. A Medline search for all of the available publications regarding the use of temozolomide for the treatment of pituitary tumors was perf...

  1. Metanephric Adenoma: clinical, imaging, and histological findings

    Torricelli, Fabio Cesar Miranda; Marchini, Giovanni Scala, E-mail: fabio_torri@yahoo.com.b [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Dept. de Urologica; Campos, Rodrigo Sousa Madeira [Hospital do Servidor Publico Estadual, Sao Paulo, SP (Brazil). Dept. de Urologia; Gil, Antonio Otero [Instituto Dante Pazanezzi, Sao Paulo, SP (Brazil)

    2011-07-01

    Metanephric adenoma (MA), also designated nephrogenic nephroma or renal epithelial tumor resembling immature nephron, has just been recently recognized as a special type of benign renal epithelial tumor. Only few reports are found in the literature regarding this rare renal tumor. The purpose of this paper is to describe our clinical, imaging and histological / immunohistochemical observations of MA diagnosed in two patients and compare these data to previous information reported in medical databases (author)

  2. Why might they be giants? Towards an understanding of polar gigantism.

    Moran, Amy L; Woods, H Arthur

    2012-06-15

    Beginning with the earliest expeditions to the poles, over 100 years ago, scientists have compiled an impressive list of polar taxa whose body sizes are unusually large. This phenomenon has become known as 'polar gigantism'. In the intervening years, biologists have proposed a multitude of hypotheses to explain polar gigantism. These hypotheses run the gamut from invoking release from physical and physiological constraints, to systematic changes in developmental trajectories, to community-level outcomes of broader ecological and evolutionary processes. Here we review polar gigantism and emphasize two main problems. The first is to determine the true strength and generality of this pattern: how prevalent is polar gigantism across taxonomic units? Despite many published descriptions of polar giants, we still have a poor grasp of whether these species are unusual outliers or represent more systematic shifts in distributions of body size. Indeed, current data indicate that some groups show gigantism at the poles whereas others show nanism. The second problem is to identify underlying mechanisms or processes that could drive taxa, or even just allow them, to evolve especially large body size. The contenders are diverse and no clear winner has yet emerged. Distinguishing among the contenders will require better sampling of taxa in both temperate and polar waters and sustained efforts by comparative physiologists and evolutionary ecologists in a strongly comparative framework.

  3. File list: His.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available His.Dig.10.AllAg.Intestinal_adenoma mm9 Histone Digestive tract Intestinal adenoma ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Dig.10.AllAg.Intestinal_adenoma.bed ...

  4. File list: His.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available His.Dig.50.AllAg.Intestinal_adenoma mm9 Histone Digestive tract Intestinal adenoma ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Dig.50.AllAg.Intestinal_adenoma.bed ...

  5. File list: His.Dig.05.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available His.Dig.05.AllAg.Intestinal_adenoma mm9 Histone Digestive tract Intestinal adenoma ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Dig.05.AllAg.Intestinal_adenoma.bed ...

  6. File list: His.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available His.Dig.20.AllAg.Intestinal_adenoma mm9 Histone Digestive tract Intestinal adenoma ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Dig.20.AllAg.Intestinal_adenoma.bed ...

  7. Lymphocitic infundibuloneurohypophysitis mimicking a pituitary adenoma

    Hubertus Maximilian Mehdorn

    2011-04-01

    Full Text Available A rare case of infundibulo-neurohypophysitis mimicking a pituitary adenoma is presented. A 69-years-old female patient developed polyuria and polydipsia. Laboratory analysis revealed central diabetes insipidus. No hormonal abnormalities. Cranial-magnetic resonance imaging (MRI showed a left sided mass in the adenohypophysis presuming a pituitary adenoma. The mass had contact to both internal carotids. Admission to our department for neurosurgical treatment followed. Ophthalmo - logic examination and neurological examination yielded normal findings. A second MRI focussing on the sellar-region showed a leftsided (T2-MRI.hyperintense, distended adenohypophysis, without contrast enhancement in T1. The stalk appeared thickened. T1- weighted sequences of the neurohypophysis showed loss of signal intensity. We diagnosed an infundibulo-neurohypophysitis and abstai - ned from surgical removal. The patient was discharged under treatment with corticosteroids and desmopressin. Hypophysitis is rare and shows special clinical characteristics. Despite defined radiological features to differentiate between hypophysitis and adenoma the possibility of misdiagnosis, and unnecessary surgical procedures, should always kept in mind.

  8. Bile Duct Adenoma with Oncocytic Features

    E. J. Johannesen

    2014-01-01

    Full Text Available Bile duct adenomas are benign bile duct proliferations usually encountered as an incidental finding. Oncocytic bile duct neoplasms are rare and the majority are malignant. A 61-year-old male with a diagnosis of colorectal adenocarcinoma was undergoing surgery when a small white nodule was discovered on the surface of the right lobe of his liver. This lesion was composed of cytologically bland cells arranged in tightly packed glands. These cells were immunopositive for cytokeratin 7, negative for Hep Par 1, contained mucin, and had a Ki67 proliferation index of 8%. The morphology, immunophenotype, presence of mucin, and normal appearing bile ducts, as well as the increased Ki67 proliferation rate, were consistent with a bile duct adenoma with oxyphilic (oncocytic change. Oncocytic tumors in the liver are rare; the first described in 1992. Only two bile duct adenomas with oncocytic change have been reported and neither of them had reported mucin production or the presence of normal appearing bile ducts within the lesion.

  9. Risk of colorectal cancer in patients with sessile serrated adenomas/polyps is the same magnitude or even higher than in patients with conventinal adenomas

    Erichsen, Rune; Baron, John A; Snover, Dale;

    2014-01-01

    Risk of colorectal cancer in patients with sessile serrated adenomas/polyps is the same magnitude or even higher than in patients with conventinal adenomas......Risk of colorectal cancer in patients with sessile serrated adenomas/polyps is the same magnitude or even higher than in patients with conventinal adenomas...

  10. Sequels after radiotherapy of adenoma of adenohypophysis. Folgen einer Hypophysenadenombestrahlung

    Knuepffer, J.; Helpap, B. (Staedtisches Krankenhaus, Singen (Germany). Inst. fuer Pathologie); Saeger, W. (Marienkrankenhaus, Hamburg (Germany). Abt. fuer Pathologie)

    1991-10-01

    14 years before his death, iridium seeds were implanted in the adenohypophysis of a 69-year-old patient with a STH producing adenoma of the adenohypophysis and acromegaly. 5 years after recurrence, transsphenoidal hypophysectomy was done. The patient died of central dysregulation due to cerebral insults. At autopsy, a recurrence of the undifferentiated acidophilic adenoma was found within the sphenoidal bone corpus. Immunohistochemistry was positive for STH, prolactin, TSH, LH, and FSH. Besides the adenoma, a mucoepidermoid carcinoma was found within the sphenoid cavity. This carcinoma may be a consequence of the radiotherapy of the adenoma of the adenohypophysis. (orig.).

  11. Biology of the sauropod dinosaurs: the evolution of gigantism.

    Sander, P Martin; Christian, Andreas; Clauss, Marcus; Fechner, Regina; Gee, Carole T; Griebeler, Eva-Maria; Gunga, Hanns-Christian; Hummel, Jürgen; Mallison, Heinrich; Perry, Steven F; Preuschoft, Holger; Rauhut, Oliver W M; Remes, Kristian; Tütken, Thomas; Wings, Oliver; Witzel, Ulrich

    2011-02-01

    The herbivorous sauropod dinosaurs of the Jurassic and Cretaceous periods were the largest terrestrial animals ever, surpassing the largest herbivorous mammals by an order of magnitude in body mass. Several evolutionary lineages among Sauropoda produced giants with body masses in excess of 50 metric tonnes by conservative estimates. With body mass increase driven by the selective advantages of large body size, animal lineages will increase in body size until they reach the limit determined by the interplay of bauplan, biology, and resource availability. There is no evidence, however, that resource availability and global physicochemical parameters were different enough in the Mesozoic to have led to sauropod gigantism. We review the biology of sauropod dinosaurs in detail and posit that sauropod gigantism was made possible by a specific combination of plesiomorphic characters (phylogenetic heritage) and evolutionary innovations at different levels which triggered a remarkable evolutionary cascade. Of these key innovations, the most important probably was the very long neck, the most conspicuous feature of the sauropod bauplan. Compared to other herbivores, the long neck allowed more efficient food uptake than in other large herbivores by covering a much larger feeding envelope and making food accessible that was out of the reach of other herbivores. Sauropods thus must have been able to take up more energy from their environment than other herbivores. The long neck, in turn, could only evolve because of the small head and the extensive pneumatization of the sauropod axial skeleton, lightening the neck. The small head was possible because food was ingested without mastication. Both mastication and a gastric mill would have limited food uptake rate. Scaling relationships between gastrointestinal tract size and basal metabolic rate (BMR) suggest that sauropods compensated for the lack of particle reduction with long retention times, even at high uptake rates. The

  12. Biology of the sauropod dinosaurs: the evolution of gigantism

    Sander, P Martin; Christian, Andreas; Clauss, Marcus; Fechner, Regina; Gee, Carole T; Griebeler, Eva-Maria; Gunga, Hanns-Christian; Hummel, Jürgen; Mallison, Heinrich; Perry, Steven F; Preuschoft, Holger; Rauhut, Oliver W M; Remes, Kristian; Tütken, Thomas; Wings, Oliver; Witzel, Ulrich

    2011-01-01

    The herbivorous sauropod dinosaurs of the Jurassic and Cretaceous periods were the largest terrestrial animals ever, surpassing the largest herbivorous mammals by an order of magnitude in body mass. Several evolutionary lineages among Sauropoda produced giants with body masses in excess of 50 metric tonnes by conservative estimates. With body mass increase driven by the selective advantages of large body size, animal lineages will increase in body size until they reach the limit determined by the interplay of bauplan, biology, and resource availability. There is no evidence, however, that resource availability and global physicochemical parameters were different enough in the Mesozoic to have led to sauropod gigantism. We review the biology of sauropod dinosaurs in detail and posit that sauropod gigantism was made possible by a specific combination of plesiomorphic characters (phylogenetic heritage) and evolutionary innovations at different levels which triggered a remarkable evolutionary cascade. Of these key innovations, the most important probably was the very long neck, the most conspicuous feature of the sauropod bauplan. Compared to other herbivores, the long neck allowed more efficient food uptake than in other large herbivores by covering a much larger feeding envelope and making food accessible that was out of the reach of other herbivores. Sauropods thus must have been able to take up more energy from their environment than other herbivores. The long neck, in turn, could only evolve because of the small head and the extensive pneumatization of the sauropod axial skeleton, lightening the neck. The small head was possible because food was ingested without mastication. Both mastication and a gastric mill would have limited food uptake rate. Scaling relationships between gastrointestinal tract size and basal metabolic rate (BMR) suggest that sauropods compensated for the lack of particle reduction with long retention times, even at high uptake rates. The

  13. Cisto gigante de colédoco Giant choledochal cyst

    Olival Cirilo Lucena da Fonseca-Neto

    2007-12-01

    Full Text Available INTRODUÇÃO: A doença cística das vias biliares é anomalia congênita que pode acometer as vias biliares intra e/ou extra-hepáticas. A extra-hepática inclui os cistos de colédoco e a intra-hepática é conhecida por Doença de Caroli. Os cistos de colédoco de tamanho gigante são muito raros. OBJETIVO: Relatar o caso de um cisto de colédoco de tamanho gigante em uma paciente feminina. RELATO DE CASO: Mulher de 19 anos foi admitida com história de icterícia e acolia fecal há sete dias. Referia dor epigástrica associada com ingestão de dieta rica em gordura. Nos antecedentes pessoais relatou dois episódios de icterícia, aos 8 e 14 anos, que progrediram espontaneamente. No exame físico apresentava icterícia (+3/+4 e uma massa palpável indolor em mesogástrio foram os únicos achados. A ultrassonografia demonstrou grande formação cística de paredes finas adjacente ao hepatocolédoco, pâncreas e rim direito que media 18,5 x 10,2 cm. A colangioressonância confirmou o grande cisto de colédoco e hepatojejunoanastomose em "Y" de Roux após excisão do cisto e colecistectomia foi realizada. A formação cística media 20 x 15,5 x 12,5 cm e com um volume médio de 1000 mL. A paciente encontra-se em acompanhamento ambulatorial sem alterações hepatobiliares após o sétimo mês da operação. CONCLUSÃO: O cisto de colédoco deve fazer parte do diagnóstico diferencial em pacientes adultos jovens com icterícia e massa palpável; no entanto, a diferenciação entre ele e neoplasia maligna deve ser pesquisada.BACKGROUND: Choledochal cyst represents a rare congenital anomaly, eventually associated with intra and extrahepatic biliary tract disorders. Extrahepatic diseases include choledochal cysts and congenital dilation of the lower intrahepatic bile duct is known as Caroli's disease. Giant choledochal cyst constitutes a very rare abnormality. AIM:To report a giant choledochal cyst in a female patient. CASE REPORT: A 19-year

  14. Corticoides intralesionales en lesiones a células gigantes

    J.P. Crestanello Nese

    2003-12-01

    Full Text Available Desde su descripción original, las lesiones de células gigantes (LCG han sido entidades controvertidas, desde el punto de vista de su origen, de su comportamiento clínico, de sus características radiográficas e histológicas, así como de su tratamiento. Para su tratamiento se han considerado alternativas quirúrgicas y no quirúrgicas. En este trabajo, se presentan tres nuevos casos de LCG, en los cuales se realizó infiltración intralesional con corticoides como una maniobra previa y complementaria a la quirúrgica. Luego de la infiltración, se observó una disminución del tamaño de las lesiones y un cambio en sus características macroscópicas, se trato por enucleación un caso y por remodelación quirúrgica los dos restantes.Giant cell lesions (GCL have been controversial entities since its original description. Its origin, clinical behavior, radiographic and histological features and also its treatment are polemical. The therapeutic possibilities are surgical or non surgical. In this paper, the intralesional infiltration with steroids is presented like a previous and complementary therapy to surgery alone. Three new cases of GCL are presented. All of them were first treated with intralesional infiltration with steroids. After that,a partial remission and a change of the macroscopic characteristics were observed and one of the lesion was then enucleated while for the others two surgical remodelation were necessary to do.

  15. Slow DNA loss in the gigantic genomes of salamanders.

    Sun, Cheng; López Arriaza, José R; Mueller, Rachel Lockridge

    2012-01-01

    Evolutionary changes in genome size result from the combined effects of mutation, natural selection, and genetic drift. Insertion and deletion mutations (indels) directly impact genome size by adding or removing sequences. Most species lose more DNA through small indels (i.e., ~1-30 bp) than they gain, which can result in genome reduction over time. Because this rate of DNA loss varies across species, small indel dynamics have been suggested to contribute to genome size evolution. Species with extremely large genomes provide interesting test cases for exploring the link between small indels and genome size; however, most large genomes remain relatively unexplored. Here, we examine rates of DNA loss in the tetrapods with the largest genomes-the salamanders. We used low-coverage genomic shotgun sequence data from four salamander species to examine patterns of insertion, deletion, and substitution in neutrally evolving non-long terminal repeat (LTR) retrotransposon sequences. For comparison, we estimated genome-wide DNA loss rates in non-LTR retrotransposon sequences from five other vertebrate genomes: Anolis carolinensis, Danio rerio, Gallus gallus, Homo sapiens, and Xenopus tropicalis. Our results show that salamanders have significantly lower rates of DNA loss than do other vertebrates. More specifically, salamanders experience lower numbers of deletions relative to insertions, and both deletions and insertions are skewed toward smaller sizes. On the basis of these patterns, we conclude that slow DNA loss contributes to genomic gigantism in salamanders. We also identify candidate molecular mechanisms underlying these differences and suggest that natural variation in indel dynamics provides a unique opportunity to study the basis of genome stability.

  16. Aneurisma gigante parasselar simulando tumor de hipófise

    Luiz Augusto Casulari Roxo da Motta

    1988-12-01

    Full Text Available Revisamos 7 pacientes com comprometimento da sela turca ao raio X do crânio que apresentavam aneurisma gigante da porção intracavernosa da artéria carótida (6 casos e aneurisma da artéria comunicante anterior (1 caso. As alterações encontradas foram: cefaléia (7/7, oftalmoplegia complexa interessando III, IV e VI nervos cranianos (5/7 e comprometimento do V nervo (4/7, dor ocular (4/7. Outras alterações encontradas foram: sinais meníngeos (2/7, cegueira unilateral (1/7, hemiparesia (1/7 cacosmia (1/7 e quadrantanopsia bitemporal inferior (1/7. Cinco pacientes com aneurisma da porção intracavernosa da artéria carótida beneficiaram-se com a ligadura progressiva da artéria carótida interna a nível cervical; o outro paciente faleceu antes da realização da operação. O paciente com aneurisma da artéria comunicante anterior foi submetido a clipagem do aneurisma, tendo boa evolução. Baseados neste estudo e em concordância com a literatura, concluímos que o diagnóstico diferencial entre aneurisma localizado na região parasselar e outras patologias dessa área freqüentemente apresenta dificuldade. O diagnóstico definitivo requer a realização de angiografia cerebral. O tratamento cirúrgico, por ligadura da carótida interna na região cervical, é benéfico e quase desprovido de complicações.

  17. [Complex ultrasonic diagnosis of large and gigantic non-parasitic cysts of liver].

    Kuntsevich, G I; Gavrilin, A V; Vishnevskiĭ, V A; Zhurenkova, T V; Chebysheva, E N; Zhavoronkova, O I; Agafonov, V A

    2007-01-01

    The results of clinical and complex ultrasonic examination of 95 patients with large and gigantic liver non-parasitic cysts (LNC) are analyzed. The morphological examination was performed in all the cases. The mean diameter of large LNC was 105+/-7 mm, of gigantic cysts -- 149+/-33 mm (p<0,05), cyst volume was respectively 600+/-142 and 1721+/-954 ml (p<0,05). Analysis of clinical, ultrasonic and laboratory data allowed to describe three variants of large and gigantic, complicated and non-complicated cysts with 97,9% accuracy. The 3-D US reconstruction permitted to precise the anatomic structure and trace selection during transcutaneous US-assisted treatment.

  18. DNA aneuploidy in colorectal adenomas: Role in the adenoma-carcinoma sequence Aneuploidía del ADN en adenomas colónicos: Papel en la secuencia adenoma-carcinoma

    M. Alcántara Torres

    2005-01-01

    Full Text Available Introduction: aneuploidy has been observed in 6-27% of lesions known to be precursors of colorectal cancer, such as adenomas or ulcerative colitis. It has been suggested that aneuploidy may predispose to malignancy in these cases. However, its role in the adenoma-carcinoma sequence has not been definitely established. The objective of this study was to assess the incidence of aneuploidy in colon adenomas, as well as to study its possible role in the adenoma-carcinoma sequence. Material and methods: the study was performed on a series of 57 large bowel adenomas measuring 10 mm or more, collected from 54 consecutive patients. All specimens were obtained either by endoscopic or by surgical resection. There were 49 adenomas with low-grade dysplasia, two with high-grade dysplasia, two intramucous carcinomas, and four microinvasive carcinomas. A flow cytometric DNA analysis was performed in fresh specimens following Vindelov´s method. Results: aneuploid DNA was detected in five out of 49 low-grade dysplasia adenomas (10%, in all four high-grade dysplasia adenomas or intramucous carcinomas (100%, and in three out of four microinvasive carcinomas (75%. The association between aneuploidy and high-grade dysplasia adenomas, intramucous, or microinvasive carcinoma was statistically significant (p Introducción: en patología benigna de intestino grueso precursora del cáncer colorrectal, como adenomas o colitis ulcerosa, se ha observado aneuploidía en el 6-27% de los casos y se ha sugerido que su presencia predispone al desarrollo de malignidad. Sin embargo, su papel en la secuencia adenoma-carcinoma no se ha demostrado de forma concluyente. El objetivo de nuestro trabajo fue valorar la incidencia de aneuploidía en adenomas colónicos, con y sin signos de malignidad, y estudiar su posible papel en la secuencia adenoma-carcinoma. Material y métodos: el estudio se realizó en una serie de 57 adenomas de intestino grueso, de 10 o más mil

  19. Gigantism and Acromegaly Due to Xq26 Microduplications and GPR101 Mutation

    Trivellin, G.; Daly, A.F.; Faucz, F.R.; Yuan, B.; Rostomyan, L.; Larco, D.O.; Schernthaner-Reiter, M.H.; Szarek, E.; Leal, L.F.; Caberg, J.-H.; Castermans, E.; Villa, C.; Dimopoulos, A.; Chittiboina, P.; Xekouki, P.; Shah, N.; Metzger, D.; Lysy, P.A.; Ferrante, E.; Strebkova, N.; Mazerkina, N.; Zatelli, M.C.; Lodish, M.; Horvath, A.; de Alexandre, R. Bertollo; Manning, A.D.; Levy, I.; Keil, M.F.; de la Luz Sierra, M.; Palmeira, L.; Coppieters, W.; Georges, M.; Naves, L.A.; Jamar, M.; Bours, V.; Wu, T.J.; Choong, C.S.; Bertherat, J.; Chanson, P.; Kamenický, P.; Farrell, W.E.; Barlier, A.; Quezado, M.; Bjelobaba, I.; Stojilkovic, S.S.; Wess, J.; Costanzi, S.; Liu, P.; Lupski, J.R.; Beckers, A.; Stratakis, C.A.

    2015-01-01

    BACKGROUND Increased secretion of growth hormone leads to gigantism in children and acromegaly in adults; the genetic causes of gigantism and acromegaly are poorly understood. METHODS We performed clinical and genetic studies of samples obtained from 43 patients with gigantism and then sequenced an implicated gene in samples from 248 patients with acromegaly. RESULTS We observed microduplication on chromosome Xq26.3 in samples from 13 patients with gigantism; of these samples, 4 were obtained from members of two unrelated kindreds, and 9 were from patients with sporadic cases. All the patients had disease onset during early childhood. Of the patients with gigantism who did not carry an Xq26.3 microduplication, none presented before the age of 5 years. Genomic characterization of the Xq26.3 region suggests that the microduplications are generated during chromosome replication and that they contain four protein-coding genes. Only one of these genes, GPR101, which encodes a G-protein–coupled receptor, was overexpressed in patients’ pituitary lesions. We identified a recurrent GPR101 mutation (p.E308D) in 11 of 248 patients with acromegaly, with the mutation found mostly in tumors. When the mutation was transfected into rat GH3 cells, it led to increased release of growth hormone and proliferation of growth hormone–producing cells. CONCLUSIONS We describe a pediatric disorder (which we have termed X-linked acrogigantism [X-LAG]) that is caused by an Xq26.3 genomic duplication and is characterized by early-onset gigantism resulting from an excess of growth hormone. Duplication of GPR101 probably causes X-LAG. We also found a recurrent mutation in GPR101 in some adults with acromegaly. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and others.) PMID:25470569

  20. An evolutionary cascade model for sauropod dinosaur gigantism--overview, update and tests.

    Sander, P Martin

    2013-01-01

    Sauropod dinosaurs are a group of herbivorous dinosaurs which exceeded all other terrestrial vertebrates in mean and maximal body size. Sauropod dinosaurs were also the most successful and long-lived herbivorous tetrapod clade, but no abiological factors such as global environmental parameters conducive to their gigantism can be identified. These facts justify major efforts by evolutionary biologists and paleontologists to understand sauropods as living animals and to explain their evolutionary success and uniquely gigantic body size. Contributions to this research program have come from many fields and can be synthesized into a biological evolutionary cascade model of sauropod dinosaur gigantism (sauropod gigantism ECM). This review focuses on the sauropod gigantism ECM, providing an updated version based on the contributions to the PLoS ONE sauropod gigantism collection and on other very recent published evidence. The model consist of five separate evolutionary cascades ("Reproduction", "Feeding", "Head and neck", "Avian-style lung", and "Metabolism"). Each cascade starts with observed or inferred basal traits that either may be plesiomorphic or derived at the level of Sauropoda. Each trait confers hypothetical selective advantages which permit the evolution of the next trait. Feedback loops in the ECM consist of selective advantages originating from traits higher in the cascades but affecting lower traits. All cascades end in the trait "Very high body mass". Each cascade is linked to at least one other cascade. Important plesiomorphic traits of sauropod dinosaurs that entered the model were ovipary as well as no mastication of food. Important evolutionary innovations (derived traits) were an avian-style respiratory system and an elevated basal metabolic rate. Comparison with other tetrapod lineages identifies factors limiting body size.

  1. An evolutionary cascade model for sauropod dinosaur gigantism--overview, update and tests.

    P Martin Sander

    Full Text Available Sauropod dinosaurs are a group of herbivorous dinosaurs which exceeded all other terrestrial vertebrates in mean and maximal body size. Sauropod dinosaurs were also the most successful and long-lived herbivorous tetrapod clade, but no abiological factors such as global environmental parameters conducive to their gigantism can be identified. These facts justify major efforts by evolutionary biologists and paleontologists to understand sauropods as living animals and to explain their evolutionary success and uniquely gigantic body size. Contributions to this research program have come from many fields and can be synthesized into a biological evolutionary cascade model of sauropod dinosaur gigantism (sauropod gigantism ECM. This review focuses on the sauropod gigantism ECM, providing an updated version based on the contributions to the PLoS ONE sauropod gigantism collection and on other very recent published evidence. The model consist of five separate evolutionary cascades ("Reproduction", "Feeding", "Head and neck", "Avian-style lung", and "Metabolism". Each cascade starts with observed or inferred basal traits that either may be plesiomorphic or derived at the level of Sauropoda. Each trait confers hypothetical selective advantages which permit the evolution of the next trait. Feedback loops in the ECM consist of selective advantages originating from traits higher in the cascades but affecting lower traits. All cascades end in the trait "Very high body mass". Each cascade is linked to at least one other cascade. Important plesiomorphic traits of sauropod dinosaurs that entered the model were ovipary as well as no mastication of food. Important evolutionary innovations (derived traits were an avian-style respiratory system and an elevated basal metabolic rate. Comparison with other tetrapod lineages identifies factors limiting body size.

  2. Contrast-enhanced ultrasound in diagnosis of gallbladder adenoma

    Hai-Xia Yuan; Jia-Ying Cao; Wen-Tao Kong; Han-Sheng Xia; Xi Wang; Wen-Ping Wang

    2015-01-01

    BACKGROUND:Gallbladder adenoma is a pre-cancerous neoplasm and needs surgical resection. It is dififcult to differ-entiate adenoma from other gallbladder polyps using imaging examinations. The study aimed to illustrate characteristics of contrast-enhanced ultrasound (CEUS) and its diagnostic value in gallbladder adenoma. METHODS:Thirty-seven patients with 39 gallbladder adenoma-toid lesions (maximal diameter≥10 mm and without metastasis) were enrolled in this study. Lesion appearances in conventional ultrasound and CEUS were documented. The imaging features were compared individually among gallbladder cholesterol polyp, gallbladder adenoma and malignant lesion. RESULTS:Adenoma lesions showed iso-echogenicity in ul-trasound, and an eccentric enhancement pattern, "fast-in and synchronous-out" contrast enhancement pattern and homo-geneous at peak-time enhancement in CEUS. The homogenic-ity at peak-time enhancement showed the highest diagnostic ability in differentiating gallbladder adenoma from cholesterol polyps. The sensitivity, speciifcity, positive predictive value, negative predictive value, accuracy and Youden index were 100%, 90.9%, 92.9%, 100%, 95.8% and 0.91, respectively. The characteristic of continuous gallbladder wall shown by CEUS had the highest diagnostic ability in differentiating adenoma from malignant lesion (100%, 86.7%, 86.7%, 100%, 92.9% and 0.87, respectively). The characteristic of the eccentric enhance-ment pattern had the highest diagnostic ability in differenti-ating adenoma from cholesterol polyp and malignant lesion, with corresponding indices of 69.2%, 88.5%, 75.0%, 85.2%, 82.1% and 0.58, respectively. CONCLUSIONS:CEUS is valuable in differentiating gallbladder adenoma from other gallbladder polyps (≥10 mm in diameter). Homogeneous echogenicity on peak-time enhancement, a con-tinuous gallbladder wall, and the eccentric enhancement pat-tern are important indicators of gallbladder adenoma on CEUS.

  3. Contemporary issues in the evaluation and management of pituitary adenomas.

    Pekic, S; Stojanovic, M; Popovic, V

    2015-12-01

    Pituitary adenomas are common benign monoclonal neoplasms accounting for about 15% of intracranial neoplasms. Data from postmortem studies and imaging studies suggest that 1 of 5 individuals in the general population may have pituitary adenoma. Some pituitary adenomas (mainly microadenomas which have a diameter of less than 1 cm) are exceedingly common and are incidentally diagnosed on magnetic resonance imaging (MRI) performed for an unrelated reason (headache, vertigo, head trauma). Most microadenomas remain clinically occult and stable in size, without an increase in tumor cells and without local mass effects. However, some pituitary adenomas grow slowly, enlarge by expansion and become demarcated from normal pituitary (macroadenomas have a diameter greater than 1 cm). They may be clinically silent or secrete anterior pituitary hormones in excess such as prolactin, growth hormone (GH), or adrenocorticotropic hormone (ACTH) causing diseases like prolactinoma, acromegaly, Cushing's disease or rarely thyroid-stimulating hormone (TSH) or gonadotropins (LH, FSH). The incidence of the various subtypes of pituitary adenoma varies but the most common is prolactinoma. Clinically non-functioning pituitary adenomas (NFPAs), which do not secrete hormones often cause local mass symptoms and represent one-third of pituitary adenomas. Given the high prevalence of pituitary adenomas and their heterogeneity (different tumor subtypes), it is critical that clinicians have a thorough understanding of the potential abnormalities in pituitary function and prognostic factors for behavior of pituitary adenomas in order to timely implement specific treatment modalities. Regarding pathogenesis of these tumors genetics, epigenetics and signaling pathways are the focus of current research yet our understanding of pituitary tumorigenesis remains incomplete. Although several genes and signaling pathways have been identified as important factors in the development of pituitary tumors, current

  4. Heterogeneity of colorectal adenomas, the serrated adenoma, and implications for screening and surveillance

    Hugh James Freeman

    2008-01-01

    Current algorithms for screening and surveillance for colon cancer are valuable, but may be limited by the underlying nature of the targeted neoplastic lesions. Although part of the success of adenoma removal relates to interruption of so-called "adenoma-carcinoma sequence", an alternate serrated pathway to colon cancer may pose difficulties with the ultimate results achieved by traditional colonoscopic methods. The endpoint carcinoma in this unique pathway may be derived from a dysplastic serrated adenoma. These tend to be located primarily in the right colon, especially in females, and are frequently associated with coexistent colon cancer. Unfortunately, however, there are few, if any, other identifiable risk factors, including age or family history of colon polyps or colon cancer. Moreover, this alternate serrated pathway may itself also be quite biologically heterogeneous as reflected in sessile serrated adenomas (SSA) with virtually exclusive molecular signatures defined by the presence of either BRAF or KRAS mutations. Screening algorithms in the future may need to be modified and individualized, depending on new information that likely will emerge on the natural history of these biologically heterogeneous lesions that differs from traditional adenomatous polyps.

  5. Simple numerical chromosome aberrations in two pituitary adenomas

    Dietrich, C U; Pandis, N; Bjerre, P

    1993-01-01

    Cytogenetic analysis of short-term cultures of one non-secreting and one prolactin-producing pituitary adenoma revealed simple clonal numerical abnormalities in both tumors. The karyotype of the non-secreting adenoma was 48,XX, +4, +9[42]/49,XX, +4, +9, +20[2]/46,XX[6]. In the prolactin-secreting...

  6. Resection of a large ectopic parathyroid adenoma: A case report

    Seijiro Sato

    2016-01-01

    Discussion and conclusions: Parathyroid adenomas and parathyroid carcinomas have disparate natural histories, but they can be difficult to differentiate on the basis of preoperative clinical characteristics. We believe that long-term follow-up of these cases is required because there have been few reports on the postoperative natural history of large parathyroid adenomas.

  7. Pleomorphic adenoma of the parotid gland 1985-2010

    Andreasen, Simon; Therkildsen, Marianne H; Bjørndal, Kristine

    2016-01-01

    one recurrence. An incidence of 4.29/100,000/year was found. The rate of malignant transformation in recurrent pleomorphic adenoma was 3.3%. CONCLUSION: We report an up-to-date assessment of the epidemiology of pleomorphic adenoma. We found an increasing incidence and low recurrence rate compared...

  8. Large Brunner's gland adenoma: Case report and literature review

    Alba Rocco; Pasquale Borriello; Debora Compare; Patrizia De Colibus; Loredana Pica; Alessandro Iacono; Gerardo Nardone

    2006-01-01

    Brunner's gland adenoma (BGA) is a very rare benign tumour of the duodenum, which is usually asymptomatic and discovered incidentally at endoscopy. Occasionally,this lesion may be large, causing upper gastrointestinal haemorrhage or intestinal obstruction. The case had a large Brunner's gland adenoma, presenting melena that was managed by endoscopic excision.

  9. Expression of Neuropeptide Y in Human Pituitary Adenoma

    Laizhao Chen; Jingjian Ma; Anchao Zheng; Honggang Zheng

    2006-01-01

    OBJECTIVE Neuropeptid e Y (NPY) acts as a neuroendocrine modulator in the anterior pituitary, and NPY mRNA and NPY-immunoreactivity have been detected in normal human anterior pituitaries. However, only a few studies of NPY expression in human pituitary adenomas have been published. Our study was conducted to determine whether or not adenomatous cells express NPY, to investigate the relationship between NPY expression and the subtypes of pituitary adenoma and to explore the clinical significance of NPY.METHODS The study included tissues from 58 patients with pituitary adenomas who underwent surgery because of their clinical diagnosis.Using a highly specific anti-NPY polyclonal antibody, immunohistochemical analysis was performed on the surgically removed pituitary adenomas. Six fresh specimens also were examined using immuno-electron microscopy. NPY was labeled with colloidal gold in order to study the distribution of NPY at the subcellular level.RESULTS The NPY expression level was significantly different among subgroups of pituitary adenomas (P<0.05). NPY was immuno-detected in 58.6% of all adenomas, in 91.7% of gonadotrophic adenomas and in 14.3% of prolactinomas. NPY expression was slightly lower in invasive pituitary adenomas compared to noninvasive adenomas, but the difference was not significant (t=1.81, P>0.05). Of particular interest was the finding that vascular endothelial cells showed positive NPY expression in some pituitary adenomas. Parts of strongly positive tumor cells were seen in channels formed without endothelial cells, but which contained some red blood cells in a formation similar to so-called vasculogenic mimicry. Immuno-electron microscopy demonstrated that 4 of the 6 fresh specimens displayed positive NPY staining with a high density of gold particles located mainly in the secretory granulas. In addition, gold particles were sparsely detected in the rough endoplasmic reticulum and cell matrix.CONCLUSION NPY exists in pituitary adenomas

  10. [Colorectal adenomas: postpolypectomy surveillance strategies and chemoprevention].

    Castells, Antoni

    2008-10-01

    Colorectal adenomas are the most fully characterized premalignant lesions in the development of colorectal cancer. Consequently, the identification and resolution of these lesions, as well as the follow-up of affected patients, are a priority in the prevention of this neoplasm. The studies presented in the annual meeting of the American Gastroenterological Association 2008 show that the results of current surveillance strategies can be improved with a view to reducing the rate of interval neoplasia. Improvement of these results includes optimization of the endoscopic technique (colonic preparation, cecal intubation, withdrawal time, etc.) as well as the incorporation of new diagnostic methods and the possible administration of chemopreventive drugs.

  11. Ectopic pituitary adenoma presenting as midline nasopharyngeal mass.

    Ali, R

    2012-02-01

    INTRODUCTION: Ectopic pituitary adenomas are extremely rare. We report a case of ectopic pituitary adenoma in the midline of the nasopharynx. This adenoma probably arose from the pharyngeal remnant of Rathke\\'s pouch. METHODS: We discuss a case of a lady who presented to our unit with 2 months history of dryness and sensation of lump in her throat and a long standing history of hypothyroidism. Examination of nasopharynx revealed a smooth and fluctuant midline mass. CT scan of nose and paranasal sinuses confirmed the midline mass with small defect communicating with the sphenoid sinus. An initial diagnosis of Thornwaldt\\'s cyst was made and she underwent upper aerodigestive tract endoscopy and marsupialization of the mass. Histopathological examination revealed ectopic pituitary adenoma. CONCLUSION: Ectopic pituitary adenoma is an important differential diagnosis for a midline nasopharyngeal mass. It is recommended that prior to surgical resection of midline nasopharyngeal mass biopsy is taken and MRI is performed.

  12. Inverted cystic tubulovillous adenoma involving Brunner's glands of duodenum

    Ji Hoon Kim; Jong-Jae Park; Jung Woo Choi; Yeon Seok Seo; Beom Jae Lee; Jong Fun Yeon; Jae Seon Kim; Kwan Soo Byun; Young-Tae Bak; Insun Kim

    2007-01-01

    Benign neoplasia of the duodenum are very rare.Moreover, duodenal tubulovillous adenomas are more uncommon lesions. The microscopic structure of tubulovillous adenoma has frond-like projection of mucosa with branching papillary structure and generally upward growth into the lumen. We describe a 72-year-old man who showed aduodenal tubulovillous adenoma with unusual inverted cystic growth pattern.Interestingly, this tubulovillous adenomatous lesion was interrupted by gastric metaplasia in the deep portion of the cyst and was closely surrounded by Brunner's glands. Although histogenesis of gastric metaplasia of duodenum is not fully understood, Brunner's glands has been suggested as a precursor for gastric metaplasia.Therefore, these findings argued that this adenoma arises from Brunner's glands through gastric metaplasia.This is the first case of inverted cystic tubulovillous adenoma involving Brunner's glands of duodenum with gastric metaplasia.

  13. Adenoma incidence decreases under the effect of polypectomy

    Isadora Rosa; Carlos N Leit(a)o; Paulo Fidalgo; José Soares; Susana Vinga; Carla Oliveira; Jo(a)o P Silva; Susana M Ferro; Paula Chaves; António G Oliveira

    2012-01-01

    AIM:To investigate whether,under the influence of polypectomy,the incidence of adenoma decreases with age.METHODS:Consecutive patients with colonic adenomas identified at index colonoscopy were retrospectively selected if they had undergone three or more complete colonoscopies,at least 24 mo apart.Patients who had any first-degree relative with colorectal cancer were excluded.Data regarding number of adenomas at each colonoscopy,their location,size and histological classification were recorded.The monthly incidence density of adenomas after the index examination was estimated for the study population,by using the person-years method.Baseline adenomas were excluded from incidence calculations but their characteristics were correlated with recurrence at follow-up,using the x2 test.RESULTS:One hundred and fifty-six patients were included (109 male,mean age at index colonoscopy 56.8 ± 10.3 years),with follow-up that ranged from 48 to 232 mo.No significant correlations were observed between the number,the presence of villous component,or the size of adenomas at index colonoscopy and the presence of adenomas at subsequent colonoscopies (P =0.49,0.12 and 0.78,respectively).The incidence of colonic adenomas was observed to decay from 1.4%person-months at the beginning of the study to values close to 0%,at 12 years after index colonoscopy.CONCLUSION:Our results suggest the sporadic formation of adenomas occurs within a discrete period and that,when these adenomas are removed,all neoplasia-prone clones may be extinguished.

  14. Lagarto gigante de La Gomera. Un fósil que vuelve a la vida

    2000-01-01

    La única población conocida cuenta con sólo seis ejemplares. El lagarto gigante de La Gomera se encuentra en una situación bastante más grave que otros vertebrados europeos en peligro de extinción como el lince ibérico, la foca monje o el oso pardo.

  15. Clonal karyotypic abnormalities in colorectal adenomas: clues to the early genetic events in the adenoma-carcinoma sequence

    Bomme, L; Bardi, G; Pandis, N

    1994-01-01

    Cytogenetic analysis of short-term cultures from colorectal adenomas revealed acquired clonal chromosome aberrations in 14 of 17 tumors. In 4 adenomas, only numerical changes were found, whereas 10 had structural rearrangements. Trisomy 7 was found as the sole change in one of the tumors and toge......Cytogenetic analysis of short-term cultures from colorectal adenomas revealed acquired clonal chromosome aberrations in 14 of 17 tumors. In 4 adenomas, only numerical changes were found, whereas 10 had structural rearrangements. Trisomy 7 was found as the sole change in one of the tumors...... and together with other numerical changes in another. A +7 was also present in one case with structural aberrations. Other recurrent numerical aberrations were -14 and -18, both found in 2 adenomas with structural karyotypic changes; in addition, one chromosome 14 was lost in one of the tumors with only...

  16. The early ELF signals of the gigantic jets captured by the Taiwan ground observation network

    Chen, A. B. C.; Huang, P. H.; Su, H. T.; Hsu, R. R.

    2015-12-01

    The in-cloud ignition process of gigantic jets and blue jets receives attentions and discussions in the past years. The polarity and the position of their breakdown were proposed by Krehbiel et al. [2008] but no concrete observational evidence to support it directly. ELF spectrogram is a good tool to explore the electric activities, but traditional spectrograms are generated by a Fourier transform which obtain the frequency information through an integration operation. However the integration greatly limits the lowest frequency revealed by spectrogram and buries the important transient features. In this study, we applied a new but widely-used method, the Hilbert-Huang transform (HHT), to explore the spectrogram. Instead of the integration, HHT obtains the frequency information by differentiating on the phase angle, and become a powerful tool to reveal the fast frequency variation associated with transient luminous events. More than 100 transient luminous events including 25 gigantic jets observed by Taiwan ground optical observation network were analyzed. The results indicate that approximately 70% of gigantic jets can identify a rapid frequency variation in the interval of 300-600 milliseconds before main surge discharge, and this early feature can not find a clear corresponding amplitude variation in its sferic. Since this early signal can not be identified from the traditional Fourier spectrogram, but clear in-cloud lightning was registered correspondingly by the ground optical observation. In contrast to gigantic jets, this feature of early frequency change can be seen only in less than 30% of sprites and elves. These observational evidences are able to provide new constraints on the early discharge process of gigantic jets in clouds.

  17. Diagnosis and Surgical Treatment of Parathyroid Adenoma (24 Case Report)

    Wei Zhang; Junchu Zhang; Daqiao Zhu; Zhiqian Hu; Qiang Wang

    2005-01-01

    OBJECTIVE To summarize the experience in diagnosing and treating parathyroid adenoma.METHODS Twenty-four patients were diagnosed with parathyroid adenoma and received parathyroidectomy in our hospital. Sixteen of them presented with hyperparathyroidism. The patients received ultrasounography, CT or 99mTc-MIBI to locate the tumor site. Serum concentrations of PTH and calcium were checked before the operation. All operations were performed under general anesthesia. The adenomas were resected and the four glands explored.RESULTS All of the patients were cured and there was no mortality in our group. The symptoms of hyperparathyroidism remitted to various degrees after the operation. PTH dropped to the normal range 2 days after operation.Serum calcium concentrations declined to different levels from the first day after operation. Seven patients developed hypocalcemia post-operation but recovered by injection of calcium gluconate. Only one of the patients with parathyroid adenoma recurred 2 years after the operation and was found to have malignancy of the parathyroid adenoma.CONCLUSION Not all the patients with parathyroid adenoma had clinical manifestations. The CT and 99mTc-MIBI were more accurate than ultrasounography in locating the adenoma. The four glands should be explored during the operation. Protecting the recurrent laryngeal nerve from being injuried and maintaning secure hemastasis were most important.

  18. Reg Ⅳ, a differentially expressed gene in colorectal adenoma

    张宇伟; 来茂德; 谷雪梅; 罗敏捷; 邵丽娜

    2003-01-01

    ObjectiveTo discover and identify differentially expressed genes associated with colorectal adenoma formation and the role of RegⅣ in colorectal adenoma differentiation.MethodsA subtracted cDNA library was constructed with cDNAs that were isolated from either the normal mucosa or adenoma tissue of a single patient. Suppressive subtractive hybridization (SSH) combined with virtual northern blotting was used to characterize differentially expressed genes and contigs were assembled by electronic cloning (in silico cloning) with the EST database. Semi-quantitative RT-PCR was performed in 9 colorectal adenomas.ResultsThe amino acid sequence was determined with open reading frame (ORF) prediction software and was found to be 100% homologous to the protein product of RegⅣ (a novel gene isolated from a large inflammatory bowel disease library). RegⅣ was found to be highly expressed in all of the adenoma samples (9/9) compared with the normal mucosa samples, while 5/6 cases showed RegⅣ to be more strongly expressed in adenocarcinoma.Conclusion RegⅣ may play an important role in the initiation of colorectal adenoma differentiation, and its detection may be useful in the early diagnosis of colorectal adenoma formation.

  19. Follicle stimulating hormone secreting pituitary adenoma: a challenging diagnosis

    Madhuri Alap Mehendale

    2015-04-01

    Full Text Available FSH secreting pituitary adenomas are relatively uncommon brain tumours and usually non-functioning. But in rare cases they produce ovarian hyperstimulation. We report a case of a 32 year old female P2L2, with amenorrhoea of 1 year, pain in abdomen and galactorrhoea since 6 months. Initially thought to be a simple prolactinoma with multicystic ovaries, but after thorough investigations to our surprise diagnosed to be a rare case of gonadotropin secreting pituitary adenoma. Patient was successfully managed by excision of the pituitary adenoma. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 493-496

  20. A gigantic nothosaur (Reptilia: Sauropterygia) from the Middle Triassic of SW China and its implication for the Triassic biotic recovery

    Liu, Jun; Hu, Shi-Xue; Rieppel, Olivier; Jiang, Da-Yong; Benton, Michael J.; Kelley, Neil P.; Aitchison, Jonathan C.; Zhou, Chang-Yong; Wen, Wen; Huang, Jin-Yuan; Xie, Tao; Lv, Tao

    2014-11-01

    The presence of gigantic apex predators in the eastern Panthalassic and western Tethyan oceans suggests that complex ecosystems in the sea had become re-established in these regions at least by the early Middle Triassic, after the Permian-Triassic mass extinction (PTME). However, it is not clear whether oceanic ecosystem recovery from the PTME was globally synchronous because of the apparent lack of such predators in the eastern Tethyan/western Panthalassic region prior to the Late Triassic. Here we report a gigantic nothosaur from the lower Middle Triassic of Luoping in southwest China (eastern Tethyan ocean), which possesses the largest known lower jaw among Triassic sauropterygians. Phylogenetic analysis suggests parallel evolution of gigantism in Triassic sauropterygians. Discovery of this gigantic apex predator, together with associated diverse marine reptiles and the complex food web, indicates global recovery of shallow marine ecosystems from PTME by the early Middle Triassic.

  1. Efficacy, safety, and pharmacokinetics of sustained-release lanreotide (lanreotide Autogel) in Japanese patients with acromegaly or pituitary gigantism.

    Shimatsu, Akira; Teramoto, Akira; Hizuka, Naomi; Kitai, Kazuo; Ramis, Joaquim; Chihara, Kazuo

    2013-01-01

    The somatostatin analog lanreotide Autogel has proven to be efficacious for treating acromegaly in international studies and in clinical practices around the world. However, its efficacy in Japanese patients has not been extensively evaluated. We examined the dose-response relationship and long-term efficacy and safety in Japanese patients with acromegaly or pituitary gigantism. In an open-label, parallel-group, dose-response study, 32 patients (29 with acromegaly, 3 with pituitary gigantism) received 5 injections of 60, 90, or 120 mg of lanreotide Autogel over 24 weeks. Four weeks after the first injection, 41% of patients achieved serum GH level of gigantism) received lanreotide Autogel once every 4 weeks for a total of 13 injections. Dosing was initiated with 90 mg and adjusted according to clinical responses at Weeks 16 and/or 32. At Week 52, 47% of patients had serum GH levels of gigantism.

  2. Sellar lesion: Not always a pituitary adenoma

    Rao Shalinee

    2008-04-01

    Full Text Available Inflammatory lesions of the hypophysis account for 0.5% of all symptomatic diseases of the pituitary, which include lymphocytic hypophysitis, granulomatous hypophysitis with or without specific etiology and pituitary abscess. Sellar tuberculoma is a rare type of granulomatous hypophysitis. We document a case of a postmenopausal lady who presented with galactorrhea, headache and blurring of vision. Based on preliminary investigations, a clinical diagnosis of pituitary adenoma was made and the pituitary gland was surgically excised. Histopathological examination showed caseating granulomas, along with normal areas of preserved pituitary gland and a final diagnosis of tuberculous hypophysitis was made. This case is being documented due to the extremely rare involvement of the pituitary gland by granulomatous lesions such as tuberculosis and to emphasize the role of intraoperative consultation to obviate the need for radical surgery in such lesions.

  3. Hiperparatiroidismo primario por adenoma paratiroideo mediastinal

    Jeffry Solís-Torres

    2015-06-01

    Full Text Available El hiperparatiroidismo primario cursa con un aumento de la secreción de hormona paratiroidea, generalmente debido a un adenoma, e hipercalcemia. Su presentación clásica se diagnostica con la determinación de calcio sérico y de hormona paratiroidea, asociada con estudios de imágenes. Su tratamiento es quirúrgico y tiene altas tasas de éxito. Se analiza el caso de una paciente hipertensa, de 63 años, con historia de pérdida de apetito y debilidad de un año y medio de evolución, por lo que se le realizaron exámenes de laboratorio que revelaron hipercalcemia y elevación de la hormona paratiroidea. Se le indicó entonces una gamagrafía con Tecnecio 99, que evidenció un nódulo de 18mm de diámetro, ubicado 2 centímetros caudal al lóbulo tiroideo derecho. Se le efectuó una exploración cervical sin encontrarse la lesión, por lo que requirió una esternotomía media superior, que permitió encontrar un adenoma en el mediastino superior, detrás de la vena braquiocefálica derecha, de manera que se procedió a su extracción. Los controles de calcio y de hormona paratiroidea a las 24 horas estaban entre los límites normales, y se egresó.

  4. Coffee intake and the risk of colorectal adenoma: The colorectal adenoma study in Tokyo.

    Budhathoki, Sanjeev; Iwasaki, Motoki; Yamaji, Taiki; Sasazuki, Shizuka; Tsugane, Shoichiro

    2015-07-15

    Coffee is a commonly consumed beverage which contains several potential anticarcinogenic and chemopreventive compounds, and has been hypothesized to have protective effects in colorectal neoplasia. However, the limited available data on coffee consumption in relation to colorectal adenoma (CRA), a precursor lesion to most colorectal cancers, remain largely inconsistent. In this study, we evaluated the association of coffee intake with the risk of CRA in a middle-aged Japanese population. Study subjects were selected from examinees who underwent total colonoscopy as part of a cancer screening program and responded to self-administered dietary and lifestyle questionnaires. A total of 738 patients with adenoma and 697 controls were included in the study. Coffee intake was assessed with a food frequency questionnaire, and divided into quartiles based on the distribution among controls. Unconditional logistic regression models were used to estimate odds ratio (OR) and 95% confidence interval (CI) of CRA, with adjustment for potential confounding factors. High coffee consumption was associated with a reduced risk of CRA, with a multivariate-adjusted OR for the highest versus lowest quartile of coffee intake of 0.67 (95% CI = 0.48-0.93; ptrend  = 0.02). The inverse association of coffee intake was limited to proximal (OR = 0.64; 95%CI = 0.44-0.95; ptrend  = 0.04) and distal colon adenoma (OR = 0.62; 95%CI = 0.39-0.99; ptrend  = 0.06), and appeared to be more evident with small (OR = 0.68; 95%CI = 0.49-0.96; ptrend  = 0.04) and single adenomas (OR = 0.65; 95%CI = 0.44-0.95; ptrend  = 0.02). Green tea intake was not found to be associated with CRA risk. This study provides support for the protective effect of coffee drinking on colon adenomas, a precursor of colon cancer.

  5. Coexistent adenocarcinoma and microcystic adenoma of the pancreas.

    Posniak, H V; Olson, M C; Demos, T C

    1991-01-01

    A case with coexistent pancreatic adenocarcinoma and microcystic adenoma is presented. These diagnoses were suspected on the basis of their computed tomography (CT) appearances and confirmed with CT-guided fine-needle aspiration.

  6. Spongiocytic adrenocortical adenomas - risk of misinterpretation as cysts in CT

    Will, C.H.; Kissler, W.; Bach, D.

    1986-12-01

    A report on two cases where solid benign tumours of the adrenals (spongiocytic adrenocortical adenomas) were misinterpreted as adrenal cysts due to water-equivalent density values. The CT scans are compared with the microscopic cuts.

  7. Metanephric adenoma: Management in a 7-year-old child

    Katharine Caldwell

    2015-12-01

    Full Text Available We report the case of a 7-year-old girl in whom a left renal mass was incidentally discovered on computerized tomography (CT scan during evaluation for acute perforated appendicitis. The presence of polycythemia and the radiographic characteristics of the mass suggested a metanephric adenoma but a Wilm's tumor could not be excluded with preoperative studies. Gross inspection and intra-operative ultrasound of the tumor supported the suspicion of a metanephric adenoma and a partial nephrectomy was performed. Frozen section and permanent pathologic analysis confirmed a benign metanephric adenoma. At current date, patient is recovering well and polycythemia has resolved. A review of the management of metanephric adenoma in the child is presented.

  8. Molecular screening of pituitary adenomas for gene mutations and rearrangements

    Herman, V.; Drazin, N.Z.; Gonskey, R.; Melmed, S. (Cedars-Sinai Medical Center, Los Angeles, CA (United States))

    1993-07-01

    Although pituitary tumors arise as benign monoclonal neoplasms, genetic alterations have not readily been identified in these adenomas. The authors studied restriction fragment abnormalities involving the GH gene locus, and mutations in the p53 and H-, K-, and N-ras genes in 22 human GH cell adenomas. Twenty two nonsecretory adenomas were also examined for p53 and ras gene mutations. Seven prolactinoma DNA samples were tested for deletions in the multiple endocrine neoplasia-1 (MEN-1) locus, as well as for rearrangements in the hst gene, a member of the fibroblast growth factor family. In DNA from GH-cell adenomas, identical GH restriction patterns were detected in both pituitary and lymphocyte DNA in all patients and in one patient with a mixed GH-TSH cell adenoma. Using polymerase chain reaction (PCR)-single stranded conformation polymorphism analysis, no mutations were detected in exons 5, 6, 7 and 8 of the p53 gene in GH cell adenomas nor in 22 nonsecretory adenomas. Codons 12/13 and 61 of H-ras, K-ras, and N-ras genes were also intact on GH cell adenomas and in nonsecretory adenomas. Site-specific probes for chromosome 11q13 including, PYGM, D11S146, and INT2 were used in 7 sporadic PRL-secreting adenomas to detect deletions of the MEN-1 locus on chromosome 11. One patient was identified with a loss of 11p, and the remaining 6 patients did not demonstrate loss of heterozygosity in the pituitary 11q13 locus, compared to lymphocyte DNA. None of these patients demonstrated hst gene rearrangements which also maps to this locus. These results show that p53 and ras gene mutations are not common events in the pathogenesis of acromegaly and nonsecretory tumors. Although hst gene rearrangements and deletions of 11q13 are not associated with sporadic PRl-cell adenoma formation, a single patient was detected with a partial loss of chromosome 11, including the putative MEN-1 site. 31 refs., 5 figs., 2 tabs.

  9. An unusual presentation of lacrimal gland pleomorphic adenoma

    Josie Naomi Iyeyasu

    2013-10-01

    Full Text Available Tumors of the lacrimal gland are rare in clinical practice. Among all of them, the most common epithelial tumor is the lacrimal gland pleomorphic adenoma, which is a benign indolent tumor that usually affects adults in the third and fourth decades of life. We present an unusual case of lacrimal gland pleomorphic adenoma. Its management, radiological findings and outcomes are also described, along with a brief review of the literature.

  10. Association between measures of obesity and colorectal adenoma

    KIM You Joung; LEE Kang-moon; CHUNG Woo Chul; PAIK Chang Nyol; JUNG Sung Hoon

    2011-01-01

    Background Few studies have used body mass index (BMI),waist-to-hip ratio (WHR) and waist circumference (WC) at the same time to investigate the association between obesity and colorectal adenoma.This study examined the strength of association between colorectal adenoma and obesity using not only BMI,but also WHR and WC.Methods Subjects of this study included 1322 asymptomatic patients who underwent colonoscopy for cancer screening from January 2006 to June 2008.Anthropometric measurements,blood test results,and a self-administered questionnaire from each subject were analyzed.Results Four hundred and fourteen adenoma cases were identified in 1322 subjects.Using univariate analysis,the prevalence of adenoma was associated with BMI and WHR and was higher among the abdominal obesity group using WC guidelines of the Korean Society for the Study of Obesity,but not using WC guidelines of the International Diabetes Federation.In multiple Logistic regression analysis,general obesity (BMI >25 kg/m2) increased the risk of colorectal adenoma (odds ratio (OR),1.43; 95% confidence interval (CI),1.05-1.94).Also,abdominal obesity by the WC cutoffs and the highest WHR percentile group (WHR >0.95) were significantly associated with adenoma.Among three measures of obesity,however,only BMI had a persistent association with adenoma after adjusting reciprocally for BMI,WC,and WHR (OR,1.30; 95% CI,1.02-1.80; and 1.49; 1.06-2.10,adjusted for WC and WHR,respectively).Conclusion The data suggest that general obesity is associated with an increased risk of colorectal adenoma.

  11. Minimally invasive treatment of hepatic adenoma in special cases

    Nasser, Felipe; Affonso, Breno Boueri; Galastri, Francisco Leonardo [Hospital Israelita Albert Einstein, São Paulo, SP (Brazil); Odisio, Bruno Calazans [MD Anderson Cancer Center, Houston (United States); Garcia, Rodrigo Gobbo [Hospital Israelita Albert Einstein, São Paulo, SP (Brazil)

    2013-07-01

    Hepatocellular adenoma is a rare benign tumor that was increasingly diagnosed in the 1980s and 1990s. This increase has been attributed to the widespread use of oral hormonal contraceptives and the broader availability and advances of radiological tests. We report two cases of patients with large hepatic adenomas who were subjected to minimally invasive treatment using arterial embolization. One case underwent elective embolization due to the presence of multiple adenomas and recent bleeding in one of the nodules. The second case was a victim of blunt abdominal trauma with rupture of a hepatic adenoma and clinical signs of hemodynamic shock secondary to intra-abdominal hemorrhage, which required urgent treatment. The development of minimally invasive locoregional treatments, such as arterial embolization, introduced novel approaches for the treatment of individuals with hepatic adenoma. The mortality rate of emergency resection of ruptured hepatic adenomas varies from 5 to 10%, but this rate decreases to 1% when resection is elective. Arterial embolization of hepatic adenomas in the presence of bleeding is a subject of debate. This observation suggests a role for transarterial embolization in the treatment of ruptured and non-ruptured adenomas, which might reduce the indication for surgery in selected cases and decrease morbidity and mortality. Magnetic resonance imaging showed a reduction of the embolized lesions and significant avascular component 30 days after treatment in the two cases in this report. No novel lesions were observed, and a reduction in the embolized lesions was demonstrated upon radiological assessment at a 12-month follow-up examination.

  12. Endoscopic resection of a huge Brunner's gland adenoma

    Binbin ZHANG; Xu REN; Xiufen TANG; Yuxin CHI; Xuesong SHI

    2008-01-01

    Brunner's gland adenoma is a rare tumour of the duodenum, which is usually benign. A 71-year-old woman presenting with epigastric pain, upper gastro-intestinal haemorrhage and melaena was reported in this paper. Upper gastro-intestinal (GI) endoscopy revealed a large pedunculated tumour on the superior part of the duodenal bulb. Endoscopic polypectomy was successfully performed by clipping and nylon thread without any com-plications. Histological examination revealed a Brunner's gland adenoma.

  13. [Aspects of the operative treatment of prostatic adenoma].

    Gogichaev, Z Kh; zolotarev, I I

    1977-02-01

    The authors have gained minimum blood losses when suturing with provisional catgut ligature through the urinary bladder bottom between interureteral fold and internal urethral orifice yet before dessection of adenoma surgical capsule and tumor enucleation. Depending on the functional state of the upper urinary tract, the bladder tonus and adenoma size, the method of postoperative drainage of the urinary bladder is selected: cystostomy, microirrigation, active suction, etc.

  14. Gigantic Cosmic Corkscrew Reveals New Details About Mysterious Microquasar

    2004-10-01

    Making an extra effort to image a faint, gigantic corkscrew traced by fast protons and electrons shot out from a mysterious microquasar paid off for a pair of astrophysicists who gained new insights into the beast's inner workings and also resolved a longstanding dispute over the object's distance. Microquasar SS 433 VLA Image of Microquasar SS 433 CREDIT: Blundell & Bowler, NRAO/AUI/NSF (Click on Image for Larger Version) The astrophysicists used the National Science Foundation's Very Large Array (VLA) radio telescope to capture the faintest details yet seen in the plasma jets emerging from the microquasar SS 433, an object once dubbed the "enigma of the century." As a result, they have changed scientists' understanding of the jets and settled the controversy over its distance "beyond all reasonable doubt," they said. SS 433 is a neutron star or black hole orbited by a "normal" companion star. The powerful gravity of the neutron star or black hole draws material from the stellar wind of its companion into an accretion disk of material tightly circling the dense central object prior to being pulled onto it. This disk propels jets of fast protons and electrons outward from its poles at about a quarter of the speed of light. The disk in SS 433 wobbles like a child's top, causing its jets to trace a corkscrew in the sky every 162 days. The new VLA study indicates that the speed of the ejected particles varies over time, contrary to the traditional model for SS 433. "We found that the actual speed varies between 24 percent to 28 percent of light speed, as opposed to staying constant," said Katherine Blundell, of the University of Oxford in the United Kingdom. "Amazingly, the jets going in both directions change their speeds simultaneously, producing identical speeds in both directions at any given time," Blundell added. Blundell worked with Michael Bowler, also of Oxford. The scientists' findings have been accepted by the Astrophysical Journal Letters. SS 433 New VLA

  15. ACTH adenomas transforming their clinical expression: report of 5 cases.

    Zoli, Matteo; Faustini-Fustini, Marco; Mazzatenta, Diego; Marucci, Gianluca; De Carlo, Eugenio; Bacci, Antonella; Pasquini, Ernesto; Lanzino, Giuseppe; Frank, Giorgio

    2015-02-01

    OBJECT Adrenocorticotropic hormone (ACTH) adenomas have been recognized as a more aggressive and invasive subtype of pituitary adenomas. An additional and clinically relevant peculiarity of these tumors is their ability to modify their clinical expression from a silent form to Cushing disease or vice versa. The aim of this study was to review a series of patients with pituitary adenomas and analyze the clinical implications of the transformation of clinical expression in 5 cases that showed this phenomenon. METHODS The authors retrospectively reviewed a series of patients with pituitary adenoma and collected clinical, biohumoral, and neuroradiological data of those who presented with a transformation from silent ACTH adenomas to functioning tumors or vice versa. In all the cases, preoperative assessment consisted of brain MRI, ophthalmological examination, and complete baseline endocrinological investigation. In patients with clinical and/or biochemical findings suspicious for Cushing syndrome, a low-dose dexamethasone suppression test was performed to rule in or out this diagnosis. Endocrinological evaluations were repeated 1 month after surgery, 3 months after surgery, and every 6 months or annually thereafter. Ophthalmological evaluations and brain MRIs were repeated after 3 months and then every 6 or 12 months thereafter. RESULTS Five patients (2 men and 3 women) included in this series had corticotropic tumors that showed transformation from an endocrinologically silent form to manifest Cushing disease and vice versa. The mean age at presentation was 40 years (range 18-51 years). In 3 of these patients, a transformation from silent to functioning ACTH adenoma with manifest Cushing disease occurred. In 1 patient, the authors observed the transition from a functioning to a silent adenoma with spontaneous resolution of hypercortisolism. Another patient's silent adenoma "shifted" to a functioning adenoma and then regressed back to a silent form with spontaneous

  16. Mixoma gigante de átrio esquerdo Giant left atrial myxoma

    Juan Francisco Muñoz Cruz

    1998-11-01

    Full Text Available Homem de 65 anos, portador de miocardiopatia dilatada e hipertensão arterial de longa data, com antecedentes de acidente vascular cerebral e que, ao ecocardiograma, apresentou mixoma gigante de átrio esquerdo.A 65 year-old man with dilated cardiomiopathy and long history of high blood pressure and a previous cerebral vascular accident had a giant left atrial myxoma as an echocardiographic finding.

  17. EL ERYNGIUM ("CARDO" GIGANTE DEL DELTA DEL PARANA Y DE LA MESOPOTAMIA ARGENTINA

    Troels Myndel Pedersen

    2010-11-01

    Full Text Available Un Eryngium gigante, espectacular por su tamaño y la abundancia donde se presenta, muy común a lo largo de la Mesopotamia argentina, el delta del Río Paraná, y la orilla sur del Río de la Plata, cuya identidad ha sido interpretada de diversas maneras, se describe como una nueva especie, Eryngium mesopotamicum Pedersen

  18. Unilateral delayed opercularization in a case of Sotos' syndrome (cerebral gigantism)

    Barth, P.G.; Vlasveld, L.; Valk, J.

    1980-08-01

    A case of Sotos' syndrome (cerebral gigantism) is described. Pneumencephalography, performed at the age of 15 days, revealed abnormal separation of the opercula on the right. By comparing the contours with developmental anatomical features of this area it agreed with a foetal development of 24 weeks gestational age. Bilateral carotid angiography was normal. CT showed normal development of the Sylvian area at the age of 27 months.

  19. Increased Population Risk of AIP‐Related Acromegaly and Gigantism in Ireland

    Radian, Serban; Diekmann, Yoan; Gabrovska, Plamena; Holland, Brendan; Bradley, Lisa; Wallace, Helen; Stals, Karen; Bussell, Anna‐Marie; McGurren, Karen; Cuesta, Martin; Ryan, Anthony W.; Herincs, Maria; Hernández‐Ramírez, Laura C.; Holland, Aidan; Samuels, Jade; Aflorei, Elena Daniela; Barry, Sayka; Dénes, Judit; Pernicova, Ida; Stiles, Craig E.; Trivellin, Giampaolo; McCloskey, Ronan; Ajzensztejn, Michal; Abid, Noina; Akker, Scott A.; Mercado, Moises; Cohen, Mark; Thakker, Rajesh V.; Baldeweg, Stephanie; Barkan, Ariel; Musat, Madalina; Levy, Miles; Orme, Stephen M.; Unterländer, Martina; Burger, Joachim; Kumar, Ajith V.; Ellard, Sian; McPartlin, Joseph; McManus, Ross; Linden, Gerard J.; Atkinson, Brew; Balding, David J.; Agha, Amar; Thompson, Chris J.; Hunter, Steven J.; Thomas, Mark G.; Morrison, Patrick J.

    2016-01-01

    ABSTRACT The aryl hydrocarbon receptor interacting protein (AIP) founder mutation R304* (or p.R304*; NM_003977.3:c.910C>T, p.Arg304Ter) identified in Northern Ireland (NI) predisposes to acromegaly/gigantism; its population health impact remains unexplored. We measured R304* carrier frequency in 936 Mid Ulster, 1,000 Greater Belfast (both in NI) and 2,094 Republic of Ireland (ROI) volunteers and in 116 NI or ROI acromegaly/gigantism patients. Carrier frequencies were 0.0064 in Mid Ulster (95%CI = 0.0027–0.013; P = 0.0005 vs. ROI), 0.001 in Greater Belfast (0.00011–0.0047) and zero in ROI (0–0.0014). R304* prevalence was elevated in acromegaly/gigantism patients in NI (11/87, 12.6%, P < 0.05), but not in ROI (2/29, 6.8%) versus non‐Irish patients (0–2.41%). Haploblock conservation supported a common ancestor for all the 18 identified Irish pedigrees (81 carriers, 30 affected). Time to most recent common ancestor (tMRCA) was 2550 (1,275–5,000) years. tMRCA‐based simulations predicted 432 (90–5,175) current carriers, including 86 affected (18–1,035) for 20% penetrance. In conclusion, R304* is frequent in Mid Ulster, resulting in numerous acromegaly/gigantism cases. tMRCA is consistent with historical/folklore accounts of Irish giants. Forward simulations predict many undetected carriers; geographically targeted population screening improves asymptomatic carrier identification, complementing clinical testing of patients/relatives. We generated disease awareness locally, necessary for early diagnosis and improved outcomes of AIP‐related disease. PMID:27650164

  20. Cerebral gigantism associated with jaw cyst basal cell naevoid syndrome in two families.

    Cramer, H; Niederdellmann, H

    1983-01-01

    We report 9 subjects from 2 families with the syndrome of cerebral gigantism, seven of the patients also had jaw cyst basal cell naevoid syndrome. Neurological, radiological, somatic and biochemical features of this hitherto unreported association are described. Neurological symptoms included mild hydrocephalus, ventricular malformation, cerebellar syndrome, intracranial calcification, oculomotor disturbances, EEG abnormalities and rarely, mild peripheral nervous disorders. A disturbance of calcium metabolism appears to be a prominent feature of the genetically determined nonprogressive syndrome.

  1. Ecological explanations to island gigantism: dietary niche divergence, predation, and size in an endemic lizard.

    Runemark, Anna; Sagonas, Kostas; Svensson, Erik I

    2015-08-01

    Although rapid evolution of body size on islands has long been known, the ecological mechanisms behind this island phenomenon remain poorly understood. Diet is an important selective pressure for morphological divergence. Here we investigate if selection for novel diets has contributed to the multiple independent cases of island gigantism in the Skyros wall lizard (Podarcis gaigeae) and if diet, predation, or both factors best explain island gigantism. We combined data on body size, shape, bite force, and realized and available diets to address this. Several lines of evidence suggest that diet has contributed to the island gigantism. The larger islet lizards have relatively wider heads and higher bite performance in relation to mainland lizards than would be expected from size differences alone. The proportions of consumed and available hard prey are higher on islets than mainland localities, and lizard body size is significantly correlated with the proportion of hard prey. Furthermore, the main axis of divergence in head shape is significantly correlated with dietary divergence. Finally, a model with only diet and one including diet and predation regime explain body size divergence equally well. Our results suggest that diet is an important ecological factor behind insular body size divergence, but could be consistent with an additional role for predation.

  2. Starvation reveals the cause of infection-induced castration and gigantism.

    Cressler, Clayton E; Nelson, William A; Day, Troy; McCauley, Edward

    2014-10-01

    Parasites often induce life-history changes in their hosts. In many cases, these infection-induced life-history changes are driven by changes in the pattern of energy allocation and utilization within the host. Because these processes will affect both host and parasite fitness, it can be challenging to determine who benefits from them. Determining the causes and consequences of infection-induced life-history changes requires the ability to experimentally manipulate life history and a framework for connecting life history to host and parasite fitness. Here, we combine a novel starvation manipulation with energy budget models to provide new insights into castration and gigantism in the Daphnia magna-Pasteuria ramosa host-parasite system. Our results show that starvation primarily affects investment in reproduction, and increasing starvation stress reduces gigantism and parasite fitness without affecting castration. These results are consistent with an energetic structure where the parasite uses growth energy as a resource. This finding gives us new understanding of the role of castration and gigantism in this system, and how life-history variation will affect infection outcome and epidemiological dynamics. The approach of combining targeted life-history manipulations with energy budget models can be adapted to understand life-history changes in other disease systems.

  3. The triangulation of the gigantic jets observed by the optical observation network in Taiwan

    Chen, Alfred B.; Huang, Chien-Fong; Peng, Kang-Ming; Su, Han-Tzong; Hsu, Rue-Ron

    2015-04-01

    The optical triangulation of sprites and elves by the multiple sites has been done in the past decades, but the similar observation on gigantic jets has never been reported yet. A ground optical observation network consisting of four stations at Kimen, Penghu, Tainan, and Taitung (from west to east) has been established in Taiwan since 2012. Each station equipped with two sets of Watec low-light sensitivity cameras, and the elevation and azimuth of the observation can be fully remote controlled to point toward the on-going convection system in the vicinity of Taiwan. In summer 2014, more than 6 gigantic jets were captured by at least two stations successfully. The triangulation and ULF sferics of these interesting events provides an excellent chance to explore the spatial and temporal evolution of the jets in different phases. In this presentation, this ground observation network will be introduced, the detail evolution of the recorded gigantic jets is presented. The preliminary result implies that the jets may not pop from the cloudtop straightforwardly, and some twists occur during the propagation of the jets. A more complicated analysis of the tomography for the advanced triangulation will be mentioned, too.

  4. Hiperparatiroidismo secundario a adenoma paratiroideo mediastinal Hyperparathyroidism due to mediastinal parathyroid adenoma

    C Agostinis

    2012-03-01

    Full Text Available Las glándulas paratiroides se localizan en el cuello, en la cara posterior de la glándula tiroides. Tienen como función secretar PTH, la cual está regulada por la concentración extracelular de calcio. Se define como hiperparatiroidismo a la producción excesiva de PTH por las glándulas paratiroideas, siendo el 85 % aproximadamente de los casos producto de un adenoma; un 12 % debido a hiperplasia y menos del 1 % por carcinomas. El hiperparatiroidismo primario ectápico se presenta en el 10 % de los pacientes, de los cuales del 1 al 2 % corresponde a la localización mediastinal(1. Presentamos una paciente de 38 años, internada en nuestra institución por hipercalcemia sintomática, comprobándose niveles plasmáticos elevados de PTH. Se le realizá una gammagrafía con tecnecio 99 MIBI que evidenció una imagen hipercaptante a nivel de mediastino anterior. Fue intervenida quirúrgicamente, obteniendo como resultado de la anatomía patolágica un adenoma paratiroideo.The parathyroid glands are located in the neck, on the back of the thyroid gland. Their function is to secrete PTH, which is regulated by extracellular calcium concentration. Hyperparathyroidism is defined as the excessive production of PTH by the parathyroid glands; approximately 85 % of the cases are caused by an adenoma, 12 % due to hyperplasia and less than 1 % by carcinomas. Ectopic Primary hyperparathyroidism occurs in 10 % of the patients, of which from 1 to 2 % are of mediastinal location(1. We report the case of a 38-year-old patient hospitalized in our institution for symptomatic hypercalcemia. During her hospitalization elevated plasma levéis of PTH were found with image MIBI technetium 99 high uptake in the anterior mediastinum. She underwent surgery, and the pathology report showed parathyroid adenoma.

  5. The Spectrum of Hormone Immunoreactivity in Typical and Atypical Pituitary Adenomas

    Yeşim ERTAN

    2009-09-01

    Full Text Available Objective: We aimed to assess the spectrum of hormone immunoreactivity in our pituitary adenoma cases and discuss the diagnostic parameters of atypical pituitary adenomas.Material and Methods: A total of 166 pituitary adenoma cases diagnosed from 2005 to 2008 in our department were included in the present study. Hematoxylin-eosin stained and immunohistochemistry performed slides (ACTH, PRL, GH, TSH, FSH, LH, Ki-67, and p53 were evaluated. Cases having more than two mitoses on 10 high power fields besides more than 3% Ki-67 index were accepted in the atypical group.Results: Histologically, 159 cases were typical pituitary adenoma and 7 were atypical pituitary adenoma. Of the atypical pituitary adenoma cases, one case was ACTH, one GH and one both GH and prolactin hormone immunoreactive pituitary adenomas. Four cases were hormone immunonegative adenomas. Of the typical pituitary adenoma cases, 39 cases were GH, 19 ACTH, 17 prolactin, 10 FSH, 8 LH and one TSH immunreactive pituitary adenomas. Fourty-seven cases were hormone immunonegative adenomas.Twenty-two of the all pitutary adenoma cases had recurrence. Of these cases, 18 were typical adenoma and four were atypical adenoma.Conclusion: The ratio of prolactin immunoreactive pituitary adenoma cases in the surgical material of neuropathology is decreasing due to medical therapy. Atypical pituitary adenomas are not the sole factor affecting the recurrence mechanism but these tumors have higher recurrence rate compared with typical pituitary adenomas and we think the proliferation index might be the principal approach in the diagnosis of these lesions.

  6. Unsuspected meningioma in a patient with pituitary gigantism. Case report with autopsy findings

    Stock, J.M.; Ghatak, N.R.; Oppenheimer, J.H.

    1975-06-01

    A unique example of a clinically unsuspected large parasellar meningioma is described in a 36-yr-old pituitary giant who had been treated initially with conventional irradiation, subsequently by surgical excision of an acidophil adenoma, and ultimately with medroxyprogesterone acetate (MPA) prior to his demise. The patient died of increased intracranial pressure resulting from a combined mass effect of the meningioma and recurrent tumor. The relationship between radiation and the development of the meningioma is discussed, as well as the fine ultrastructure of a highly functioning acidophil adenoma.

  7. Middle ear adenoma is an amphicrine tumor: why call it adenoma?

    Ketabchi, S; Massi, D; Franchi, A; Vannucchi, P; Santucci, M

    2001-01-01

    Middle ear adenoma (MEA) is a rare tumor postulated to take origin from the lining epithelium of the middle ear cavity. The authors report on a case of MEA arising in a 53-year old woman suffering from a sensation of fullness in her left ear, otalgia, and light left-sided hearing loss. Histopathologically, the lesion was composed of cuboidal and polygonal cells displaying a trabecular, tubulo-glandular, and solid pattern of growth. Immunohistochemically, neoplastic cells diffusely stained with anti-vimentin antibodies and were focally positive for chromogranin A, neuron-specific enolase, lysozyme, and cytokeratins AE1/AE3. The majority of tumor cells showed weak and diffuse staining with both anti-PP and anti-ACTH antibodies and intense positivity with anti-glucagon and anti Leu-7 antibodies. Ultrastructural investigation revealed both mucinous-glandular and neuroendocrine differentiation. The authors suggest that the appropriate terminology would be adeno-carcinoid or amphicrine tumor of the middle ear rather than "adenoma," a term that does not reflect its dual nature.

  8. Pediatric adrenocortical neoplasms: can imaging reliably discriminate adenomas from carcinomas?

    Flynt, Kelsey A.; Dillman, Jonathan R.; Smith, Ethan A.; Strouse, Peter J. [University of Michigan Health System, Section of Pediatric Radiology, C. S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Davenport, Matthew S.; Caoili, Elaine M. [University of Michigan Health System, Division of Abdominal Imaging, Department of Radiology, Ann Arbor, MI (United States); Else, Tobias [University of Michigan Health System, Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, Ann Arbor, MI (United States)

    2015-08-15

    There is a paucity of literature describing and comparing the imaging features of adrenocortical adenomas and carcinomas in children and adolescents. To document the CT and MRI features of adrenocortical neoplasms in a pediatric population and to determine whether imaging findings (other than metastatic disease) can distinguish adenomas from carcinomas. We searched institutional medical records to identify pediatric patients with adrenocortical neoplasms. Pre-treatment CT and MRI examinations were reviewed by two radiologists in consensus, and pertinent imaging findings were documented. We also recorded relevant histopathological, demographic, clinical follow-up and survival data. We used the Student's t-test and Wilcoxon rank sum test to compare parametric and nonparametric continuous data, and the Fisher exact test to compare proportions. We used receiver operating characteristic (ROC) curve analyses to evaluate the diagnostic performances of tumor diameter and volume for discriminating carcinoma from adenoma. A P-value ≤0.05 was considered statistically significant. Among the adrenocortical lesions, 9 were adenomas, 15 were carcinomas, and 1 was of uncertain malignant potential. There were no differences in mean age, gender or sidedness between adenomas and carcinomas. Carcinomas were significantly larger than adenomas based on mean estimated volume (581 ml, range 16-2,101 vs. 54 ml, range 3-197 ml; P-value = 0.003; ROC area under the curve = 0.92) and mean maximum transverse plane diameter (9.9 cm, range 3.0-14.9 vs. 4.4 cm, range 1.9-8.2 cm; P-value = 0.0001; ROC area under the curve = 0.92). Carcinomas also were more heterogeneous than adenomas on post-contrast imaging (13/14 vs. 2/9; odds ratio [OR] = 45.5; P-value = 0.001). Six of 13 carcinomas and 1 of 8 adenomas contained calcification at CT (OR = 6.0; P-value = 0.17). Seven of 15 children with carcinomas exhibited metastatic disease at diagnosis, and three had inferior vena cava invasion. Median

  9. Myoepithelial carcinoma arising in recurrent pleomorphic adenoma in maxillary sinus.

    Gupta, Ashumi; Manipadam, Marie Therese; Michael, Rajiv

    2013-09-01

    Myoepithelial carcinoma is characterized by nearly exclusive myoepithelial differentiation and evidence of malignancy. It may arise de novo or in preexisting benign tumors including pleomorphic adenoma and benign myoepithelioma. A 39-year-old lady presented with painless progressive swelling on the right cheek and right side of palate. On surgery, there was a mass in right maxillary sinus which was surgically excised and diagnosed on histopathology as pleomorphic adenoma. Subsequently, there were two recurrences. The first recurrence was in the right maxilla after 2 years that was removed surgically and diagnosed as pleomorphic adenoma. One year later, she came with rapidly progressive swelling in bilateral cheeks and face. Intraoperatively, there was a large tumor in both maxillary sinuses with extensive local infiltration. Histologically, it was diagnosed as myoepithelial carcinoma. Carcinoma ex pleomorphic adenoma is usually a high grade malignancy. It occurs most commonly in parotid gland followed by submandibular glands, minor salivary glands and occasionally in sublingual gland. To the best of our knowledge, this is the first case of myoepithelial carcinoma arising in a recurrent pleomorphic adenoma in the maxillary sinus.

  10. Cushing-type ectopic pituitary adenoma with unusual pathologic features

    Kristopher T. Kimmell, MD

    2014-06-01

    Full Text Available Ectopic pituitary adenomas comprise, by varying reports, approximately 1-2% of all pituitary adenomas. They are often located in the nasopharyngeal region associated with the pharyngeal pituitary. The location and pathologic features of these masses make them atypical when compared with intrasellar pituitary adenomas. A 54-year-old man presented with vertebral compression fracture and physical stigmata of Cushing’s disease. Biochemical testing confirmed hypercortisolemia responsive to high dose dexamethasone suppression. MRI of the head demonstrated an enhancing mass in the posterior aspect of the sphenoid sinus not involving the sella turcica. Endoscopic biopsy followed by resection confirmed this mass to be a pituitary adenoma with unusual pathologic features. Most notably, the tumor cells demonstrated large, eosinophilic, vacuolated cytoplasm. Immunohistochemical profile of the tumor was typical of an ACTH secreting tumor, notably with positivity for ACTH. The patient did well from his surgery. Post-operatively his serum cortisol level normalized and he remains in chemical remission one year after surgery. Ectopic pituitary adenomas are an unusual manifestation of hormonally active pituitary neoplastic disease. Their atypical clinical presentations, location, and pathologic features can make them a diagnostic challenge. Clinicians should be aware of these entities, especially when considering differential diagnosis for a mass in the sphenoid sinus and nasopharyngeal region.

  11. Chondroid chordoma of the sella turcica mimicking a pituitary adenoma.

    Wu, Arthur W; Bhuta, Sunita; Salamon, Noriko; Martin, Neil; Wang, Marilene B

    2015-01-01

    We report an unusual case of a chondroid chordoma of the sella turcica that mimicked the clinical and radiologic presentation of the more common pituitary adenoma. A 50-year-old man presented with bitemporal visual field deficits. Magnetic resonance imaging (MRI) detected a sellar mass that was suggestive of a pituitary adenoma. However, the intraoperative appearance of the mass was not consistent with an adenoma, and frozen-section pathology was obtained. Pathology identified the mass as a malignant lesion. Based on this finding, the mass was treated more aggressively. Chondroid chordomas are rare and slowly growing but locally aggressive tumors. The prognosis depends on the ability to totally resect the mass, so differentiating this tumor from a benign lesion is critical. An intrasellar chordoma can be confused clinically and radiologically with a pituitary adenoma. These two lesions are nearly identical on MRI, although T2-weighted imaging sometimes demonstrates higher intensity with a chondroid chordoma. Computed tomography may be helpful in demonstrating bony destruction by these lesions, as can the presence of intralesional calcifications. Intraoperative findings of bony invasion or a purple-red color may also lead the surgeon to suspect a diagnosis other than pituitary adenoma.

  12. Matrix metalloproteinase-13 expression in the progression of colorectal adenoma to carcinoma : Matrix metalloproteinase-13 expression in the colorectal adenoma and carcinoma.

    Foda, Abd Al-Rahman Mohammad; El-Hawary, Amira K; Abdel-Aziz, Azza

    2014-06-01

    Most colorectal carcinomas (CRCs) are considered to arise from conventional adenoma based on the concept of the adenoma-carcinoma sequence. Matrix metalloproteinases (MMPs) are known to be overexpressed as normal mucosa progresses to adenomas and carcinomas. There has been little previous investigation about MMP-13 expression in adenoma-carcinoma sequence. In this study, we aimed to investigate the immunohistochemical expression of MMP-13 in colorectal adenoma and CRC specimens using tissue microarray (TMA) technique. A total of 40 cases of CRC associated with adenoma were collected from files of the Pathology laboratory at Mansoura Gastroenterology Center between January 2007 and January 2012. Sections from TMA blocks were prepared and stained for MMP-13. Immunoreactivity to MMP-13 staining was localized to the cytoplasm of mildly, moderately, and severely dysplatic cells of adenomas and CRC tumor cells that were either homogenous or heterogeneous. There was no significant difference in MMP-13 expression between adenomas and CRCs either non-mucinous or mucinous. Adenomas with high MMP-13 expression were significantly associated with moderate to marked degree of inflammatory cellular infiltrate and presence of familial adenomatous polyps. In conclusion, MMP-13 may be a potential biological marker of early tumorigenesis in the adenoma-carcinoma sequence.

  13. File list: NoD.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  14. File list: ALL.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  15. File list: Unc.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  16. File list: Pol.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  17. File list: Unc.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  18. File list: ALL.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  19. File list: Unc.Dig.05.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  20. File list: Unc.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  1. File list: ALL.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  2. File list: NoD.Dig.05.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  3. File list: Pol.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  4. File list: Pol.Dig.05.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  5. File list: InP.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  6. File list: Oth.Dig.05.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  7. File list: NoD.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  8. File list: Oth.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available Oth.Dig.20.AllAg.Intestinal_adenoma mm9 TFs and others Digestive tract Intestinal a...denoma SRX648718 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Oth.Dig.20.AllAg.Intestinal_adenoma.bed ...

  9. File list: InP.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  10. File list: NoD.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available NoD.Dig.50.AllAg.Intestinal_adenoma mm9 No description Digestive tract Intestinal a...denoma http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Dig.50.AllAg.Intestinal_adenoma.bed ...

  11. File list: Pol.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  12. File list: DNS.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  13. File list: InP.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  14. File list: Oth.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available Oth.Dig.50.AllAg.Intestinal_adenoma mm9 TFs and others Digestive tract Intestinal a...denoma SRX648718 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Oth.Dig.50.AllAg.Intestinal_adenoma.bed ...

  15. File list: Oth.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  16. File list: DNS.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Full Text Available DNS.Dig.10.AllAg.Intestinal_adenoma mm9 DNase-seq Digestive tract Intestinal adenom...a http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/DNS.Dig.10.AllAg.Intestinal_adenoma.bed ...

  17. Coexisting intracranial tumors with pituitary adenomas: Genetic association or coincidence?

    Furtado Sunil

    2010-01-01

    Full Text Available The co-occurrence of two or more brain tumors with different histological features is rare. The authors report three rare cases of intracranial tumors associated with pituitary adenomas. Two of the pituitary tumors were functioning adenomas: a prolactinoma and a thyrotropin secreting adenoma. Two of the associated intracranial neoplasms were gliomas and one was a meningioma. Radiological and clinical examination for syndromal association was negative in all cases. We briefly discuss the presentation and treatment options of these cases and review the 19 previous publications in the literature of pituitary tumors occurring in association with other neoplasms and explore the possible links underlying these co-occurring neoplasms. Our three cases represent 0.86% of all pituitary tumors operated at our institute over a 9-year period.

  18. Parathyroid Adenoma Presenting as a Brown Tumour of the Mandible

    Kavit Amin

    2012-01-01

    Full Text Available Background. Parathyroid adenoma is the commonest cause of primary hypercalcaemia and usually presents with symptoms/signs of hypercalcaemia. This paper highlights an unusual presentation. Case Report. A 27-year-old female presented with a painful left mandibular swelling, suspicious of neoplasia. A computed tomography (CT guided biopsy was performed. Based on the histology result, serum calcium was carried out, confirming hypercalcaemia. A left inferior parathyroid adenoma was subsequently removed. CT mandible showed extensive erosive lesions at the left 2nd/3rd inferior molar roots with protrusion to adjacent soft tissues. USS revealed a hypoechoic lesion on the left inferior parathyroid gland. Sestamibi scan showed a focus of MIBI uptake and retention at the inferior aspect of the left thyroid lobe. Conclusion. This case highlights the importance of a thorough history and examination. Clinicians should always bear in mind atypical presentations of parathyroid adenomas, with the need to exclude this differential in the presence of hypercalcaemia.

  19. Pictures of focal nodular hyperplasia and hepatocellular adenomas

    Christine; Sempoux; Charles; Balabaud; Paulette; Bioulac-Sage

    2014-01-01

    This practical atlas aims to help liver and non liver pa-thologists to recognize benign hepatocellular nodules on resected specimen. Macroscopic and microscopic views together with immunohistochemical stains illustrate typical and atypical aspects of focal nodular hyperplasia and of hepatocellular adenoma, including hepatocel-lular adenomas subtypes with references to clinical and imaging data. Each step is important to make a correct diagnosis. The specimen including the nodule and the non-tumoral liver should be sliced, photographed and all different looking areas adequately sampled for par-affin inclusion. Routine histology includes HE, trichrome and cytokeratin 7. Immunohistochemistry includes glu-tamine synthase and according to the above results ad-ditional markers such as liver fatty acid binding protein, C reactive protein and beta catenin may be realized to differentiate focal nodular hyperplasia from hepatocel-lular adenoma subtypes. Clues for differential diagnosis and pitfalls are explained and illustrated.

  20. Tubulovillous adenoma of anal canal: A case report

    Bhupinder S Anand; Gordana Verstovsek; George Cole

    2006-01-01

    Tumors arising from the anal canal are usually of epithelial origin and are mostly squamous cell carcinoma or basal cell carcinoma. We present a case of benign anal adenomas arising from the anus, an extremely rare diagnosis. A 78-year-old white man presented with rectal bleeding of several months duration. Examination revealed a 4 cm friable mass attached to the anus by a stalk. At surgery, the mass was grasped with a Babcock forceps and was resected using electrocautery.Microscopic examination revealed a tubulovillus adenoma with no areas of high grade dysplasia or malignant transformation. The squamocolumnar junction was visible at the edges of the lesion confirming the anal origin of the tumor. We believe the tubulovillus adenoma arose from either an anal gland or its duct that opens into the anus. Although seen rarely, it is important to recognize and treat these tumors at an early stage because of their potential to transform into adenocarcinoma.

  1. Structure of the TPR domain of AIP: lack of client protein interaction with the C-terminal α-7 helix of the TPR domain of AIP is sufficient for pituitary adenoma predisposition.

    Rhodri M L Morgan

    Full Text Available Mutations of the aryl hydrocarbon receptor interacting protein (AIP have been associated with familial isolated pituitary adenomas predisposing to young-onset acromegaly and gigantism. The precise tumorigenic mechanism is not well understood as AIP interacts with a large number of independent proteins as well as three chaperone systems, HSP90, HSP70 and TOMM20. We have determined the structure of the TPR domain of AIP at high resolution, which has allowed a detailed analysis of how disease-associated mutations impact on the structural integrity of the TPR domain. A subset of C-terminal α-7 helix (Cα-7h mutations, R304* (nonsense mutation, R304Q, Q307* and R325Q, a known site for AhR and PDE4A5 client-protein interaction, occur beyond those that interact with the conserved MEEVD and EDDVE sequences of HSP90 and TOMM20. These C-terminal AIP mutations appear to only disrupt client-protein binding to the Cα-7h, while chaperone binding remains unaffected, suggesting that failure of client-protein interaction with the Cα-7h is sufficient to predispose to pituitary adenoma. We have also identified a molecular switch in the AIP TPR-domain that allows recognition of both the conserved HSP90 motif, MEEVD, and the equivalent sequence (EDDVE of TOMM20.

  2. Structure of the TPR domain of AIP: lack of client protein interaction with the C-terminal α-7 helix of the TPR domain of AIP is sufficient for pituitary adenoma predisposition.

    Morgan, Rhodri M L; Hernández-Ramírez, Laura C; Trivellin, Giampaolo; Zhou, Lihong; Roe, S Mark; Korbonits, Márta; Prodromou, Chrisostomos

    2012-01-01

    Mutations of the aryl hydrocarbon receptor interacting protein (AIP) have been associated with familial isolated pituitary adenomas predisposing to young-onset acromegaly and gigantism. The precise tumorigenic mechanism is not well understood as AIP interacts with a large number of independent proteins as well as three chaperone systems, HSP90, HSP70 and TOMM20. We have determined the structure of the TPR domain of AIP at high resolution, which has allowed a detailed analysis of how disease-associated mutations impact on the structural integrity of the TPR domain. A subset of C-terminal α-7 helix (Cα-7h) mutations, R304* (nonsense mutation), R304Q, Q307* and R325Q, a known site for AhR and PDE4A5 client-protein interaction, occur beyond those that interact with the conserved MEEVD and EDDVE sequences of HSP90 and TOMM20. These C-terminal AIP mutations appear to only disrupt client-protein binding to the Cα-7h, while chaperone binding remains unaffected, suggesting that failure of client-protein interaction with the Cα-7h is sufficient to predispose to pituitary adenoma. We have also identified a molecular switch in the AIP TPR-domain that allows recognition of both the conserved HSP90 motif, MEEVD, and the equivalent sequence (EDDVE) of TOMM20.

  3. The prevalence of human papillomavirus in colorectal adenomas and adenocarcinomas

    Baandrup, Louise; Thomsen, Louise T; Olesen, Tina Bech;

    2014-01-01

    The role of human papillomavirus (HPV) in colorectal cancer has been widely studied with conflicting results. We performed a systematic review and a meta-analysis to estimate the prevalence of HPV in colorectal adenocarcinomas and adenomas, and test the potential association.......The role of human papillomavirus (HPV) in colorectal cancer has been widely studied with conflicting results. We performed a systematic review and a meta-analysis to estimate the prevalence of HPV in colorectal adenocarcinomas and adenomas, and test the potential association....

  4. Análisis de un registro de adenomas pituitarios Analysis of a pituitary adenoma registry

    Carolina Albiero

    2010-10-01

    Full Text Available Dada la complejidad que reviste el enfoque diagnóstico y terapéutico de los tumores pituitarios, el registro y análisis de la experiencia clínica acumulada es de gran ayuda en la toma de decisiones. En este trabajo se informan datos clínico-terapéuticos, extraídos de un registro computarizado, sobre 519 de un total de 670 pacientes con adenomas pituitarios. Trescientos cuarenta y cinco fueron mujeres (66% y 174 varones (34%, de 14 a 80 años de edad. El diagnóstico final fue: acromegalia en 176, enfermedad de Cushing en 153, prolactinoma en 101 y adenoma clínicamente no-funcionante (ANF en 89. La edad media al momento del diagnóstico de acromegalia fue 43.9 ± 13.5 (16-80, para enfermedad de Cushing 35.7 ± 12.9 (14-72, para prolactinomas 30.0 ± 13.4 (15-79 y para ANF 52.1 ± 15.2 (17-79 años. La creación de un registro institucional de tumores de hipófisis es un instrumento de gran utilidad para el análisis de la experiencia adquirida y constituye una herramienta valiosa para mejorar la estrategia terapéutica, optimizar la relación costo/beneficio y mejorar el cuidado del paciente. Contribuye a la docencia médica, tanto en el pre como en el posgrado y da base a la realización de trabajos de investigación clínica, aportando a la difusión y transferencia de conocimientos.Collection and analysis of data obtained during the clinical treatment of pituitary tumours are of great utility in the decision making process, when facing clinical situations. We report here data on 519 from 670 patients with pituitary adenomas obtained from a computerized registry. Three hundred and forty five were females (66% and 174 males (34%, aged 14-80. Final diagnosis was acromegaly in 176, Cushing's disease in 153, prolactinoma in 101 and clinically non-functioning adenoma in 89. Mean age at diagnosis was 43.9 ± 13.5 (16-80 for acromegalics, 35.7 ± 12.9 (14-72 for Cushing's, 30.0 ± 13.4 (15-79 for prolactinoma and 52.1 ± 15.2 (17-79, for non

  5. Vínculos observacionais para o processo-S em estrelas gigantes de Bário

    Smiljanic, R. H. S.; Porto de Mello, G. F.; da Silva, L.

    2003-08-01

    Estrelas de bário são gigantes vermelhas de tipo GK que apresentam excessos atmosféricos dos elementos do processo-s. Tais excessos são esperados em estrelas na fase de pulsos térmicos do AGB (TP-AGB). As estrelas de bário são, no entanto, menos massivas e menos luminosas que as estrelas do AGB, assim, não poderiam ter se auto-enriquecido. Seu enriquecimento teria origem em uma estrela companheira, inicialmente mais massiva, que evolui pelo TP-AGB, se auto-enriquece com os elementos do processo-s e transfere material contaminado para a atmosfera da atual estrela de bário. A companheira evolui então para anã branca deixando de ser observada diretamente. As estrelas de bário são, portanto, úteis como testes observacionais para teorias de nucleossíntese pelo processo-s, convecção e perda de massa. Análises detalhadas de abundância com dados de alta qualidade para estes objetos são ainda escassas na literatura. Neste trabalho construímos modelos de atmosferas e, procedendo a uma análise diferencial, determinamos parâmetros atmosféricos e evolutivos de uma amostra de dez gigantes de bário e quatro normais. Determinamos seus padrões de abundância para Na, Mg, Al, Si, Ca, Sc, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Sr, Y, Zr, Ba, La, Ce, Nd, Sm, Eu e Gd, concluindo que algumas estrelas classificadas na literatura como gigantes de bário são na verdade gigantes normais. Comparamos dois padrões médios de abundância, para estrelas com grandes excessos e estrelas com excessos moderados, com modelos teóricos de enriquecimento pelo processo-s. Os dois grupos de estrelas são ajustados pelos mesmos parâmetros de exposição de nêutrons. Tal resultado sugere que a ocorrência do fenômeno de bário com diferentes intensidades não se deve a diferentes exposições de nêutrons. Discutimos ainda efeitos nucleossintéticos, ligados ao processo-s, sugeridos na literatura para os elementos Cu, Mn, V e Sc.

  6. Miocarditis de células gigantes que simula un infarto agudo de miocardio

    Andrea Zappi

    2009-01-01

    Full Text Available La miocarditis de células gigantes (MCG es una entidad rara, de causa desconocida, de probable etiología autoinmune. Puede presentarse como insuficiencia cardíaca refractaria, asociarse con arritmias ventriculares y en otras ocasiones simular un infarto agudo de miocardio. Su pronóstico con frecuencia es ominoso, salvo que se realicen tratamiento inmunosupresor o trasplante cardíaco, este último con elevada recurrencia.REV ARGENT CARDIOL 2009;77:60-62.

  7. Bariones y gravitones gigantes en el marco de la correspondencia AdS/CFT

    Picos Sol, Marco Antonio

    2016-01-01

    Se construyen y analizan dos tipos de configuraciones que pueden construirse en el espacio dual a la teoría ABJM (en la dualidad AdS_4/CFT_3): gravitones gigantes y vértices bariónicos. Ambas configuraciones hacen uso de la posibilidad de enrrollar branas en ciclos topológicamente no triviales en el lado gravitatorio de la dualidad. Los vértices bariónicos están formados por branas enrrolladas atadas a cuerdas que se extienden hasta la frontera de AdS, y son vistos desde el lado gauge com...

  8. Velocidades radiales de estrellas gigantes rojas y blue stragglers en cúmulos abiertos

    González, J. F.; Lapasset, E.

    Se presentan mediciones de las estrellas más brillantes en los campos de los cúmulos abiertos NGC 6530, NGC 2516, NGC 3114, Cr 223 y NGC 2437. Mediante correlaciones cruzadas se obtiene la velocidad de unas 25 gigantes rojas con el objeto de derivar la velocidad media de cada asociación. En base a los espectros obtenidos de los blue stragglers se discuten sus principales características y su probabilidad de pertenencia. Finalmente, se presentan las observaciones para cinco nuevas binarias espectroscópicas detectadas.

  9. Gigantic terahertz magnetochromism via electromagnons in hexaferrite magnet Ba$_2$Mg$_2$Fe$_{12}$O$_{22}$

    Kida, N.; Kumakura, S.; Ishiwata, S.; Taguchi, Y.; Tokura, Y.

    2011-01-01

    Effects of temperature (6--225 K) and magnetic field (0--7 T) on the low-energy (1.2--5 meV) electrodynamics of the electromagnon, the magnetic resonance driven by the light electric field, have been investigated for a hexaferrite magnet Ba$_2$Mg$_2$Fe$_{12}$O$_{22}$ by using terahertz time-domain spectroscopy. We find the gigantic terahertz magnetochromism via electromagnons; the magnetochromic change, as defined by the difference of the absorption intensity with and without magnetic field, ...

  10. Formación y evolución de planetas gigantes

    Benvenuto, O. G.; Brunini, A.

    Presentamos el estado actual del trabajo que estamos realizando en el estudio de la formación de planetas gigantes. Detallamos los algoritmos numéricos necesarios para realizar este tipo de cálculo. Presentamos algunos resultados de la formación de objetos con masas de hasta una docena de veces la del planeta Júpiter, resaltando las principales caracteríticas. Finalmente detallamos los problemas que pensamos abordar en un futuro cercano en este tema de investigación.

  11. IN VITRO CELL CULTURE AND HORMONE RADIOIMMUNOASSAY OF HUAMAN PITUITARY ADENOMAS

    陆汉魁; 林祥通; 等

    1994-01-01

    Tissues from 30 human pituitary adenomas are monolayer-cell-cultured in vitro.Hormone secretion of GH,PRL,TSH,LH and FSH by cells into medium is detected by radioimmunoassay .The pattern and amount of hormone(s0 in the medium are used to determine the nature of the cells and thus to establish functional classification of pituitary adenomas.The results show that cell culture technique provides and easy and suitable mode for investigating the nature of pituitary adenomas.Hormone radioimmunoassay of culture medium is precise and reliable and represents the whole adenoma tissue.Further studies can lead to clearer understandngs of the pathology of pituitary adenomas.

  12. Management of Duodenal Adenomas Involving the Ampulla of Vater – A Warning against Limited Resection

    Jeremy Rossaak

    2008-03-01

    Full Text Available Duodenal adenomas are uncommon, however, when present a proportion have dysplasia associated with the adenoma and therefore require treatment. The options range from less invasive endoscopic treatments to a pancreaticoduodenectomy. This case report describes two patients with adenomas involving the ampulla of Vater. One patient had familial adenomatous polyposis, the other was a renal transplant patient with a large adenoma. Both patients’ adenomas contained high-grade dysplasia. Both patients underwent a pancreaticoduodenectomy. Histology of both specimens demonstrated that the adenoma had migrated up the bile duct for at least 7 mm, and the pancreatic duct for 8 mm in one patient. Limited resection of ampullary adenomas may leave residual adenomatous tissue in the bile duct with the risk of recurrent adenomatous disease and malignant transformation.

  13. CLINICOPATHOLOGICAL ANALYSIS OF 50 RECTAL CANCER CASES DIAGNOSED AS ADENOMA IN BIOPSY

    BU Zhao-de; LI Zi-yu; XIE Yu-quan; JI Jia-fu; SU Xiang-qian

    2005-01-01

    Objective: To evaluate the clinicopathological characteristics of rectal cancer diagnosed as adenoma in biopsy. Methods: 50 rectal cancer cases diagnosed as adenoma in biopsy were analyzed retrospectively in this study by comparing the biopsy and postoperative pathology. Results: Among these 50 patients, biopsy pathology showed 26% (13/50) adenoma with mild dysplasia, 30% (15/50) adenoma with moderate dysplasia, and 44% (22/50) adenoma with severe dysplasia. In 8 cases, the adenomas were smaller than 2cm. On postoperatively surgical pathology, only 10 cases were carcinoma-in-situ, while 40 cases were invasive cancer. Conclusion: Special emphasis should be taken to biopsy-negative rectal adenomas and those smaller than 2cm.

  14. Evidence for colorectal sarcomatoid carcinoma arising from tubulovillous adenoma

    2008-01-01

    Sarcomatoid carcinomas of the colorectum are rare tu- mors that display both malignant epithelial and stromal components. Clinically, they are aggressive tumors with early metastasis. Due to their infrequent occurrence, the pathogenesis is poorly understood. We report a case of a 52-year-old woman who presented with a rectal mass and intermittent hematochezia. Superficial biopsies during colonoscopy revealed a tubulovillous adenoma with high-grade dysplasia. Endoscopic ultra- sonography confirmed an invasive nature of the mass, and deeper biopsies revealed the presence of neoplasm with mixed histological components. The surgically- excised specimen demonstrated the presence of poorly differentiated spindle cells underneath the tubulovillous adenoma and an intermediate stage of invasive acleno- carcinoma. Based on the histological appearance and imrnunohistochemical studies, a diagnosis of sarcoma- toid carcinoma was made. Only nine cases of sarcoma- told carcinomas of the colorectum have been reported to date. As a result, the terminology and pathogenesis of sarcomatoid carcinoma remain speculative. To the best of our knowledge, this is the first report of co- existence of sarcomatoid carcinoma and invasive ad-enocarcinoma with tubulovillous adenoma; all stagesrepres ented within the same tumor. This observation supports the "monoclonal theory" of pathogenesis with an adenoma-sarcoma progression with or without an intermediate stage of carcinoma.

  15. Clinico-pathological aspects of colorectal serrated adenomas

    Ashish Chandra; Adnan A Sheikh; Anton Cerar; Ian C Talbot

    2006-01-01

    AIM: To study the association of colorectal serrated adenomas (SAs) with invasive carcinoma, local recurrence, synchronicity and metachronicity of lesions.METHODS: A total of 4536 polyps from 1096patients over an eight-year period (1987-1995) were retrospectively examined. Adenomas showing at least 50% of serrated architecture were called SAs by three reviewing pathologists.RESULTS: Ninety-one (2%) of all polyps were called SAs, which were found in 46 patients. Invasive carcinomas were seen in 3 out of 46 (6.4%) patients, of whom one was a case of familial adenomatous polyposis (FAP). A male preponderance was noted and features of a mild degree of dysplasia were seen in majority (n=75,83%) of serrated adenomas. Follow-up ranged 1-12years with a mean time of 5.75 years. Recurrences of SAs were seen in 3 (6.4%) cases, synchronous SAs in 16 (34.8%) cases and metachronous SAs in 9 (19.6%)cases.CONCLUSION: Invasive carcinoma arising in serrated adenoma is rare, accounting for 2 (4.3%) cases studied in this series.

  16. Adrenal myelolipoma within myxoid cortical adenoma associated with Conn's syndrome

    Hong-sheng LU; Mei-fu GAN; Han-song CHEN; Shan-qiang HUANG

    2008-01-01

    The coexistence of myelolipoma within adrenal cortical adenoma is extremely rare, for both tumors present usually as separate entities. There are only 16 such cases reported worldwide. To the best of our knowledge, the case we reported here is the first one of myxoid adrenal cortical adenoma associated with myelolipoma reported. A 32-year-old Chinese woman with 4-year history of hypertension was presented in our study. Computed tomography (CT) of the abdomen showed a large heterogeneously-enhancing mass (4.5cm in diameter) in the left suprarenal region. Clinical history and laboratory results suggest a metabolic disorder as Conn's syndrome. The patient underwent a left adrenalectomy, and a histopathological study confirmed the mass to be a myxoid adrenal cortical adenoma containing myelolipoma. The patient was postoperatively well and discharged uneventfully. In the present case report, we also discuss the etiology of simultaneous myelolipoma and adrenal adenoma associated with Conn's syndrome, and the methods of the diagnosis and differential diagnosis.

  17. [Multihormonal and multifunctional hypophyseal adenoma and the acromegaly syndrome].

    Dusková, J; Marek, J; Povýsil, C

    2000-07-19

    Woman 75-year-old treated 30 years for syndrome of acromegaly refused pituitary surgery and irradiation. Five years and nine months before death she had a colon carcinoma successfully removed. Multinodular hyperfunctional goitre was treated with carbimazole. For six last years of life corticosteroids were given as a replacement therapy. Her cause of death was the heart failure due to acromegalic heart disease. In autopsy a large intrasellar and extrasellar pituitary adenoma without rests of nonneoplastic tissue was found. Nevertheless the target peripheral endocrine glands except ovaries, were not atrophic. A multinodular goitre and diffuse adrenocortical hyperplasia were revealed. Histology, and immunohistochemistry demonstrated that mot neoplastic cells were producing GH and ACTH, dispersly Prl, scattered cells were positive for beta-subunit of FSH, LH, TSH. Electron microscopy proved most of the cells to be densely granulated. We classify the adenoma according to the newly proposed WHO pituitary tumours classification (1) as plurihormonal, hyperfunctional, extrasellar, typical adenoma from densely granulated cells. We conclude that in plurihormonal adenomas with dominant (in the case referred acromegalic) symptomatology the additional hormonal production should be monitored as a possible source of important complications.

  18. Histochemical alterations in colorectal carcinoma and adenoma in Egyptian patients

    Saber A Sakr; Moshira M Abdel-Wahed; Asmaa G Abdou; Eman K El-Adely

    2016-01-01

    Objective:To evaluate the histochemical alterations inDNA and total carbohydrates, in colorectal cancer cells. Methods:This study was carried out on 48 colorectal carcinoma and 10 adenoma specimens. Hematoxylin and Eosin staining was carried out for histopathological examination to confirm the diagnosis and to evaluate the histopathological characteristics of tumor. Histologic grade and pathologic stage was assessed according to TNM staging system. Staging was also assessed according to original Dukes’ staging system.DNA was demonstrated by Feulgen method and carbohydrates were demonstrated by periodic acid Schiff’s reaction. Results:Adenoma cases showed that the cells lining the glands of the polyp have more crowded, irregular and darker nuclei (hyperchromatic), anisonucleosis, abnormal mitotic figures with prominent nucleoli and variability in the size and shape of nuclei. Colorectal carcinoma cases showed a condensation and reduction in the size of a cell nucleus associated with hyperchromatosis, pyknotic nuclei, abnormal mitotic figures, anisonucleosis, irregular nuclear membrane and inequality in the size of the nuclei (Pleomorphosis). There was a statistical significant differences between adenoma and carcinoma regarding number of mitotic cells (P = 0.03) that was in favour of malignant group. Adenoma and colorectal carcinoma cases showed periodic acid Schiff’s reactivity with different degree. Conclusions:These histochemical alterations can be so characteristic of a given tumor type and stage that they are used in cancer diagnosis and might also be related to the altered functional properties of cancer cells.

  19. Outcomes following Purely Endoscopic Endonasal Resection of Pituitary adenomas

    Rezaul Amin

    2013-01-01

    Full Text Available Background: The use of endoscope for the management of pituitary adenoma is not new. The better magnification and illumination provided by the endoscope gives better outcome than microscopic pituitary surgery. Objective: To find out the benefits of endoscope in relation to microscopic surgery. Materials and Methods: We performed 45 cases of pituitary adenoma surgery by endoscopic endonasal approach from July 2008 to July 2010. Results: Forty five cases underwent endoscopic transsphenoidal approach. Gross total removal was done in 35 cases and subtotal removal was done in 10 cases. Residual tumours were seen in 10 cases (22% in postoperative follow-up MRI scan. Visual improvement was satisfactory, and hormonal improvement of functional adenoma was nice. Postoperative visual acuity and visual field were improved in 75% cases. There were 37% cases of temporary diabetes insipidus and about 4.5% cases of permanent diabetes insipidus. The average duration of follow-up was 20 months. One patient required reexploration to correct visual deterioration in the immediate postoperative period. There were 4.5% cases of CSF leak and 6.6% mortality. Mortality was due to electrolyte imbalance and improper management of infection and hydrocephalus. Conclusion: Endoscopic endonasal pituitary surgery now has become a gold standard surgery for most of the pituitary adenomas because of its better advantages in relation to microscopic surgery and less complications and less hospital stay.

  20. Fractionated stereotactic radiotherapy in the treatment of pituitary adenomas

    Kopp, C.; Theodorou, M.; Poullos, N.; Astner, S.T.; Geinitz, H.; Molls, M. [Technische Univ. Muenchen, Klinikum rechts der Isar (Germany). Klinik und Poliklinik fuer Strahlentherapie und Radiologische Onkologie; Stalla, G.K. [Max-Planck-Institut fuer Psychiatrie, Muenchen (Germany). Klinische Neuroendokrinologie; Meyer, B. [Technische Univ. Muenchen, Klinikum rechts der Isar (Germany). Neurochirurgische Klinik und Poliklinik; Nieder, C. [Nordland Hospital, Bodoe (Norway). Dept. of Oncology and Palliative Medicine; Tromsoe Univ. (Norway). Inst. of Clinical Medicine; Grosu, A.L [Freiburg Univ. (Germany). Klinik fuer Strahlenheilkunde

    2013-11-15

    Purpose: The purpose of this work was to evaluate tumor control and side effects associated with fractionated stereotactic radiotherapy (FSRT) in the management of residual or recurrent pituitary adenomas. Patients and methods: We report on 37 consecutive patients with pituitary adenomas treated with FSRT at our department. All patients had previously undergone surgery. Twenty-nine patients had nonfunctioning, 8 had hormone-producing adenoma. The mean total dose delivered by a linear accelerator was 49.4 Gy (range 45-52.2 Gy), 5 x 1.8 Gy weekly. The mean PTV was 22.8 ccm (range 2.0-78.3 ccm). Evaluation included serial imaging tests, endocrinologic and ophthalmologic examination. Results: Tumor control was 91.9 % for a median follow-up time of 57 months (range 2-111 months). Before FSRT partial hypopituitarism was present in 41 % of patients, while 35 % had anterior panhypopituitarism. After FSRT pituitary function remained normal in 22 %, 43 % had partial pituitary dysfunction, and 35 % had anterior panhypopituitarism. Visual acuity was stable in 76 % of patients, improved in 19 %, and deteriorated in 5 %. Visual fields remained stable in 35 patients (95 %), improved in one and worsened in 1 patient (2.7 %). Conclusion: FSRT is an effective and safe treatment for recurrent or residual pituitary adenoma. Good local tumor control and preservation of adjacent structures can be reached, even for large tumors. (orig.)

  1. The pathology of pituitary adenomas from a clinical perspective.

    Dworakowska, Dorota; Korbonits, Marta; Aylwin, Simon; McGregor, Alan; Grossman, Ashley B

    2011-01-01

    Pituitary adenomas present with a variety of clinical endocrine manifestations and arise in a sporadic setting or rarely as part of hereditary genetic syndromes. Molecular analysis of familial pituitary adenomas has provided significant insight into pituitary tumorigenesis. Some specific genes have been identified that predispose to pituitary neoplasia, but these are rarely involved in the pathogenesis of sporadic tumors. The number of identified genes involved in pituitary tumorigenesis is progressively increasing. The possible resulting mechanisms of action involve abnormalities in signal transduction pathways, cell cycle regulators, growth factors, chromosome stability and others. Further studies are needed to evaluate the clinical significance of genetic alterations and their implications for patient prognosis, as well as to identify targets for existing and new therapeutic options. The aim of this review is to focus on the molecular pathology of pituitary adenomas from a practical perspective and discuss the possible clinical implications which may relate to particular molecular alterations. We have summarised familial syndromes related to pituitary adenomas and considered the prognostic value of selected molecular alterations in these tumors.

  2. Alcohol consumption, alcohol dehydrogenase 3 polymorphism, and colorectal adenomas

    Tiemersma, E.W.; Wark, P.A.; Ocké, M.C.; Bunschoten, A.; Otten, M.H.; Kok, F.J.; Kampman, E.

    2003-01-01

    Alcohol is a probable risk factor with regard to colorectal neoplasm and is metabolized to the carcinogen acetaldehyde by the genetically polymorphic alcohol dehydrogenase 3 (ADH3) enzyme. We evaluated whether the association between alcohol and colorectal adenomas is modified by ADH3 polymorphism.

  3. Role of radionuclide scintigraphy in the detection of parathyroid adenoma

    Singh N

    2007-01-01

    Full Text Available Background: Preoperative detection of parathyroid adenoma is a diagnostic challenge. The sonography and computerized tomography (CT scan demonstrate high sensitivity but low specificity. The advent of radionuclide scanning technique has enhanced the specificity in this context. Aim: We undertook a study to assess the role of radionuclide scanning in suspected cases of parathyroid adenomas. Materials And Methods: Totally 28 cases were incorporated in the study. The suspicion was raised either due to raised PTH levels or recurrent calcinosis. Most of these patients had estimation of calcium done as a routine or specific investigation. The parathyroid scan was performed using either of the two techniques - Dual isotope subtraction or Sestamibi washout technique. We also used the recent approach of fusion imaging (CT + tomographic nuclear images in selected cases. Results: There were 16 true positive, 10 true negative, 1 false negative and 1 equivocal scan findings. The findings were compared with sonography, CT Scan and PTH values. The true positive yield in our study was 57%, true negative 35% and the overall sensitivity and specificity was found to be 94% and 100% respectively. Conclusion: We conclude that parathyroid scintigraphy is a reliable and sensitive technique in the preoperative detection of parathyroid adenomas and should be the first choice of imaging modality in suspicion of parathyroid adenoma.

  4. Systematic review of hepatocellular adenoma in China and other regions

    H. Lin; J. van den Esschert; C. Liu; T.M. van Gulik

    2011-01-01

    Hepatocellular adenoma (HCA) is a benign liver neoplasm with a risk of spontaneous bleeding and malignant transformation. The aim of this review article is to review all the case reports and case series of patients with HCA from 1998 to 2008 in China and other parts of the world in order to compare

  5. [Hypergonadotropic hypogonadism with sella turcica tumor syndrome: gonadotropic adenoma?].

    Sidibe, E H

    2006-09-01

    A 43-year-old patient, known for infertility for ten years, presented hypogonadism (low libido, impotence, low testosteronemia) with hypergonadotropism (high FSH contrasting with low LH) and a tumor syndrome of the sella turcica. The biological, immunohistochemical and clinical features of gonadotropic adenoma are presented.

  6. An intracapsular carcinoma ex pleomorphic adenoma with lung metastases composed exclusively of benign elements: histological evidence of a continuum between metastasizing pleomorphic adenoma and carcinoma ex pleomorphic adenoma.

    Weissferdt, Annikka; Langman, Gerald

    2010-07-15

    Malignant mixed tumors of the salivary glands, encompassing carcinoma ex pleomorphic adenoma (ca ex PA), carcinosarcoma and metastasizing pleomorphic adenoma (mPA), are rare neoplasms. Ca ex PA arises in a pre-existing pleomorphic adenoma (PA). When the malignant component does not breach the capsule of the parent PA, the lesion is termed intracapsular ca ex PA, a neoplasm which is thought to have no metastatic potential. Metastatic deposits of ca ex PA are composed exclusively of malignant elements or mixed benign and malignant components. We describe the case of a 62-year-old female with an intracapsular ca ex PA of the buccal mucosa with subsequent metastases to the lung. The metastatic deposits resembled benign PA with no histological evidence of malignancy. This pattern of spread is described with mPA, an entity that caused controversy in the past regarding its exact classification as a benign or malignant tumor. The possibility that ca ex PA originates from a mPA, with intracapsular ca ex PA representing an intermediate lesion in a histological continuum, is discussed.

  7. Are sick individuals weak competitors? Competitive ability of snails parasitized by a gigantism-inducing trematode.

    Otto Seppälä

    Full Text Available Parasitized individuals are often expected to be poor competitors because they are weakened by infections. Many trematode species, however, although extensively exploiting their mollusc hosts, also induce gigantism (increased host size by diverting host resources towards growth instead of reproduction. In such systems, alternatively to reduced competitive ability due to negative effects of parasitism on host performance, larger size could allow more efficient resource acquisition and thus increase the relative competitive ability of host individuals. We addressed this hypothesis by testing the effect of a trematode parasite Diplostomum pseudospathaceum on the competitive ability of its snail host Lymnaea stagnalis. We experimentally examined the growth of snails kept in pairs in relation to their infection status and intensity of resource competition (i.e. food availability. We found that parasitized snails grew faster and their reproduction was reduced compared to unparasitized individuals indicating parasite-induced gigantism. However, growth of the snails was faster when competing with parasitized individuals compared to unparasitized snails indicating reduced competitive ability due to parasitism. The latter effect, however, was relatively weak suggesting that the effects of the parasite on snail physiology may partly override each other in determining competitive ability.

  8. A novel neonatal Michelin Tire Baby Syndrome with craniosynostosis and gigantism

    Ižbrahim Akalin

    2014-03-01

    Full Text Available     Michelin Tire Baby Syndrome is a rare congenital disorder and characterized clinically well defined multiple ring shaped skin creases. Our patient was born to onconsanguineous healthy parents as the third child of the family at 40 weeks of uneventful gestation with distinctive skin creases and gigantism. He was 4,950 g in weight (>90 percentile, 57.5 cm in length (>90 percentile, and had a head circumferences of 39.5 cm (>90 percentile at birth. The physical examination showed a rough face, brachicephaly and craniosynostosis. His vital and laboratory findings were within normal limits at birth. Cranial and renal ultrasonograms, Xray graphics and cytogenetic analyses were normal. Echocardiography revealed small patent ductus arteriosis and patent foramen ovale. In this report, we present a new case of Michelin Tire Baby Syndrome who is the first neonate associated with severe gigantism and craniosynostosis, in the literature. A review of the related literature has also been presented.

  9. Are sick individuals weak competitors? Competitive ability of snails parasitized by a gigantism-inducing trematode.

    Seppälä, Otto; Karvonen, Anssi; Kuosa, Marja; Haataja, Maarit; Jokela, Jukka

    2013-01-01

    Parasitized individuals are often expected to be poor competitors because they are weakened by infections. Many trematode species, however, although extensively exploiting their mollusc hosts, also induce gigantism (increased host size) by diverting host resources towards growth instead of reproduction. In such systems, alternatively to reduced competitive ability due to negative effects of parasitism on host performance, larger size could allow more efficient resource acquisition and thus increase the relative competitive ability of host individuals. We addressed this hypothesis by testing the effect of a trematode parasite Diplostomum pseudospathaceum on the competitive ability of its snail host Lymnaea stagnalis. We experimentally examined the growth of snails kept in pairs in relation to their infection status and intensity of resource competition (i.e. food availability). We found that parasitized snails grew faster and their reproduction was reduced compared to unparasitized individuals indicating parasite-induced gigantism. However, growth of the snails was faster when competing with parasitized individuals compared to unparasitized snails indicating reduced competitive ability due to parasitism. The latter effect, however, was relatively weak suggesting that the effects of the parasite on snail physiology may partly override each other in determining competitive ability.

  10. The small but clear gravity signal above the natural cave 'Grotta Gigante' (Trieste, Italy)

    Braitenberg, Carla; Sampietro, Daniele; Zuliani, David; Barbagallo, Alfio; Fabris, Paolo; Fabbri, Julius; Rossi, Lorenzo; Handi Mansi, Ahmed

    2014-05-01

    Gravity observations are a powerful means for detecting underground mass changes. The Italian and Slovenian Karst has a number of explored caves, several are also touristic due to their size (e.g. Grotta Gigante in Italy; Skocjianske Jame and Postojnska Jama in Slovenia). Just a few years ago another big cave was discovered by chance close to Trieste when drilling a tunnel for a motor-highway, which shows that more caves are expected to be discovered in coming years. We have acquired the gravity field above the Grotta Gigante cave, a cave roughly 100 m high and 200 m long with a traditional spring-gravity meter (Lacoste&Romberg) and height measurements made with GPS and total station. The GPS was made with two different teams and processing algorithms, to cross-check accuracy and error estimate. Some stations had to be surveyed with a classical instrument due to the vegetation which concealed the satellite positioning signal. Here we present the results of the positioning acquisitions and the gravity field. The cave produces a signal of 1.5 mGal, with a clear elongated concentric symmetry. The survey shows that a systematic coverage of the Karst would have the benefit to recover the position of all of the greater existing caves. This will have a large impact on civil and environmental purposes, since it will for example allow to plan the urban development at a safety distance from subsurface caves.

  11. Unusual mixed gangliocytoma-pituitary adenoma in sellar region

    Jie-tian JIN

    2016-10-01

    Full Text Available Background The presence of ganglion cells within an endocrine pituitary adenoma in sellar region is rare, and is usually diagnosed as "mixed gangliocytoma-pituitary adenoma". Due to lack of radiological characteristics, it is very difficult to make an accurate diagnosis preoperatively. Herein we describe one case of unusual mixed gangliocytoma - growth hormone (GH secreting pituitary adenoma in sellar region and review related literatures, so as to summarize the clinicopathological characteristics and improve the diagnosis and differential diagnosis of this tumor. Methods and Results A 28 - year - old female presented with headache and blurred vision for 8 months. She also complained of acromegaly and amenorrhea. Head CT and MRI examinations showed a sellar and suprasellar mass with clear boundary compressing the optic chiasm and buttom of the third ventricle. The mass exhibited isointense signal or mild hypointensity on T1WI and mild hyperintensity on T2WI with heterogeneous enhancement on the contrast MRI. The tumor was removed totally. The histological sections demonstrated two parts of intermixed areas. One part of areas was marked by a proliferation of scattered gangliocyte - like cells arranged in a fibrillary background. Other areas were marked by a sheet - like or locally papillary proliferation of round and oval cells. Immunohistochemically, cytoplasm of gangliocyte-cells were diffusely positive for synaptophysin (Syn, and negative for adenohypophysial hormones; cytoplasm of round and oval cells were diffusely positive for Syn, and almost 30% cells were positive for GH, and negative for other neurohypophysial hormones. A final diagnosis of mixed gangliocytoma-GH secreting pituitary adenoma in sellar region (WHO grade Ⅰ was made. The patient did not receive postoperatively adjuvant therapy and was followed-up for one year, without any neurological deficit or signs of recurrence. Conclusions Mixed gangliocytoma - pituitary

  12. [Expression of CD10 in tumor-associated fibroblast of cancerized or recurrent colorectal adenomas].

    Zheng, Jiangjiang; Zhu, Yin; Li, Changshui; Li, Yinya; Nie, Qianqian; Zhu, Ziling; Deng, Hong

    2016-05-25

    Objective: To investigate the expression of CD10 in tumor-associated fibroblasts (TAF) in colorectal adenomas and its relation to cancerization and recurrence of adenoma. Methods: Tissue samples of low-grade adenoma (n=50), high-grade adenoma (n=50) and colorectal adenocarcinoma (n=50) were collected, and tissue samples at the distal margin of corresponding colorectal lesions were taken as controls. The expression of CD10 in the stromal TAFs, and the expressions of β-catenin, Ki-67, p53 and CyclinD1 in tumor cells were detected by immunohistochemistry (Envision). The correlation of CD10 expression in stromal TAFs with the expressions of β-catenin, Ki-67, p53 and CyclinD1 in tumor cells was analyzed by Spearmen. One hundred samples of low-grade colorectal adenoma were collected, including 57 non-recurrent cases and 43 recurrent cases (16 cases of recurrent adenoma and 27 cases of recurrent adenocarcinoma); the expression of stromal TAF CD10 were determined and compared among groups. Results: There was no TAF in normal colorectal mucosa. The expression rates of TAF CD10 in low-grade adenoma, high-grade adenoma and colorectal adenocarcinoma were 22%, 50% and 78%, respectively (all P0.05). The expression of p53 in colorectal adenocarcinoma and high-grade adenoma was higher than that in low grade adenoma (all P0.05). The TAF CD10 level was significantly higher in low-grade adenoma with recurrence than that in those without recurrence (Pcancer, indicating that it may play an important role in the canceration of adenoma. Adenomas with high expression of CD10 TAF are likely to be recurrent and cancerized, and detection of TAF CD10 combined with p53, Ki-67 and β-catenin may be of value in predicting canceration or recurrence of colorectal adenoma.

  13. Thymosin ß4 expression in colorectal polyps and adenomas

    Nemolato, Sonia; Cabras, Tiziana; Restivo, Angelo; Zorcolo, Luigi; Di Felice, Eliana; Fanni, Daniela; Gerosa, Clara; Messana, Irene; Castagnola, Massimo; Faa, Gavino; Casula, Giuseppe

    2013-01-01

    OBJECTIVE: Thymosin beta 4 (Tβ4) is a ubiquitous peptide that plays pivotal roles in the cytoskeletal system and in cell differentiation. Recently, a role for Tβ4 has been proposed in experimental and human carcinogenesis, including gastrointestinal cancer. This study was aimed at evaluating the relationship between Tβ4 immunoreactivity and the initial steps of carcinogenesis. METHODS: In total, 60 intestinal biopsies, including 10 hyperplastic polyps, 10 sessile serrated adenomas/polyps, 15 colorectal adenomas with low-grade dysplasia, 15 adenomas with high-grade dysplasia, 15 adenocarcinomas and 10 samples of normal colon mucosa, were analyzed for Tβ4 expression by immunohistochemistry. RESULTS: Weak cytoplasmic reactivity for Tβ4 was detected in the normal colon mucosa. No reactivity for Tβ4 was found in hyperplastic and sessile serrated polyps/adenomas. Tβ4 expression was observed in 10/15 colorectal adenocarcinomas. In adenomas with low-grade dysplasia, Tβ4 immunoreactivity was mainly detected in dysplastic glands but was absent in hyperplastic glands. Tβ4 immunoreactivity was characterized by spot-like perinuclear staining. In high-grade dysplastic polyps, immunostaining for Tβ4 appeared diffuse throughout the entire cytoplasm of dysplastic cells. Spot-like perinuclear reactivity was detected in adenocarcinoma tumor cells. CONCLUSIONS: Our study shows for the first time that Tβ4 is expressed during different steps of colon carcinogenesis. The shift of Tβ4 immunolocalization from low-grade to high-grade dysplastic glands suggests a role for Tβ4 in colorectal carcinogenesis. However, the real meaning of Tβ4 reactivity in dysplastic intestinal epithelium remains unknown. PMID:24141838

  14. RT-01FRACTIONATED STEREOTACTIC RADIOTHERAPY FOR PITUITARY ADENOMA WITH NOVALIS

    Arakawa, Yoshiki; Mizowaki, Takashi; Ogura, Kengo; Sakanaka, Katsuyuki; Hojo, Masato; Hiraoka, Masahiro; Miyamoto, Susumu; Murata, Daiki

    2014-01-01

    BACKGROUND: Radiation therapy is an available treatment modality for pituitary adenoma. In particular, it is effective for the case unable to be removed with surgery or repeating recurrence. However, hypopituitarism and optic nerve injury associated with radiation therapy become a problem. Novalis® (Brain Lab) is an equipment of radiation to establish the detailed irradiation area, fractionated stereotactic radiotherapy (fSRT) and intensity-modulated radiation therapy (IMRT). Retrospectively, we review local control and morbidity following fSRT with Novalis in pituitary adenoma. PATIENTS AND METHODS: Between 2007 and 2012, 29 patients with pituitary adenoma (9 functioning, 20 non-functioning) received fSRT with Novalis in our institute. Total radiation dose was 50.4-54Gy (1.8 Gy per fraction) and prescribed to the gross target volume + 2 mm. The effectiveness of fSRT was evaluated by tumor volume and clinical symptoms on pre- fSRT, and every 1-year. RESULTS: The median follow-up time was 59.1 months (20 to 83 months). Tumor regrowth was observed in 2 cases. Progression free survival rate was 93%. New visual field deficit was observed in 1 case, and new pituitary dysfunction were not observed in all patients. CONCLUSION: fSRT with Novalis is safe and effective in the treatment for pituitary adenoma. Although follow-up time is short, any problematic complications were not observed. In the future, fSRT is expected to make for safe and effective treatment in pituitary adenoma impossible to cure surgically.

  15. Expression pattern of the Hedgehog signaling pathway in pituitary adenomas.

    Yavropoulou, Maria P; Maladaki, Anna; Topouridou, Konstantina; Kotoula, Vasiliki; Poulios, Chris; Daskalaki, Emily; Foroglou, Nikolaos; Karkavelas, George; Yovos, John G

    2016-01-12

    Several studies have demonstrated the role of Wnt and Notch signaling in the pathogenesis of pituitary adenomas, but data are scarce regarding the role of Hedgehog signaling. In this study we investigated the differential expression of gene targets of the Hedgehog signaling pathway. Formalin-fixed, paraffin-embedded specimens from adult patients who underwent transphenoidal resection and normal human pituitary tissues that were obtained from autopsies were used. Clinical information and data from pre-operative MRI scan (extracellular tumor extension, tumor size, displacement of the optic chiasm) were retrieved from the Hospital's database. We used a customized RT(2) Profiler PCR Array, to investigate the expression of genes related to Notch and Hedgehog signaling pathways (PTCH1, PTCH2, GLI1, GLI3, NOTCH3, JAG1, HES1, and HIP). A total of 52 pituitary adenomas (32 non-functioning adenomas, 15 somatotropinomas and 5 prolactinomas) were used in the final analysis. In non-functioning pituitary adenomas there was a significant decrease (approximately 75%) in expression of all Hedgehog related genes that were tested, while Notch3 and Jagged-1 expression was found significantly increased, compared with normal pituitary tissue controls. In contrast, somatotropinomas demonstrated a significant increase in expression of all Hedgehog related genes and a decrease in the expression of Notch3 and Jagged-1. There was no significant difference in the expression of Hedgehog and Notch related genes between prolactinomas and healthy pituitary tissues. Hedgehog signalling appears to be activated in somatotropinomas but not in non-functioning pituitary adenomas in contrast to the expression pattern of Notch signalling pathway.

  16. Prognostic model for patients treated for colorectal adenomas with regard to development of recurrent adenomas and carcinoma

    Jensen, P; Krogsgaard, M R; Christiansen, J

    1996-01-01

    -80. INTERVENTIONS: All patients were followed up by rectoscopy and double contrast barium enema. The survival data were analysed by Cox's proportional hazards model. MAIN OUTCOME MEASURES: Variables of significant prognostic importance for recurrence of adenomas and the development of cancer were identified...

  17. Identification of Differentially Expressed Genes in Pituitary Adenomas by Integrating Analysis of Microarray Data

    Peng Zhao

    2015-01-01

    Full Text Available Pituitary adenomas, monoclonal in origin, are the most common intracranial neoplasms. Altered gene expression as well as somatic mutations is detected frequently in pituitary adenomas. The purpose of this study was to detect differentially expressed genes (DEGs and biological processes during tumor formation of pituitary adenomas. We performed an integrated analysis of publicly available GEO datasets of pituitary adenomas to identify DEGs between pituitary adenomas and normal control (NC tissues. Gene function analysis including Gene Ontology (GO, Kyoto Encyclopedia of Genes and Genomes (KEGG pathway enrichment analysis, and protein-protein interaction (PPI networks analysis was conducted to interpret the biological role of those DEGs. In this study we detected 3994 DEGs (2043 upregulated and 1951 downregulated in pituitary adenoma through an integrated analysis of 5 different microarray datasets. Gene function analysis revealed that the functions of those DEGs were highly correlated with the development of pituitary adenoma. This integrated analysis of microarray data identified some genes and pathways associated with pituitary adenoma, which may help to understand the pathology underlying pituitary adenoma and contribute to the successful identification of therapeutic targets for pituitary adenoma.

  18. Radiosurgery for pituitary adenomas: evaluation of its efficacy and safety

    Canteras Miguel M

    2010-11-01

    Full Text Available Abstract Object To assess the effects of radiosurgery (RS on the radiological and hormonal control and its toxicity in the treatment of pituitary adenomas. Methods Retrospective analysis of 42 patients out of the first 48 consecutive patients with pituitary adenomas treated with RS between 1999 and 2008 with a 6 months minimum follow-up. RS was delivered with Gamma Knife as a primary or adjuvant treatment. There were 14 patients with non-secretory adenomas and, among functioning adenomas, 9 were prolactinomas, 9 were adrenocorticotropic hormone-secreting and 10 were growth hormone-secreting tumors. Hormonal control was defined as hormonal response (decline of more than 50% from the pre-RS levels and hormonal normalization. Radiological control was defined as stasis or shrinkage of the tumor. Hypopituitarism and visual deficit were the morbidity outcomes. Hypopituitarism was defined as the initiation of any hormone replacement therapy and visual deficit as loss of visual acuity or visual field after RS. Results The median follow-up was 42 months (6-109 months. The median dose was 12,5 Gy (9 - 15 Gy and 20 Gy (12 - 28 Gy for non-secretory and secretory adenomas, respectively. Tumor growth was controlled in 98% (41 in 42 of the cases and tumor shrinkage ocurred in 10% (4 in 42 of the cases. The 3-year actuarial rate of hormonal control and normalization were 62,4% and 37,6%, respectively, and the 5-year actuarial rate were 81,2% and 55,4%, respectively. The median latency period for hormonal control and normalization was, respectively, 15 and 18 months. On univariate analysis, there were no relationships between median dose or tumoral volume and hormonal control or normalization. There were no patients with visual deficit and 1 patient had hypopituitarism after RS. Conclusions RS is an effective and safe therapeutic option in the management of selected patients with pituitary adenomas. The short latency of the radiation response, the highly

  19. First case of villous adenoma of the appendix leading to acute appendicitis presenting as strangulated femoral hernia: changes in management owing to concurrent adenoma.

    Suppiah, A; Barandiaran, J; Morgan, R; Perry, E P

    2008-02-01

    A 78-year-old lady presented with signs and symptoms of a strangulated femoral hernia. Peri-operatively she was found to have appendicitis within the hernia sac. Appendicectomy and non-mesh hernia repair were performed. Histology revealed acute inflammation and a villous adenoma of the appendix. Villous adenomas of the vermiform appendix are extremely rare tumours of the gastrointestinal tract. This is the first case combining two very rare pathologies--acute appendicitis presenting as strangulated femoral hernia and villous adenoma of the appendix. Early diagnosis and surgery are required to avoid high morbidity of perforated appendicitis within a femoral hernia. First, we discuss the diagnosis and surgical treatment of acute appendicitis within a femoral hernia. Second, the presence of an adenoma changes the aetiology of appendicitis. More importantly, changes in surgical management of acute appendicitis presenting as a strangulated femoral hernia owing to a co-existing adenoma are discussed.

  20. Early descriptions of acromegaly and gigantism and their historical evolution as clinical entities.

    Mammis, Antonios; Eloy, Jean Anderson; Liu, James K

    2010-10-01

    Giants have been a subject of fascination throughout history. Whereas descriptions of giants have existed in the lay literature for millennia, the first attempt at a medical description was published by Johannes Wier in 1567. However, it was Pierre Marie, in 1886, who established the term "acromegaly" for the first time and established a distinct clinical diagnosis with clear clinical descriptions in 2 patients with the characteristic presentation. Multiple autopsy findings revealed a consistent correlation between acromegaly and pituitary enlargement. In 1909, Harvey Cushing postulated a “hormone of growth" as the underlying pathophysiological trigger involved in pituitary hypersecretion in patients with acromegaly. This theory was supported by his observations of clinical remission in patients with acromegaly in whom he had performed hypophysectomy. In this paper, the authors present some of the early accounts of acromegaly and gigantism, and describe its historical evolution as a medical and surgical entity.

  1. A gigantic, exceptionally complete titanosaurian sauropod dinosaur from southern Patagonia, Argentina.

    Lacovara, Kenneth J; Lamanna, Matthew C; Ibiricu, Lucio M; Poole, Jason C; Schroeter, Elena R; Ullmann, Paul V; Voegele, Kristyn K; Boles, Zachary M; Carter, Aja M; Fowler, Emma K; Egerton, Victoria M; Moyer, Alison E; Coughenour, Christopher L; Schein, Jason P; Harris, Jerald D; Martínez, Rubén D; Novas, Fernando E

    2014-09-04

    Titanosaurian sauropod dinosaurs were the most diverse and abundant large-bodied herbivores in the southern continents during the final 30 million years of the Mesozoic Era. Several titanosaur species are regarded as the most massive land-living animals yet discovered; nevertheless, nearly all of these giant titanosaurs are known only from very incomplete fossils, hindering a detailed understanding of their anatomy. Here we describe a new and gigantic titanosaur, Dreadnoughtus schrani, from Upper Cretaceous sediments in southern Patagonia, Argentina. Represented by approximately 70% of the postcranial skeleton, plus craniodental remains, Dreadnoughtus is the most complete giant titanosaur yet discovered, and provides new insight into the morphology and evolutionary history of these colossal animals. Furthermore, despite its estimated mass of about 59.3 metric tons, the bone histology of the Dreadnoughtus type specimen reveals that this individual was still growing at the time of death.

  2. Giants among larges: how gigantism impacts giant virus entry into amoebae.

    Rodrigues, Rodrigo Araújo Lima; Abrahão, Jônatas Santos; Drumond, Betânia Paiva; Kroon, Erna Geessien

    2016-06-01

    The proposed order Megavirales comprises the nucleocytoplasmic large DNA viruses (NCLDV), infecting a wide range of hosts. Over time, they co-evolved with different host cells, developing various strategies to penetrate them. Mimiviruses and other giant viruses enter cells through phagocytosis, while Marseillevirus and other large viruses explore endocytosis and macropinocytosis. These differing strategies might reflect the evolution of those viruses. Various scenarios have been proposed for the origin and evolution of these viruses, presenting one of the most enigmatic issues to surround these microorganisms. In this context, we believe that giant viruses evolved independently by massive gene/size gain, exploring the phagocytic pathway of entry into amoebas. In response to gigantism, hosts developed mechanisms to evade these parasites.

  3. "Light" Higgs and warped models: Case for a Gigantic International Hadron Collider

    Soni, Amarjit

    2013-01-01

    The LHC seems to have made a monumental discovery, Higgs-like particle of mass around 125 GeV with properties akin to a Standard Model Higgs. In the context of a warped theory of flavor, which is theoretically very attractive, this suggests Kaluza-Klein particle masses are likely to be above 10 TeV except possibly for a radion. The interpretation of the SM-like Higgs from the perspective of other interesting beyond the SM scenarios is also likely that the relevant scale is higher than accessible to the LHC. In light of these developments, deeper understanding of flavor and other fundamental issues requires a gigantic international hadron collider [GIHC] perhaps with cm energy of $\\approx$ 100 TeV \\cite{2talks}. It is suggested that a {\\it global effort} should be made for constructing this machine for resolving many questions that SM cannot answer.

  4. ecCNO solar neutrinos: A challenge for gigantic ultra-pure liquid scintillator detectors

    Villante, F. L.

    2015-03-01

    Neutrinos produced in the Sun by electron capture reactions on 13N, 15O and 17F, to which we refer as ecCNO neutrinos, are not usually considered in solar neutrino analysis since the expected fluxes are extremely low. The experimental determination of this sub-dominant component of the solar neutrino flux is very difficult but could be rewarding since it provides a determination of the metallic content of the solar core and, moreover, probes the solar neutrino survival probability in the transition region at Eν ∼ 2.5 MeV. In this Letter, we suggest that this difficult measure could be at reach for future gigantic ultra-pure liquid scintillator detectors, such as LENA.

  5. Pituitary tumor with gigantism, acromegaly and preclinical Cushing's disease diagnosed from the 10th row.

    Tourtelot, John B; Vesely, David L

    2013-08-01

    A 7'3" basketball player was noted to have 2 to 3 times thicker tissue in his hands than 6'10" players by an endocrinologist sitting 10 rows above the player in a basketball arena. This led to the diagnosis of pituitary gigantism where the history revealed that he was 7'3" at 15 years of age. At age 19 when the acryl enlargement was noted, a diagnostic workup revealed elevated growth hormones and insulin-like growth factor 1 (IGF-1) with a 2 × 1.3 cm pituitary tumor. His history suggested that his epiphyseal plates had closed at age 15, and because he continued to produce IGF-1, he now has acromegaly. His elevated adrenocorticotropic hormone (ACTH) before surgery suggests that he also had preclinical Cushing's disease. After pituitary transsphenoidal surgery, all acryl enlargement in hands and ligaments disappeared. His growth hormone, IGF-1 and ACTH returned to normal 2 weeks after surgery.

  6. Gigantic directional asymmetry of luminescence in multiferroic CuB 2O 4

    Toyoda, S.; Abe, N.; Arima, T.

    2016-05-01

    In multiferroic materials, luminescence intensities can be direction dependent, i.e., different between the opposite propagating directions of emitted light. However, the effect has not been thought to be used for technological applications, since only small directional asymmetry has been reported so far. Here we show that the effect is robust in multiferroic CuB2O4 . The luminescence intensity changes by about 70 % between the opposite directions of the emission, which is about 100 times larger than the previously reported values. We demonstrate that such a gigantic directional asymmetry of luminescence can be applied to the imaging of canted antiferromagnetic domains. The observation of the effect and its application to magnetic domain imaging are important for a deeper understanding of light-matter interactions as well as technological applications such as optical reading techniques for magnetic memory devices.

  7. Gate-tunable gigantic lattice deformation in VO{sub 2}

    Okuyama, D., E-mail: okuyama@riken.jp, E-mail: nakano@imr.tohoku.ac.jp, E-mail: iwasa@ap.t.u-tokyo.ac.jp; Hatano, T. [RIKEN Center for Emergent Matter Science (CEMS), Wako 351-0198 (Japan); Nakano, M., E-mail: okuyama@riken.jp, E-mail: nakano@imr.tohoku.ac.jp, E-mail: iwasa@ap.t.u-tokyo.ac.jp [RIKEN Center for Emergent Matter Science (CEMS), Wako 351-0198 (Japan); Institute for Materials Research, Tohoku University, Sendai 980-8577 (Japan); Takeshita, S.; Ohsumi, H.; Tardif, S. [RIKEN SPring-8 Center, Hyogo 679-5148 (Japan); Shibuya, K. [National Institute of Advanced Industrial Science and Technology, Tsukuba 305-8562 (Japan); Yumoto, H.; Koyama, T.; Ohashi, H. [Japan Synchrotron Radiation Research Institute, SPring-8, Hyogo 679-5198 (Japan); Takata, M. [RIKEN SPring-8 Center, Hyogo 679-5148 (Japan); Japan Synchrotron Radiation Research Institute, SPring-8, Hyogo 679-5198 (Japan); Kawasaki, M.; Tokura, Y.; Iwasa, Y., E-mail: okuyama@riken.jp, E-mail: nakano@imr.tohoku.ac.jp, E-mail: iwasa@ap.t.u-tokyo.ac.jp [RIKEN Center for Emergent Matter Science (CEMS), Wako 351-0198 (Japan); Quantum-Phase Electronics Center and Department of Applied Physics, University of Tokyo, Tokyo 113-8656 (Japan); Arima, T. [RIKEN Center for Emergent Matter Science (CEMS), Wako 351-0198 (Japan); RIKEN SPring-8 Center, Hyogo 679-5148 (Japan); Department of Advanced Materials Science, University of Tokyo, Kashiwa 277-8561 (Japan)

    2014-01-13

    We examined the impact of electric field on crystal lattice of vanadium dioxide (VO{sub 2}) in a field-effect transistor geometry by in-situ synchrotron x-ray diffraction measurements. Whereas the c-axis lattice parameter of VO{sub 2} decreases through the thermally induced insulator-to-metal phase transition, the gate-induced metallization was found to result in a significant increase of the c-axis length by almost 1% from that of the thermally stabilized insulating state. We also found that this gate-induced gigantic lattice deformation occurs even at the thermally stabilized metallic state, enabling dynamic control of c-axis lattice parameter by more than 1% at room temperature.

  8. Aneurisma gigante da artéria cerebral posterior: (segmento P3) Relato de caso

    1995-01-01

    Apresentamos caso de aneurisma gigante do segmento distal (P3) da artéria cerebral posterior. O aneurisma foi tratado microcirurgicamente pela via combinada proposta por Sano com clipagem do ramo terminal da artéria cerebral posterior próximo ao aneurisma. A paciente teve evolução pós operatória favorável, com lesão parcial e transitória do III nervo craniano. Revisão da literatura e discussão a respeito da anatomia e da abordagem cirúrgica são feitas. A raridade desta patologia justifica o r...

  9. ecCNO solar neutrinos: A challenge for gigantic ultra-pure liquid scintillator detectors

    F.L. Villante

    2015-03-01

    Full Text Available Neutrinos produced in the Sun by electron capture reactions on 13N, 15O and 17F, to which we refer as ecCNO neutrinos, are not usually considered in solar neutrino analysis since the expected fluxes are extremely low. The experimental determination of this sub-dominant component of the solar neutrino flux is very difficult but could be rewarding since it provides a determination of the metallic content of the solar core and, moreover, probes the solar neutrino survival probability in the transition region at Eν∼2.5 MeV. In this Letter, we suggest that this difficult measure could be at reach for future gigantic ultra-pure liquid scintillator detectors, such as LENA.

  10. Adenoma paratiroideo. Presentación de un caso

    Daniel Olivera Fajardo

    2016-10-01

    Full Text Available El adenoma paratiroideo es un tumor no canceroso de las glándulas paratiroides, que aumenta los niveles de parathormona. Esta hormona regula los niveles de calcio, fósforo y vitamina D en sangre y huesos. Su triada clásica se caracteriza por aumento de los niveles de parathormona, hipercalcemia e hipofosfatemia. Esta entidad afecta a uno entre 500-1000 habitantes y es la causa principal de hiperparatiroidismo primario en un 80- 85 % de los pacientes. Se presenta el caso de una paciente femenina de 69 años de edad, ingresada por fracturas patológicas de cadera, clavícula y dedos de las manos, causada por hiperparatiroidismo primario originado por adenoma paratiroideo. Por la baja incidencia esta entidad, su publicación se considera de interés para el personal científico.

  11. Immunohistochemical Characteristics of Bone Forming Cells in Pleomorphic Adenoma

    Keisuke Nakano, Takehiro Watanabe, Takako Shimizu, Toshiyuki Kawakami

    2007-01-01

    Full Text Available Histopathological and immunohistochemical examinations were carried out in a case of pleomorphic adenoma with bone formation, occurring in the chin of a 34-year-old Japanese man. Examination results showed the modified neoplastic myoepithelial cells reacted positively to S-100 protein. The S-100-positive modified neoplastic myoepithelial cells were proliferated in the closely related area of the bone tissue. Furthermore, positive reaction was detected in the bone forming cells: osteoblasts and osteocytes. These cells also reacted positively to Runx2 as a marker of bone forming cells. These results suggest that the origin of the bone forming cells in this case of pleomorphic adenoma was modified neoplastic myoepithelial cells.

  12. Radiation therapy alone for growth hormone-producing pituitary adenomas

    Plataniotis, G.A.; Kouvaris, J.R.; Vlahos, L.; Papavasiliou, C. [Athens Univ. (Greece). Dept. of Radiology

    1998-09-01

    We present our experience in the treatment of growth hormone (GH)-producing pituitary adenomas using irradiation alone. Between 1983 and 1991, 21 patients suffering from GH-secreting pituitary adenomas were treated with radiotherapy alone. Two bilateral opposing coaxial fields were used in 10 patients and in the remaining 11 a third frontovertex field was added. Treatment was given in 1.8-2 Gy daily fractions and total dose ranged between 45 and 54 Gy. Treatment was given using a cobalt unit. Four patients treated with somatostatin prior to and 14 patients treated after the end of radiotherapy experienced symptom relief for 6-28 weeks. The 5-year actuarial rate of disease control was 72%. Five out of six failed patients had macroadenomas. Hypopituitarism was observed in 5/21 (24%) patients. Whereas RT alone is effective in the treatment of microadenomas, this is not true for large infiltrative macroadenomas. (orig.)

  13. Radiation therapy in the multimodal treatment approach of pituitary adenoma

    Becker, G. [Klinik am Eichert, Goeppingen (Germany). Dept. of Radiooncology and Radiation Therapy; Radiooncologic Univ. Clinic, Tuebingen (Germany); Kocher, M.; Mueller, R.P. [Koeln Univ. (Germany). Clinic of Radiation Therapy; Kortmann, R.D.; Paulsen, F.; Jeremic, B.; Bamberg, M. [Radiooncologic Univ. Clinic, Tuebingen (Germany)

    2002-04-01

    In this paper, literature will be reviewed to assess the role of modern radiotherapy and radiosurgery in the management of pituitary adenomas. Material and Methods: Nowadays, magnetic resonance imaging for the definition of the target volume and a real three-dimensional (3-D) treatment planning with field conformation and the possibility for non-coplanar irradiation has to be recommended. Most groups irradiate these benign tumors with single doses of 1.8-2.0 Gy up to a total dose of 45 Gy or 50.4 Gy in extensive parasellar adenomas. Adenomas are mostly small, well circumscribed lesions, and have, therefore, attracted the use of stereotactically guided high-precision irradiation techniques which allow extreme focussing and provide steep dose gradients with selective treatment of the target and optimal protection of the surrounding brain tissue. Results: Radiation therapy controls tumor growth in 80-98% of patients with non-secreting adenomas and 67-89% for endocrine active tumors. Reviewing the recent literature including endocrine active and non-secreting adenomas, irradiated postoperatively or in case of recurrence the 5-, 10- and 15-year local control rates amount 92%, 89% and 79%. In cases of microprolactinoma primary therapy consists of dopamine agonists. Irradiation should be preferred in patients with macroprolactinomas, when drug therapy and/or surgery failed or for patients medically unsuitable for surgery. Reduction and control of prolactin secretion can be achieved in 44-70% of patients. After radiotherapy in acromegaly patients somatomedin-C and growth hormone concentrations decrease to normal levels in 70-90%, with a decrease rate of 10-30% per year. Hypercortisolism is controlled in 50-83% of adults and 80% of children with Cushing's disease, generally in less than 9 months. Hypopituitarism is the most common side effect of pituitary irradiation with an incidence of 13-56%. Long-term overall risk for brain necrosis in a total of 1,388 analyzed

  14. Anabolic steroid abuse causing recurrent hepatic adenomas and hemorrhage

    Nlicole M Martin; Barham K Abu Dayyeh; Raymond T Chung

    2008-01-01

    Anabolic steroid abuse is common among athletes and is associated with a number of medical complications. We describe a case of a 27-year-old male bodybuilder with multiple hepatic adenomas induced by anabolic steroids. He initially presented with tumor hemorrhage and was treated with left lateral hepatic segmentectomy. Regression of the remaining tumors was observed with cessation of steroid use. However, 3 years and a half alter his initial hepatic segmentectomy, he presented with recurrent tumor enlargement and intraperitoneal hemorrhage in the setting of steroid abuse relapse. Given his limited hepatic reserve, he was conservatively managed with embolization of the right accessory hepatic artery.This is the first reported case of hepatic adenoma re-growth with recidivistic steroid abuse, complicated by life-threatening hemorrhage. While athletes and bodybuilders are often aware of the legal and social ramifications of steroid abuse, they should continue to be counseled about its serious medical risks.

  15. Pure Androgen-Secreting Adrenal Adenoma Associated with Resistant Hypertension

    René Rodríguez-Gutiérrez

    2013-01-01

    Full Text Available Pure androgen-secreting adrenal adenoma is very rare, and its diagnosis remains a clinical challenge. Its association with resistant hypertension is uncommon and not well understood. We present an 18-year-old female with a 10-year history of hirsutism that was accidentally diagnosed with an adrenal mass during the evaluation of a hypertensive crisis. She had a long-standing history of hirsutism, clitorimegaly, deepening of the voice, and primary amenorrhea. She was phenotypically and socially a male. FSH, LH, prolactin, estradiol, 17-hydroxyprogesterone, and progesterone were normal. Total testosterone and DHEA-S were elevated. Cushing syndrome, primary aldosteronism, pheochromocytoma, and nonclassic congenital adrenal hyperplasia were ruled out. She underwent adrenalectomy and pathology reported an adenoma. At 2-month followup, hirsutism and virilizing symptoms clearly improved and blood pressure normalized without antihypertensive medications, current literature of this unusual illness and it association with hypertension is presented and discussed.

  16. Pyogenic liver abscess associated with large colonic tubulovillous adenoma

    Hsueh-Chou Lai; Cho-Yu Chan; Cheng-Yuan Peng; Chih-Bin Chen; Wen-Hsin Huang

    2006-01-01

    Pyogenic liver abscesses usually occur in association with a variety of diseases. Rarely, liver abscess has been reported as the presenting manifestation of colonic tubulovillous adenoma. We report two cases of pyogenic liver abscess without hepatobiliary disease or other obvious etiologies except that one had a history of diabetes mellitus (DM). The pathogen in the patient with DM was Klebsiella pneumonia (KP). In both of the patients, ileus developed about two to three weeks after the diagnosis of liver abscess. Colonoscopy revealed large polypoid tumors with pathological findings of tubulovillous adenoma in both cases. Two lessons were learned from these two cases: (1) an underlying cause should be aggressively investigated in patients with cryptogenic liver abscess; (2) DM could be one of the etiologies but not necessarily the only cause of KP liver abscess.

  17. Main-duct intraductal papillary mucinous adenoma of the pancreas

    Takuma Kensuke

    2011-11-01

    Full Text Available Abstract Background The prevalence of carcinoma in main-duct intraductal papillary mucinous neoplasm (IPMN is high, and surgical resection is recommended for all patients with a main-duct IPMN. Results A main-duct IPMN with typical imagings including protruding lesions in the dilated main pancreatic duct was resected, but the histology was intraductal papillary mucinous adenoma of the pancreas. Discussion It has been reported that the presence of mural nodules and dilatation of MPD are significantly higher in malignant IPMNs. The presented case had protruding lesions in the dilated main pancreatic duct on endoscopic ultrasonography, but the histology was adenoma. Conclusion Preoperative distinction between benign and malignant IPMNs is difficult.

  18. Can oxygen set thermal limits in an insect and drive gigantism?

    Wilco C E P Verberk

    Full Text Available BACKGROUND: Thermal limits may arise through a mismatch between oxygen supply and demand in a range of animal taxa. Whilst this oxygen limitation hypothesis is supported by data from a range of marine fish and invertebrates, its generality remains contentious. In particular, it is unclear whether oxygen limitation determines thermal extremes in tracheated arthropods, where oxygen limitation may be unlikely due to the efficiency and plasticity of tracheal systems in supplying oxygen directly to metabolically active tissues. Although terrestrial taxa with open tracheal systems may not be prone to oxygen limitation, species may be affected during other life-history stages, particularly if these rely on diffusion into closed tracheal systems. Furthermore, a central role for oxygen limitation in insects is envisaged within a parallel line of research focussing on insect gigantism in the late Palaeozoic. METHODOLOGY/PRINCIPAL FINDINGS: Here we examine thermal maxima in the aquatic life stages of an insect at normoxia, hypoxia (14 kPa and hyperoxia (36 kPa. We demonstrate that upper thermal limits do indeed respond to external oxygen supply in the aquatic life stages of the stonefly Dinocras cephalotes, suggesting that the critical thermal limits of such aquatic larvae are set by oxygen limitation. This could result from impeded oxygen delivery, or limited oxygen regulatory capacity, both of which have implications for our understanding of the limits to insect body size and how these are influenced by atmospheric oxygen levels. CONCLUSIONS/SIGNIFICANCE: These findings extend the generality of the hypothesis of oxygen limitation of thermal tolerance, suggest that oxygen constraints on body size may be stronger in aquatic environments, and that oxygen toxicity may have actively selected for gigantism in the aquatic stages of Carboniferous arthropods.

  19. The Early ULF Signal of the Gigantic Jets Revealed By Hilbert-Huang Transform

    Huang, Po-Hsun; Bing-Chih Chen, Alfred

    2015-04-01

    The conventional Fourier analysis on the sferics in ULF and VLF bandpasses has been done for years. Several phenomena e.g. whistler and Schumann resonance have been well studied by the Fourier spectrum comprehensively. But the Fourier analysis is computed by an integration over time, therefore, the temporal resolution is smoothed, and limited not only by the sampling rate but also the size of the integration window. The instantaneous frequency can't be obtained through this conventional approach. We introduce the Hilbert-Huang transform (HHT) instead of Fourier transform to analyze the sferics of TLEs recorded at Lulin observatory. The Hilbert-Huang transform decomposes a signal into so-called intrinsic mode functions (IMF), and derive instantaneous frequency data by differentiating the phase angle yielded by Hilbert transform. Our analysis of HHT on several gigantic jets recorded by ground observation surprisingly revealed an early signal of frequency-change during the phase of the leading jet, and this early signal can not be identified by Fourier analysis. In the phase of leading jet, the amplitude of the sferics remains a constant and no significant features are recognized in the recorded waveform, but an obvious frequency change about 100-200 millisecond prior to the main discharge of the full development jets (FDJs), which can be clearly recognized in the HHT spectra of all observed gigantic jets. From a further simulation, this frequency change is confirmed to come from the nature of the discharge, not an alias or a false signal generated by the analysis method. This early signal may implies an in-cloud discharge process which is suggested by Krehbiel et al. [2008

  20. Pleomorphic adenoma of the lacrimal gland. Case report.

    Ostrosky, Alejandro; Klurfan, Federico Juan; Gonzalez, Maximiliano Jorge; Camaly, Diego; Villa, Diego

    2005-01-01

    Lacrimal gland tumors are rare. We present a case of a 69 year old male patient with a one year history of an orbital tumor (Pleomorphic Adenoma). The tumor was surgically enucleated and patient recovery was very satisfactory, with no signs of recurrence after one year of follow-up. A review of the clinical symptoms, radiologic features, treatment and histopathology of this kind of tumors is also made.

  1. Fatal complication after transsphenoidal surgery of pituitary adenoma: case report

    Conceição Aparecida Dornelas; Tereza N. A. G. Nogueira; Evandro T. Alves; River A. B. Coêlho

    2015-01-01

    ABSTRACT The objective of this study was to report a rare fatal complication in the postoperative period of transsphenoidal surgery of the pituitary gland (adenoma), with a brief review of the subject. The patient was a 54-year-old white man with acromegaly and severe heart failure, who after microsurgery developed blood pressure instability within 32 hours after the procedure and died. The autopsy revealed: hypertrophy and ventricular dilation with myocarditis, pericarditis and myocardial fi...

  2. Successful treatment of multiple hepatocellular adenomas with percutaneous radiofrequency ablation

    Ahn, Sun Young; Park, Soo Young; Kweon, Young Oh; Tak, Won Young; Bae, Han Ik; Cho, Seung Hyun

    2013-01-01

    Hepatocellular adenoma (HCA) is one of the important complications of glycogen storage disease type Ia (GSD-Ia) because it can be transformed into hepatocellular carcinoma. Although surgical resection is a standard treatment of choice for solitary HCA, multiple HCAs in GSD-Ia patients present as therapeutic challenges for curative treatment. Therefore, treatment strategy according to malignant potential is important in management of HCAs in GSD-Ia. The authors present a case of histologically...

  3. Metanephric adenoma of the kidney in an infant: a case report

    Kim, Seung Ja; Cheon, Jung Eun; Kim, Woo Sun; Kim, Chong Jai; Yoo, So Young; Kim, In One; Yeon, Kyung Mo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2005-08-15

    Metanephric adenoma is a rare tumor of the kidney that has been reported mostly in adults. Despite its rarity, metanephric adenoma should be included in any differential diagnosis of solid renal masses in children, especially because of its benign nature and benign clinical course allowing for nephron sparing surgery. We report a case of metanephric adenoma, presented as a solid renal mass in a 14-month-old boy, and discuss the histologic basis of the imaging features of this entity.

  4. Anaplastic astrocytoma 14 years after radiotherapy for pituitary adenoma

    Tamura, Masaru; Misumi, Syuuzou; Kurosaki, Syuuhei; Shibasaki, Takashi; Ohye, Chihiro (Gunma Univ., Maebashi (Japan). School of Medicine)

    1992-04-01

    A case of anaplastic astrocytoma following radiotherapy for growth hormone secreting pituitary adenoma is presented with a review of the literature. A 43 year old female was admitted with signs of acromegaly and hypertension. An eosinophilic pituitary adenoma was subtotally removed by transsphenoidal approach, followed by 60 Gy irradiation using a 2x2 cm lateral field. Fourteen years later at the age of 57, she suffered from headache, recent-memory disturbance and uncinate fits. CT scan and MRI disclosed ring-like enhanced mass lesion in the left temporal lobe, corresponding to the previous irradiated field. {sup 18}F-FDG PET showed hypermetabolism at the lesion. Left frontotemporal craniotomy was performed, and a reddish gray gelatinous tumor containing necrotic center and cyst was partially removed. Histologically, the tumor consisted of hypercellular astrocytic cells with perivascular pseudorosette. Coagulation necrosis at the center of the tumor, and hyalinosis and fibrosis of the blood vessels in and around the tumor, which might have been caused by the antecedent radiotherapy, were recognized. Postoperative radiotherapy and chemotherapy, were given, however, she expired 13 months after the operation. Seven cases, including ours, of malignant glioma following radiotherapy for pituitary adenoma were reported in the literature. A total dose of irradiation varies from 45 to 95 Gy with a mean of 50 Gy. The period of latency before tumor occurrence ranges from 5 to 22 years with a mean of 10 years. The differentiation of radiation-induced gliomas from radionecrosis of the brain is also discussed. (author).

  5. Endoscopic transsphenoidal approach to pituitary adenomas invading the cavernous sinus

    TAO Yu-xin; QU Qiu-yi; WANG Zhen-lin; ZHANG Qiu-hang

    2010-01-01

    Background Surgery of pituitary adenomas invading cavernous sinus has always been thought as a challenge due to the complex anatomical structures and high risk of complications. The purpose of this study was to evaluate endoscopic trarssphenoidal approach to pituitary adenomas invading cavernous sinus.Methods The clinical data of 22 patients who admitted to Xuanwu Hospital with pituitary adenomas invading cavernous sinus were analyzed retrospectively. All patients underwent endoscopic transsphenoidal surgery. To expose the surgical field sufficiently, the opening of sellar floor was exceeded the bone overlying the invaded cavernous sinus, and synthetic dura was used to repair and strengthen the sella floor for preventing the leak of cerebrospinal fluid.Results Among 22 patients, total resection was achieved in 14, subtotal resection in 5, and partial resection in 3; no patient underwent insufficient resection. Visual symptoms improved in 7 of 9 patients. In one patient diplopia disappeared.Headache was relieved to various extents in all patients. No serious complications were found. Patient's hospital stay ranged from 7 to 20 days.Conclusion These data suggest that the endoscopic transsphenoid approach is a safe, minimally invasive, and efficient surgical technique, which might be an important therapeutic strategy for the pituitary adenoms invading cavernous sinus.

  6. Expression of p53 protein in pituitary adenomas

    Oliveira M.C.

    2002-01-01

    Full Text Available Inactivating mutations of TP53, a tumor suppressor gene, are associated with abnormal cell proliferation. Although p53 expression is common in many human malignancies, p53 protein has seldom been evaluated in pituitary tumors. When detected, the percentage of p53-positive cells is low, and, in general, it is exclusive for invasive lesions. The aim of the present study was to use immunohistochemistry to determine the presence of p53 protein in pituitary adenomas from tumor samples of 163 surgeries performed in 148 patients (40% male, 60% female. In 35% of the cases the adenoma was nonfunctional, while in the others it was associated with PRL, GH and/or ACTH endocrine hypersecretion syndrome. Macroadenomas were observed in 83.2% of the cases with available neuroimage evaluation, of which 28% invaded the cavernous, sphenoid and/or ethmoidal sinus, bone, third ventricle or subfrontal lobe. p53 protein was detected in 2/148 patients (1.3%. Immunohistochemistry was positive for PRL and GH in these cases. Due to the high percentage of invasive pituitary adenomas found in our study, the low frequency of p53 detection suggests that it is inadequate as a routine marker for aggressiveness and as a predictive factor of tumor behavior.

  7. Hypertrophic osteopathy associated with a renal adenoma in a cat.

    Johnson, Robert L; Lenz, Stephen D

    2011-01-01

    Hypertrophic osteopathy is a hyperostotic syndrome of the appendicular skeleton that is most commonly associated with intrathoracic neoplasia or inflammation. The condition is rarely associated with intra-abdominal lesions. The majority of cases have occurred in dogs and human beings, with fewer cases reported in cats, horses, and other species. A 15-year-old male neutered Domestic Shorthair cat presented for swollen limbs and difficulty in ambulation. Radiographs and gross postmortem revealed severe periosteal hyperostosis of the diaphysis and metaphysis of all 4 limbs, including the humerus, radius, ulna, carpi, metacarpi, femur, tibia, tarsi, metatarsi, and phalanges. The axial skeleton was spared. Hyperostotic lesions were characterized microscopically by lamellar bony trabeculae separated by adipocytes and scant hematopoietic tissue. In several areas, fibrovascular connective tissue, woven bone, and islands of cartilage were also present. A 2.5 cm × 2.5 cm perirenal neoplasm compressed the left kidney and adrenal gland. This mass consisted of well-differentiated tubules of cuboidal epithelial cells and was most consistent with a renal tubular adenoma, because mitotic figures were rare, and no distant metastases were found. Thoracic pathology was absent. Hyperostosis was consistent with hypertrophic osteopathy secondary to the renal adenoma. The pathogenesis of hypertrophic osteopathy is uncertain, but predominant theories point to increased peripheral circulation and angiogenesis as a key initiating event. Recent literature highlights the potential role of vascular endothelial growth factor and platelet-derived growth factor in the human condition. The mechanism by which this renal adenoma caused hypertrophic osteopathy is unknown.

  8. A Case of Basal Cell Adenoma of the Upper Lip

    Masanori Kudoh

    2014-01-01

    Full Text Available Basal cell adenoma is a rare type of benign salivary gland tumor found most commonly in the parotid gland. We present a rare case of basal cell adenoma arising in the minor salivary gland of the upper lip. The patient was a 59-year-old Japanese man who visited our department in December 2012 with a chief complaint of a mass in the upper lip, which had increased in size over several years. A mobile, elastic, and relatively soft mass without tenderness was palpable in the upper lip region. The mucosa of the upper lip covering the mass was normal. Tumor extirpation was performed under local anesthesia. Histologically, the tumor had a capsule and was composed of islands of relatively uniform, monotonous cells. Immunohistochemically, the inner tumor comprised tubuloductal structures that showed strong staining for CK7, while the outer tumor showed weak staining for CK7. The outer tumor cells also stained positively for CD10 and p63. The MIB-1 (Ki-67 labeling index was extremely low. Basal cell adenoma was diagnosed based on these results. The postoperative course was uneventful 12 months after surgery and there has been no recurrence.

  9. Adenoma of the posterior urethra: 131 case report

    Zhen-Guo MI; Xiao-Feng YANG; Xue-Zhi LIANG; Hong-Yao LIU; Shang-Yin LIU; Hong ZHANG; Dong-Wen WANG; Chun LIU

    2001-01-01

    A case-report on adenoma of the posterior urethra. Methods: In 131 cases of adenoma of the posterior urethra, aged 17- 79 (mean: 36.4) years, a detailed medical history was taken and urinalysis, urethroscopy, and prostatic specific antigen (PSA) immunohistochemical staining were performed. They were then treated with transurethral resection (TUR) or transurethral electric coagulation (TUEC). Results: Hemospermia occurred in 51% of the cases, hematuria in 38 %, bood overflow from the urethral orifice in 6 %, and dysuria in 5 %. The position of the tumor was at or around the verurumontanum. The appearance of the rumor was similar to those of a papilla, a villus, a dactyl or polyp, or simply an engorgement. The tumor contained glandular alveoli and adeno-epithelial cells. PSA immunohistochemistry was positive in the cytoplasm and nucleus of the adeno-epithelial cell. One hundred and tweenty-nine cases were cured after TUR or TUEC, while 2 patients recurred and were operated again. Conclusion: Adenoma of the posterior urethra is a common cause of hemospermia and hematuria in young men. Urethroscopic examination and biopsy are the principal diagnostic measures. TUR or TUEC are believed to be the treatment of choice with a short-term recurrence rate of around 1.5%.

  10. Intraosseous pleomorphic adenoma: case report and review of the literature.

    Aver-De-Araujo, L M; Chaves-Tarquinio, S B; Neuzling-Gomes, A P; Etges, A

    2002-01-01

    Pleomorphic adenoma is the most common neoplasm of the salivary glands, affecting mainly the parotid gland. The preferential intraoral site of this tumor is the palate. A case of a 31-year-old woman with an intraosseous pleomorphic adenoma located in the maxilla (left paramedian region), showing an approximate evolution of one year is reported. The present intraosseous case represents a rare location, with the tumor probably originating from glandular epithelial remnants captured during embryogenesis. In a review of the literature of 142 cases of intragnathic localization (24% in the maxilla) are identified. A slight predominance of women was observed (56%), with 55% of the patients being affected during the 5th to 7th decade of life. The tumors were malignant in 94% of the cases, with special predominance of mucoepidermoid carcinoma (65%). Intraosseous pleomorphic adenomas are rare, with the present patient being the 6th case reported in the literature and the second found in the maxilla. Mean age of the 5 previously reported cases was 58.8 years.

  11. Laparoscopic simple prostatectomy: A reasonable option for large prostatic adenomas

    Abdulrahman Al-Aown

    2015-01-01

    Full Text Available Aim of the Study: In this work, surgical technique followed by two academic departments on laparoscopic simple prostatectomy (LSP of large prostatic adenomas is being described. Materials and Methods: The initial cumulative experience from 11 patients with lower urinary tract symptoms of benign prostatic hyperplasia origin subjected to LSP is being presented. Results: All cases had prostatic adenomas greater than 80 ml. Mean operation time was 99.5 min (values from 70 to 150 min and mean blood loss was 205 ml (values from 100 to 300 ml. Blood transfusion was deemed necessary in one case. Bladder catheter was removed successfully on postoperative day 5 in all cases. No significant postoperative complication was noted. At a 3 months follow-up a significant decrease in International Prostate Symptom Score (IPSS was evident in all patients (mean IPSS 27.7 vs. 15.3 preoperative vs. postoperative accordingly. Conclusions: According to our data and similarly to the rest of the LSP literature, laparoscopic excision of voluminous prostatic adenomas is a feasible and safe procedure. Nevertheless, further investigation including a larger number of patients and long-term follow-up is deemed necessary before making definite conclusions regarding the approach.

  12. Shift of the pituitary stalk in intrasellar pituitary adenomas

    Ito, Jusuke; Tokiguchi, Susumu; Nakamori, Akitoshi (Niigata Univ. (Japan). School of Medicine); Watanabe, Akira; Yokoyama, Motoharu

    1982-08-01

    Fifty-one patients from a group of 344 patients undergoing the evaluation of intrasellar or parasellar tumors were diagnosed on CT as having an intrasellar pituitary adenoma. Axial transverse sections were performed at -10/sup 0/ to Reid's basal line, using 1.5-mm-thick slices and sagittal and coronal reformation. Of these 51 patients, 17 showed a shift of the pituitary stalk. The area where a tumor was thought to be located within the sella turcica on preoperative CT became defective on CT after transsphenoidal surgery in all cases. Histological verification was obtained in all cases. Also, the shift of the pituitary stalk was normalized or markedly improved after surgery in all cases. In functioning tumors, all cases except two showed an endocrinologically normal state or a marked improvement after transsphenoidal surgery. On the basis of the above-mentioned facts, it was concluded that the shift of the pituitary stalk in intrasellar pituitary adenomas indicated the evidence of a mass and its location in the sella turcica. However, a shift of the pituitary stalk was also observed under other conditions, such as empty sella and tuberculum sellae meningioma, and so it is not a pathognomonic finding in intrasellar pituitary adenomas.

  13. Adenomas hipofisários: relação entre invasividade e índice proliferativo tumoral Pituitary adenomas: relationship between invasiveness and proliferative cell nuclear index

    OSWALDO INÁCIO DE TELLA JR

    2000-12-01

    Full Text Available Analisamos 76 pacientes com adenomas hipofisários do ponto de vista clínico, radiológico e tratamento cirúrgico. Todos os casos foram estudados por imuno-histoquímica e em 49 pacientes foi pesquisado o anticorpo monoclonal PCNA. Os adenomas bi-hormonais foram os mais frequentes seguidos dos prolactinomas e os adenomas não secretantes. Os adenomas bi-hormonais não secretantes e os produtores de subunidade alfa foram proporcionalmente mais invasivos pelos critérios radiológicos. A maioria dos pacientes (59 foi operada por via transeptoesfenoidal, em seis casos a via transcraniana foi realizada e em 11 pacientes houve necessidade das duas abordagens. A ressecção foi total em 32 pacientes, a maioria em microadenomas, subtotal em 15 e parcial em 29. A complicação endócrina mais frequente foi diabetes insipidus. Houve tendência de associação positiva para os adenomas secretantes e PCNA mais elevado, assim como relação positiva quando analisamos os adenomas invasivos pela tomografia computadorizada ou ressonância magnética e o PCNA 3 e 4. A melhora visual foi observada em 85% dos macroadenomas, mesmo quando a ressecção foi parcial ou subtotal.We evaluated clinically, radiologically and surgically a series of 76 pituitary adenomas. All cases were assessed immunohistochemically and in 49 patients the PCNA monoclonal antibody was measured. The most frequent types found were the bihormonal adenomas, followed by prolactinomas and non secreting adenomas. The bihormonal adenomas, non secreting adenonas and the sub unit alfa producing adenomas were proportionally more invase as determined by radiological criteria (CTscan or MRI. In 59 patients a transphenoidal approach was used, six cases were operated on transcranially and in 11 patients we used a combination of both approach. Total resection were achieved in 32 cases, most of which were microadenomas, in 15 cases the resection was subtotal and partial in 29 cases. Diabetes insipidus

  14. Hepatic adenoma in an elderly male patient: A rare case report

    Ravi Swami, Nimbargi RC, Karandikar MN, Jagdale KA

    2014-04-01

    Full Text Available Hepatocellular adenomas are usually affect females in their 3rd and 4th decades of life. Uses of oral contraceptives use or anabolic steroids have been blamed for this. This is rare in old age and in an elderly male presented with hepatic adenoma. Such cases are difficult to diagnose on fine needle aspiration cytology and can cause under or over diagnosis. Here we present a rare case of hepatic adenoma in an elderly male with both cytological as well as histopathology features of adenoma.

  15. Signal intensity of magnetic resonance imaging of pituitary adenoma reflects its collagen content

    Hui Wang; Xianrui Yuan; Weixi Jiang

    2006-01-01

    BACKGROUND:At present,results of a few studies demonstrate that preoperative magnetic resonance imagling (MRI)examination reveals the texture of pituitary adenoma,I.e.on the T2-weighted image,solid pituitary adenoma shows weak signal and soft one shows strong signal.Also,solid pituitary adenoma is caused by fibrosis,which is confirmlea.However,some key problems are still in question and disputation,such as how to exactly quantize MRI signal intensity,which signal is used as prediction index,and the relationship of MRI signal and collagen content which reflects the texture of pituitary adenoma,and so on.OBJECTIVE:To observe the relationship of MRI signal intensity of different textures of pituitary adenoma and its collagen content,and investigate the best prediction index of the texture of pituitary adenoma.DESIGN:Case-control observation.SETTING:Department of Neurosurgery,Third Hospital Affiliated to Sun Yat-sen University;Department of Neurosurgery,Xiangya Hospital,Central South University.PARTICIPANTS:Fifty-seven patients with pituitary adenoma,including 32 males and 25 females,aged 20 to 65 years,who received treatment in the Department of Neurosurgery,Xiangya Hospital,Central South University during June 2003 to January 2004.The involved patients were all diagnosed by MRI and confirmed by pathological resection.Informed consents were obtained from all the patients.The samples of above-mentioned patients resected by operation were fixed with 40 g/L formaldehyde for sirius red staining.METHODS:①Accordling to the texture of pituitary adenoma observed in the operation:The 57 samples of pituitary adenoma were divided into 2 groups:non-flbrosis group(n=49)and fibrosis group(n=8).In the non-fibrosis group,the texture of pituitary adenoma was soft,I.e.pituitary adenoma tissue automatically flew out,and could be aspirated by aspirater or erased by curette,and the superior part of saddle could fall in the saddle,In the fibrosis group,pituitary adenoma tissue could be

  16. Expression of Neuropeptide Y and Its Relationship with Molecular and Morphological Changes in Human Pituitary Adenomas.

    Jia, Ruichao; Li, Mu; Chang, Binge; Chen, Laichao; Ma, Jingjian

    2015-12-01

    The purpose of this study was to explore the role of neuropeptide Y (NPY) on molecular and histological changes in human pituitary adenomas. The localization of NPY and its expression at the protein, messenger RNA (mRNA), and receptor levels were investigated here in different subcategories of pituitary adenomas. Immunohistochemical staining was performed in all cases to assess expression of NPY. Reverse transcription-polymerase chain reaction (RT-PCR) was used to study the mRNA expression of NPY. NPY subcellular localization was observed using immunoelectron microscopy in cytoplasm, rough endoplasmic reticulum, and cell matrix in four of the six cases of pituitary adenoma. NPY protein expression was observed in 59.6% of 57 cases of pituitary adenoma and in 2 cases of pituitary hyperplasia. mRNA expression of NPY was observed in all 57 cases of pituitary adenoma and in 2 cases of pituitary hyperplasia. Significantly different levels of expression were observed across different subcategories of pituitary adenoma. mRNA expression of Y1R and Y2R was observed across all subcategories of pituitary adenomas, and a positive correlation was observed between NPY and Y2R. In conclusion, evidence is provided here for the expression of NPY and its receptors, Y1R and Y2R, in human pituitary adenoma, and the levels of expression were found to differ across different subcategories. Differences in expression of Y2R in human pituitary adenomas were found to have remarkable statistical significance.

  17. A case of lipomatous pleomorphic adenoma in the parotid gland: a case report

    Kondo Takeshi

    2009-06-01

    Full Text Available Abstract Introduction Pleomorphic adenoma is the most common benign neoplasm of the salivary glands. Extensive lipomatous involvement of the tumor is, however, a very rare finding. Case report Herein, a rare case of lipomatous pleomorphic adenoma arising in the parotid gland of a 14-year-old Japanese woman is presented. Conclusion This is the sixth case of lipomatous pleomorphic adenoma in the English literature. Recognition of this rare subtype of pleomorphic adenoma is important for clinical diagnosis and management. On CT scan, it may not be detected possibly due to the extensive fatty component.

  18. Application and advance of temozolomide in the treatment of pituitary adenomas

    Yi-guang LIN

    2015-12-01

    Full Text Available Pituitary adenoma is a common primary tumor in central nervons system. The aggressive pituitary adenomas show invasive characteristics with higher recurrence rate and worse prognosis, which normally need the comprehensive therapy of surgery, radiotherapy and chemical medications. The therapy of aggressive pituitary adenomas by temozolomide and whether O6-methylguanine-DNA methyltransferase (MGMT could predict the curative effect of temozolomide have become hot spots in recent years. This review intends to illustrate the advance of the therapy of aggressive pituitary adenomas by temozolomide. DOI: 10.3969/j.issn.1672-6731.2015.12.017

  19. Ganglion cell tumours in the sella turcica in close morphological connection with pituitary adenomas.

    Matyja, Ewa; Maksymowicz, Maria; Grajkowska, Wiesława; Zieliński, Grzegorz; Kunicki, Jacek; Bonicki, Wiesław; Witek, Przemysław; Naganska, Ewa

    2015-01-01

    Ganglion cell tumours in the sellar region are uncommon. They are usually associated with pituitary adenomas, while isolated ganglion cell neoplasms are extremely rare. We report the clinicopathological studies of five cases diagnosed as ganglion cell tumours located in the intrasellar region: four mixed/collision tumours composed of gangliocytoma and pituitary adenoma, and one isolated ganglioglioma unrelated to adenoma. Clinically, two patients presented with acromegaly, while three others were initially diagnosed as non-functioning adenomas. In four cases, the histopathological examination of surgical specimens revealed intermixed lesions composed of pituitary adenoma and ganglion cell elements. The adenomas appeared to secrete growth hormone. Electron microscopy enabled identification of the sparsely granulated somatotroph cells. Neoplastic neuronal lesions were composed of mature ganglion cells, including binucleate or multinucleate cells. In all cases, boundaries between adenomatous and gangliocytic components were not clearly demarcated, and numerous gangliocytic cells were closely intermingled with adenomatous tissue. One case lacked endocrine symptoms, and no pituitary adenoma was identified in the surgically excised material; it was finally diagnosed as low-grade ganglioglioma. The etiopathogenesis of ganglion cell neoplasms in the sellar region is not clearly defined. Our study revealed that if ganglion cell neoplasms were combined with adenoma, both neoplastic components were closely related to each other, and numerous neuronal elements were strictly intermingled with adenoma cells. Such a tissue pattern indicates that these neoplastic changes, including their common respective etiopathogeneses, are closely related. The identification of both components in sellar regions may have some nosological implications.

  20. Radiotherapy for pituitary adenomas: long-term outcome and complications

    Rim, Chai Hong; Yang, Dae Sik; Park, Young Je; Yoon, Won Sup; Lee, Jung AE; Kim, Chul Yong [Korea University Medical Center, Seoul (Korea, Republic of)

    2011-09-15

    To evaluate long-term local control rate and toxicity in patients treated with external beam radiotherapy (EBRT) for pituitary adenomas. We retrospectively reviewed the medical records of 60 patients treated with EBRT for pituitary adenoma at Korea University Medical Center from 1996 and 2006. Thirty-fi ve patients had hormone secreting tumors, 25 patients had non-secreting tumors. Fifty-seven patients had received postoperative radiotherapy (RT), and 3 had received RT alone. Median total dose was 54 Gy (range, 36 to 61.2 Gy). The definition of tumor progression were as follows: evidence of tumor progression on computed tomography or magnetic resonance imaging, worsening of clinical sign requiring additional operation or others, rising serum hormone level against a previously stable or falling value, and failure of controlling serum hormone level so that the hormone level had been far from optimal range until last follow-up. Age, sex, hormone secretion, tumor extension, tumor size, and radiation dose were analyzed for prognostic significance in tumor control. Median follow-up was 5.7 years (range, 2 to 14.4 years). The 10-year actuarial local control rates for non-secreting and secreting adenomas were 96% and 66%, respectively. In univariate analysis, hormone secretion was significant prognostic factor (p = 0.042) and cavernous sinus extension was marginally significant factor (p = 0.054) for adverse local control. All other factors were not significant. In multivariate analysis, hormone secretion and gender were significant. Fifty-three patients had mass-effect symptoms (headache, dizziness, visual disturbance, hypopituitarism, loss of consciousness, and cranial nerve palsy). A total of 17 of 23 patients with headache and 27 of 34 patients with visual impairment were improved. Twenty-seven patients experienced symptoms of endocrine hypersecretion (galactorrhea, amenorrhea, irregular menstruation, decreased libido, gynecomastia, acromegaly, and Cushing

  1. Análisis socioeconómico de la pesquería de calamar gigante en Guaymas, Sonora

    Francisco Javier de la Cruz-González

    2011-01-01

    Full Text Available En este trabajo hacemos un análisis socioeconómico de la pesquería de calamar gigante en Guaymas, Sonora. Se generó una base de datos con información pesquera y se aplicó una encuesta a pescadores y a trabajadores de la industria del calamar para determinar sus principales características socioeconómicas. Los resultados muestran que esta pesquería ha tenido una participación importante en la estructura productiva del sector pesquero de la región; sin embargo, el repunte en las capturas de calamar gigante en los últimos años ha permitido el crecimiento de esta pesquería, pero no su desarrollo. El documento resalta la necesidad de orientar las políticas de manejo al aprovechamiento integral de este recurso.

  2. Polyostotic fibrous dysplasia with gigantism and huge pelvic tumor: a rare case of McCune-Albright syndrome.

    Sakayama, Kenshi; Sugawara, Yoshifumi; Kidani, Teruki; Fujibuchi, Taketsugu; Kito, Katsumi; Tanji, Nozomu; Nakamura, Atsushi

    2011-06-01

    We report a rare case of polyostotic fibrous dysplasia on endocrine hyperfunction with elevated human growth hormone and normal serum level of prolactin. There were some differential points of gender, gigantism, endocrine function, and GNAS gene from McCune-Albright syndrome. Malignant transformation was suspected in the pelvic tumor from imaging because rapid growth of the tumor by imaging was observed; however, no malignant change occurred in this case.

  3. Convergent evolution of gigantism in damselflies of Africa and South America? Evidence from nuclear and mitochondrial sequence data.

    Groeneveld, Linn F; Clausnitzer, Viola; Hadrys, Heike

    2007-02-01

    Extreme large body size is rare in modern Zygoptera (damselflies). Only the South and Central American damselfly family Pseudostigmatidae and one African species, Coryphagrion grandis, share the morphological trait of gigantism. By means of phylogenetic analyses using two mitochondrial markers (16S rDNA and ND1) and one nuclear marker (EF1) in combination with an existing morphological data set, we trace the evolution of gigantism in damselflies. Individual and combined data sets were analyzed using the maximum parsimony, minimum evolution and maximum likelihood algorithms. Regardless of the algorithm used and the data set analyzed all principal tree topologies support a monophyly of the damselfly taxa displaying giant body size. This supports the view that the evolution of gigantism in damselflies from Africa and South America is not the result of convergent evolution due to strikingly similar habitat preferences, but rather the result of close genealogical relationship. Because modern odonates evolved before the split of Africa from Gondwanaland, the proposed phylogeny suggests that C. grandis represents a Gondwana relict.

  4. Somatic mutations of the APC, KRAS, and TP53 genes in nonpolypoid colorectal adenomas

    van Wyk, R; Slezak, P; Hayes, VM; Buys, CHCM; Kotze, MJ; de Jong, G; Rubio, C; Dolk, A; Jaramillo, E; Koizumi, K; Grobbelaar, JJ

    2000-01-01

    Calorectal adenomas are macroscopically visible morphological changes of the mucosa that can develop focal carcinoma in the absence of surgical intervention. The successive molecular changes proposed to occur at different: stages in the adenoma-carcinoma sequence were primarily based on DNA studies

  5. Identification and validation of highly frequent CpG island hypermethylation in colorectal adenomas and carcinomas

    Øster, Bodil; Thorsen, Kasper; Lamy, Philippe;

    2011-01-01

    .005). Identified hypermethylated sites were validated in an independent sample set of eight normal mucosas, 12 adenomas, 40 MSS and nine MSI cancer samples. The methylation patterns of 15 selected genes, hypermethylated in adenomas and carcinomas (FLI1, ST6GALNAC5, TWIST1, ADHFE1, JAM2, IRF4, CNRIP1, NRG1, and EYA...

  6. Prevalence and phenotypes of APC and MUTYH mutations in patients with multiple colorectal adenomas

    S. Grover (Shilpa); F. Kastrinos (Fay); E.W. Steyerberg (Ewout); E.F. Cook (E. Francis); A. Dewanwala (Akriti); L.A. Burbidge; R.J. Wenstrup (Richard); S. Syngal (Sapna)

    2012-01-01

    textabstractContext: Patients with multiple colorectal adenomas may carry germline mutations in the APC or MUTYH genes. Objectives: To determine the prevalence of pathogenic APC and MUTYH mutations in patients with multiple colorectal adenomas who had undergone genetic testing and to compare the pre

  7. Association between dietary fat intake and colorectal adenoma in korean adults

    Kim, Jeehyun; Oh, Seung-Won; Kim, Young-Sun; Kwon, Hyuktae; Joh, Hee-Kyung; Lee, Ji-Eun; Park, Danbee; Park, Jae-Hong; Ko, Ah-Ryoung; Kim, Ye-Ji

    2017-01-01

    Abstract The incidence of colorectal cancer is rapidly increasing in South Korea. It is important to clarify the association between colorectal cancer and diet, being one of the main modifiable risk factors, as such studies in the Korean population are lacking. A cross-sectional study was performed using data from participants who had undergone a screening colonoscopy and a nutritional assessment during a routine health check-up from January 2008 to December 2011. Dietary intake data were derived from 1-day food records; colorectal adenoma was histopathologically confirmed by biopsy during colonoscopy. Eventually, 2604 participants were included in the analysis. The risk of colorectal adenoma by quintile of dietary fat intake was analyzed using logistic regression. Subgroup analyses by degree of risk and by location of colorectal adenoma were additionally performed. In men, total fat intake was not associated with risk of colorectal adenoma. However, risk of colorectal adenoma increased with higher saturated fatty acid (SFA) intake. The adjusted odds ratio in the highest quintile was 1.71 (95% confidence interval, 1.01–2.91) compared with that in the lowest quintile. There was no significant association between fat intake and risk of colorectal adenoma characterized by subsite. In female participants, total fat and specific fatty acid intake were not associated with risk of colorectal adenoma. These data support that high SFA intake is associated with risk of colorectal adenoma in Korean men. PMID:28072719

  8. Differential expression in normal-adenoma-carcinoma sequence suggests complex molecular carcinogenesis in colon.

    Lee, Seungkoo; Bang, Seunghyun; Song, Kyuyoung; Lee, Inchul

    2006-10-01

    The majority of colon cancers develop from pre-existing adenomas. We analyzed the expression profiles in the sequence of normal colon crypts, adenomas and early-stage carcinomas using microdissected cells from tubular adenomas with foci of malignant transformation. Differentially expressed genes were detected between normal-adenoma and adenoma-carcinoma, and were grouped according to the patterns of expression changes in the sequence. Down-regulated genes in the sequence included PLA2G2A, TSPAN1, PDCD4, FCGBP, AATK, EPLIN, FABP1, AGR2, MTUS1, TSC1, galectin 4 and MT1F. PLA2G2A has been shown to suppress colon tumorigenesis in mice, but the pathobiological role in humans has been controversial. Our data showed continuous down-regulation of PLA2G2A in the sequence supporting an implication in human colon cancer. Tumor suppressor and/ or proapoptotic activities have also been reported in other genes. Up-regulated genes included ribosomal proteins, IER3 and TPR. TGF-beta2 and matrix metalloproteinase 23B were up-regulated in carcinoma but not in adenoma, supporting the pathobiological roles in malignant transformation. Differentially expressed genes partly coincided with those in the adenoma-carcinoma sequence of the stomach, which was published previously, suggesting a partial overlap between the adenoma-carcinoma sequences of the colon and stomach.

  9. Dysbiosis of fungal microbiota in the intestinal mucosa of patients with colorectal adenomas.

    Luan, Chunguang; Xie, Lingling; Yang, Xi; Miao, Huifang; Lv, Na; Zhang, Ruifen; Xiao, Xue; Hu, Yongfei; Liu, Yulan; Wu, Na; Zhu, Yuanmin; Zhu, Baoli

    2015-01-23

    The fungal microbiota is an important component of the human gut microbiome and may be linked to gastrointestinal disease. In this study, the fungal microbiota of biopsy samples from adenomas and adjacent tissues was characterized by deep sequencing. Ascomycota, Glomeromycota and Basidiomycota were identified as the dominant phyla in both adenomas and adjacent tissues from all subjects. Among the 60 genera identified, the opportunist pathogens Phoma and Candida represented an average of 45% of the fungal microbiota. When analyzed at the operational taxonomic unit (OTU) level, however, a decreased diversity in adenomas was observed, and three OTUs differed significantly from the adjacent tissues. Principal Component Analysis (PCA) revealed that the core OTUs formed separate clusters for advanced and non-advanced adenomas for which the abundance of four OTUs differed significantly. Moreover, the size of adenomas and the disease stage were closely related to changes in the fungal microbiota in subjects with adenomas. This study characterized the fungal microbiota profile of subjects with adenomas and identified potential diagnostic biomarkers closely related to different stages of adenomas.

  10. Adenomas in Patients with Inflammatory Bowel Disease Are Associated with an Increased Risk of Advanced Neoplasia

    Schaik, F.D. van; Mooiweer, E.; Have, M. van der; Belderbos, T.D.; Kate, F.J. ten; Offerhaus, G.J.; Schipper, M.E.; Dijkstra, G.; Pierik, M.; Stokkers, P.C.; Ponsioen, C.; Jong, D.J. de; Hommes, D.W.; Bodegraven, A.A. van; Siersema, P.D.; Oijen, M.G.H. van; Oldenburg, B.

    2013-01-01

    BACKGROUND:: It is still unclear whether inflammatory bowel disease (IBD) patients with adenomas have a higher risk of developing high-grade dysplasia (HGD) or colorectal cancer (CRC) than non-IBD patients with sporadic adenomas. We compared the risk of advanced neoplasia (AN, defined as HGD or CRC)

  11. Adenomas in Patients with Inflammatory Bowel Disease Are Associated with an Increased Risk of Advanced Neoplasia

    van Schaik, Fiona D. M.; Mooiweer, Erik; van der Have, Mike; Belderbos, Tim D. G.; ten Kate, Fiebo J. W.; Offerhaus, G. Johan A.; Schipper, Marguerite E. I.; Dijkstra, Gerard; Pierik, Marieke; Stokkers, Pieter C. F.; Ponsioen, Cyriel; de Jong, Dirk J.; Hommes, Daniel W.; van Bodegraven, Ad A.; Siersema, Peter D.; van Oijen, Martijn G. H.; Oldenburg, Bas

    2013-01-01

    Background: It is still unclear whether inflammatory bowel disease (IBD) patients with adenomas have a higher risk of developing high-grade dysplasia (HGD) or colorectal cancer (CRC) than non-IBD patients with sporadic adenomas. We compared the risk of advanced neoplasia (AN, defined as HGD or CRC)

  12. Disulfiram sensitizes pituitary adenoma cells to temozolomide by regulating O6-methylguanine-DNA methyltransferase expression.

    Zhao, Yachao; Xiao, Zheng; Chen, Wenna; Yang, Jinsheng; Li, Tao; Fan, Bo

    2015-08-01

    O6-methylguanine-DNA methyltransferase (MGMT) activity is responsible for temozolomide (TMZ) resistance in patients harboring aggressive pituitary adenomas. Recently, disulfiram (DSF) has been shown to induce the loss of MGMT protein and increase TMZ efficacy in glioblastoma cells, while CD133+ nestin+ cells isolated from the cell population have been implicated as pituitary adenoma stem-like cells. However, whether DSF is able to potentiate the cytotoxic effects of TMZ on human pituitary adenoma cells has not been investigated to date. In the present study, CD133+ nestin+ phenotype cells were isolated from primary cultured human pituitary adenoma cells using microbeads. It was found that DSF reduced MGMT protein expression and sensitized human pituitary adenoma cells and stem-like cells to TMZ in vitro, while the proteasome inhibitor PS-341 abrogated the inhibitory effect of DSF on MGMT in vitro. The sensitizing effect of DSF was also verified in primary cultured human pituitary adenoma cells in vivo. The results of the present study suggested that DSF can increase the efficacy of the anti-tumor effect of TMZ on human pituitary adenoma cells and CD133+ nestin+ stem like cells via the ubiquitin-proteasomal MGMT protein elimination route. DSF combined with TMZ may be an effective therapeutic strategy against aggressive pituitary adenomas.

  13. Gravity combined with laser-scan in Grotta Gigante: a benchmark cave for gravity studies

    Pivetta, Tommaso; Braitenberg, Carla

    2014-05-01

    Laser scanning has become one of the most important topographic techniques in the last decades, due to its ability to reconstruct complex surfaces with high resolution and precision and due to its fast acquisition time. Recently a laser-scan survey has been acquired (Fingolo et al., 2011) in the "Grotta Gigante" cave near Trieste, Italy, the biggest cave worldwide according to the Guinness Awards. In this paper this survey is used to obtain a 3D discretization of the cave with prisms. Then through this new model, with the densities derived from campaign measurements, the exact gravimetric effect of the structure was computed (Nagy et al., 2000) and compared with the gravity observation at the surface. The transition from the cloud of laser-scan points to the prism model was carried out by different computer elaborations; first of all the reduction of the data density through an averaging process that allows to pass from over 10000 points/m2 to less than 10points/m2. Then the whole dataset was filtered from the outliers by the means of a simple quadratic surface that fit the data (Turner, 1999). The reduced data points should be divided into the 2 surfaces of top and bottom, that are used to define the prisms. This step was performed using the local regression method (Loess) to calculate a surface located halfway between top and bottom points. Once the top and bottom interfaces were obtained it was possible to get the final prism representation and calculate the gravity signal. The observed Bouguer field is explained very well by our model and the residuals are used to evaluate possible secondary caves. The final prism model together with the gravity database on surface and inside the cave form a perfect benchmark to test forward and inverse potential field algorithms. References Fingolo M., Facco L., Ceccato A., Breganze C., Paganini P., Cezza M., Grotta Gigante di Trieste. Tra realtà virtuale e rilievi 3D ad alta risoluzione, Veneto Geologi, 75, pp.21-25, 2011

  14. Chromosome abnormalities in colorectal adenomas: two cytogenetic subgroups characterized by deletion of 1p and numerical aberrations

    Bomme, L; Bardi, G; Pandis, N

    1996-01-01

    changes were +20, +13, and monosomy 18, found in six, five, and two adenomas, respectively. Rearrangement of chromosome 1 was the most common structural change. Abnormalities involving 1p were seen in six adenomas, leading to visible loss of material in three. One adenoma had one clone with a large...

  15. Outcome of visual acuity after surgical removal of pituitary adenomas

    Grković Desanka

    2013-01-01

    Full Text Available Introduction. Pituitary adenomas with suprasellar extension may produce anterior visual pathway compression, resulting in characteristic visual deficit. Surgical decompression of these structures prevents further visual deterioration and its postop­ erative recovery. Objective. The aim of this study was to investigate pre­ and postoperative visual acuity (VA in patients with pituitary ad­ enomas, and to detect the influence of prognostic factors, such as symptoms duration, degree of visual acuity reduction and tumor size in the assessment of the prognosis of postoperative visual function. Methods. We analyzed 40 consecutive patients who fulfilled three criteria: evidence of preoperative visual dysfunction, transsphenoidal or transfrontal tumor resection and hystologically verified pituitary adenoma. A visual examination was performed under standard conditions, pre and postoperatively (10 days, one month and six months after surgery. A paired t­test was used to assess the differences of pre­ and postoperative characteristics values, and the Chisquare test of independence in the assessment of the influence of prognostic factors. Results. Postoperative improvement of VA was seen in 84.61% patients (68% eyes. Eyes with preoperative mild and moderate degree of VA reduction showed improvement in 89.65% eyes in contrast to 22.60% eyes with preoperative severe reduction of VA, which was all statistically significant. Eyes in patients with tumor smaller than 20 mm had improvement of VA in 91.66% eyes, while eyes with tumor larger than 40 mm had improvement of VA in 61.11% eyes, which was statistically significant. When symptoms duration was below two years the improvement of VA was detected in 65.38% eyes as related to 50% eyes with symptoms duration exceeding two years, which was not statistically significant. Conclusion. Pituitary adenomas commonly cause visual impairment. Postoperatively the majority of patients show a distinct improvement of

  16. Differential Gene Expression in Chemically Induced Mouse Lung Adenomas

    Ruisheng Yao

    2003-01-01

    Full Text Available Because of similarities in histopathology and tumor progression stages between mouse and human lung adenocarcinomas, the mouse lung tumor model with lung adenomas as the endpoint has been used extensively to evaluate the efficacy of putative lung cancer chemopreventive agents. In this study, a competitive cDNA library screening (CCLS was employed to determine changes in the expression of mRNA in chemically induced lung adenomas compared with paired normal lung tissues. A total of 2555 clones having altered expression in tumors were observed following competitive hybridization between normal lung and lung adenomas after primary screening of over 160,000 clones from a mouse lung cDNA library. Among the 755 clones confirmed by dot blot hybridization, 240 clones were underexpressed, whereas 515 clones were overexpressed in tumors. Sixty-five clones with the most frequently altered expression in six individual tumors were confirmed by semiquantitative RT-PCR. When examining the 58 known genes, 39 clones had increased expression and 19 had decreased expression, whereas the 7 novel genes showed overexpression. A high percentage (>60% of overexpressed or underexpressed genes was observed in at least two or three of the lesions. Reproducibly overexpressed genes included ERK-1, JAK-1, surfactant proteins A, B, and C, NFAT1, α-1 protease inhibitor, helix-loop-helix ubiquitous kinase (CHUK, α-adaptin, α-1 PI2, thioether S-methyltransferase, and CYP2C40. Reproducibly underexpressed genes included paroxanase, ALDH II, CC10, von Ebner salivary gland protein, and α- and β-globin. In addition, CCLS identified several novel genes or genes not previously associated with lung carcinogenesis, including a hypothetical protein (FLJ11240 and a guanine nucleotide exchange factor homologue. This study shows the efficacy of this methodology for identifying genes with altered expression. These genes may prove to be helpful in our understanding of the genetic basis of

  17. Retroauricular Pleomorphic Adenoma Arising from Heterotopic Salivary Gland Tissue

    Bacaj, Patrick; Borah, Gregory

    2016-01-01

    Summary: A 38-year-old woman is described who presented with a slowly growing mass on the posterior aspect of the left ear. Excision and histopathologic evaluation revealed a pleomorphic adenoma (PA) originating from heterotopic salivary gland tissue. Many authors have presented cases of PAs originating from ceruminous glands in the external auditory canal or of so-called chondroid syringoma originating from apocrine and eccrine sweat glands. This is the only case in the recent literature of a PA originating from a heterotopic rest of salivary gland tissue in the retroauricular region. The 3 main sources of PAs, their embryologic derivation, and treatment are described.

  18. Fatal complication after transsphenoidal surgery of pituitary adenoma: case report

    Conceição Aparecida Dornelas

    2015-06-01

    Full Text Available ABSTRACT The objective of this study was to report a rare fatal complication in the postoperative period of transsphenoidal surgery of the pituitary gland (adenoma, with a brief review of the subject. The patient was a 54-year-old white man with acromegaly and severe heart failure, who after microsurgery developed blood pressure instability within 32 hours after the procedure and died. The autopsy revealed: hypertrophy and ventricular dilation with myocarditis, pericarditis and myocardial fibrosis; mesenteric ischemia with transmural coagulation necrosis of the intestinal loops; acute tubular necrosis; and hepatic steatosis. The findings are consistent with cardiogenic shock and abdominal sepsis due to necrosis of the intestinal loops.

  19. Sessile serrated adenomas:Demographic,endoscopic and pathological characteristics

    Suryakanth; R; Gurudu; Russell; I; Heigh; Giovanni; De; Petris; Evelyn; G; Heigh; Jonathan; A; Leighton; Shabana; F; Pasha; Isaac; B; Malagon; Ananya; Das

    2010-01-01

    AIM:To study the demographic and endoscopic characteristics of patients with sessile serrated adenoma(SSA) in a single center.METHODS:Patients with SSA were identified by review of the pathology database of Mayo Clinic Arizona from 2005 to 2007.A retrospective chart review was performed to extract data on demographics,polyp characteristics,presence of synchronous adenomatous polyps or cancer,polypectomy methods,and related complications.RESULTS:One hundred and seventy-one(2.9%) of all patients undergoing co...

  20. Acromegaly with no pituitary adenoma and no evidence of ectopic source

    Deepak Khandelwal

    2011-01-01

    Full Text Available More than 99% of patients with acromegaly harbor a growth hormone (GH secreting pituitary adenoma. As the time from onset of signs/symptoms to diagnosis of acromegaly is long (symptom onset to diagnosis is often 4-10 years, pituitary adenomas that cause GH excess are often large and are nearly always visible on conventional magnetic resonance imaging (MRI. However, in rare circumstances, acromegalic patients without an ectopic source will not have imaging evidence of a pituitary adenoma. Management of these patients poses special challenge, and once ectopic source of GH/growth-hormone-releasing hormone (GHRH is ruled out, an exploration of pituitary might be useful. We herein report a case of acromegaly with imaging evidence of sellar floor osteoma, but no pituitary adenoma, and negative work up for an ectopic source of GH/GHRH tumor, and on surgical exploration pituitary adenoma could be identified and removed and confirmed on histopathologic examination.

  1. Expression of growth hormone (GH)-releasing factor gene in GH-producing pituitary adenoma.

    Wakabayashi, I; Inokuchi, K; Hasegawa, O; Sugihara, H; Minami, S

    1992-02-01

    Pituitary cells synthesize various neuropeptides that influence pituitary hormone secretion. GH-releasing factor (GRF) may also be produced by normal or pituitary tumor cells. We examined GRF gene expression in pituitary tumors. Standard techniques for the analysis of GRF gene expression did not appear to be suitable. Highly sensitive reverse transcription coupled to polymerase chain reaction was used. Specimens of pituitary adenoma were obtained by transsphenoidal adenomectomy from six patients with acromegaly and three patients with no clinical evidence of pituitary hormone overproduction; non-functioning adenoma. Pituitary glands were collected at autopsy from three patients who died from nonendocrine disorders. A specific GRF gene transcript was detected in five out of six GH-producing pituitary adenomas, whereas this was not found in three separate specimens of nonfunctioning pituitary adenoma or anterior and posterior pituitary tissue. The data suggest that GRF is synthesized as an intrinsic product in human GH-producing pituitary adenoma.

  2. Double, synchronous pituitary adenomas causing acromegaly and Cushing's disease. A case report and review of literature.

    Zieliński, Grzegorz; Maksymowicz, Maria; Podgórski, Jan; Olszewski, Włodzimierz T

    2013-06-01

    Double pituitary adenomas are very rare and present up to 1 % of pituitary adenomas in unselected autopsy series and up to 2 % in large surgical series. We report a case of a 47-year-old man presented slight clinical features of acromegaly with 2 years duration. Endocrine evaluation confirmed active acromegaly and revealed adrenocorticotropin hormone-dependent hypercortisolemia. Preoperative magnetic resonance imaging of the pituitary demonstrated clearly separated double microadenomas with different intensity. The patient underwent transsphenoidal surgery and both tumors were completely removed and were fixed separately. The histological and ultrastructural examination confirmed coincidence of the double, clearly separated pituitary adenomas in one gland. Postoperative function of the hypothalamo-hypophyseal axis was normalized. We conclude from this case and a literature review that double endocrinologically active pituitary adenomas leading to acromegaly and Cushing's disease may occur. Additionally, a review of the literature regarding multiple pituitary adenomas has also been performed.

  3. The transcervical approach for parapharyngeal space pleomorphic adenomas: indications and technique.

    Gilad Horowitz

    Full Text Available BACKGROUND: Head and Neck Parapharyngeal space tumors are rare. Pleomorphic Adenomas are the most common Parapharyngeal space tumors. The purpose of this study was to define preoperative criteria for enabling full extirpation of parapharyngeal space pleomorphic adenomas via the transcervical approach while minimizing functional and cosmetic morbidity. METHODS: The surgical records and medical charts of 19 females and 10 males with parapharyngeal space pleomorphic adenomas operated between 1993 and 2012 were reviewed. RESULTS: Fifteen patients were operated by a simple transcervical approach, 13 by a transparotid transcervical approach, and one by a transmandibular transcervical approach. Complications included facial nerve paralysis, infection, hemorrhage and first bite syndrome. There were three recurrences, but neither recurrence nor complications were associated with the type of surgical approach. CONCLUSION: A simple transcervical approach is preferred for parapharyngeal space pleomorphic adenomas with narrow attachments to the deep lobe of the parotid gland and for pleomorphic adenomas originating in a minor salivary gland within the parapharyngeal space.

  4. Cytopathological features of villous adenoma of the urinary bladder in urine: A rare case report.

    Ishikawa, Ryou; Kadota, Kyuichi; Hayashi, Toshitetsu; Motoyama, Mutsumi; Matsunaga, Toru; Miyai, Yumi; Katsuki, Naomi; Kushida, Yoshio; Haba, Reiji

    2016-07-01

    Villous adenoma of the urinary bladder is a rare tumor that histologically mimics its enteric counterpart. Patients with an isolated villous adenoma have an excellent prognosis, but associated adenocarcinomas can frequently be identified in them as well. There is no literature that discusses the cytopathologic features of villous adenoma. Here we report a case which was diagnosed as villous adenoma histologically, which has been followed up with urine cytology. In urine cytology, many mucin producing cells are recognized. Few cell clusters show glandular formation or arrangement along the basement membrane. When glandular cells with columnar mucin-filled goblet cells are seen in urine cytology, the presence of a primary glandular lesion of the urinary bladder, such as villous adenoma, should be considered possible. Diagn. Cytopathol. 2016;44:632-635. © 2016 Wiley Periodicals, Inc.

  5. Adenoma viloso com transformação carcinomatosa da ampola de Vater Villous adenoma with carcinomatous degeneration of the ampulla of Vater

    Guilherme Pinto Bravo Neto

    2001-02-01

    Full Text Available Villous adenomas of the duodenum and ampulla of Vater are uncommon, but they have been diagnosed more frequently with the increasing use of upper gastrointestinal endoscopy. Differential diagnosis with villous adenocarcinoma may be difficult. The authors present a case of a 47-year-old man with a giant villous adenoma of the duodenum, with intermittent jaundice, that was treated by pancreatoduodenectomy.

  6.  Immunohistochemical Expression of ki-67 and p53 in Colorectal Adenomas: A Clinicopathological Study

    Hussam Hasson Ali

    2011-07-01

    Full Text Available  Objectives: To evaluate the significance of P53 and Ki-67 expression as immunohistochemical markers in early detection of premalignant changes in different types of colorectal adenomas. Also, to correlate immunohistochemical expression of the two markers with different clinicopathological parameters including; age, and sex of the patient, type, site, size and grade of dysplasia of colorectal adenomas.Methods: Forty-seven polypectomy specimens of colorectal adenomas were retrieved from the archival materials of the Gastrointestinal and Hepatic Diseases Teaching Hospital in Baghdad from 2009 - 2010. Four µm section specimens were stained by immunohistochemical technique with Ki-67 and P53 tumor markers. P-values <0.05 were considered statistically significant.Results: Immunohistochemical expressions of Ki-67 and P53 had a significant correlation with the size and grade of dysplasia in colorectal adenomas. However, there was no significant correlation among the immunohistochemical expression of Ki-67 and P53 with the age and gender of the patient, and the type and site of colorectal adenomas. There was no significant correlation between Ki-67 and P53 expressions in colorectal adenomas. Villous adenomas of colorectum showed a significant correlation with the grade of dysplasia, while there was no significant correlation between size and site of colorectal adenoma with the grade of dysplasia.Conclusion: High grade dysplasia with significant positive immunohistochemical markers of Ki-67 and P53 could be valuable parameters for selecting from the total colorectal adenoma population, those most deserving of close surveillance in follow-up cancer prevention programs. It is closely linked with increasing age particularly in patients with a large size adenoma of villous component in their histology.

  7. Analysis of regulatory networks constructed based on gene coexpression in pituitary adenoma

    Jie Gong; Bo Diao; Guo Jie Yao; Ying Liu; Guo Zheng Xu

    2013-12-01

    Gene coexpression patterns can reveal gene collections with functional consistency. This study systematically constructs regulatory networks for pituitary tumours by integrating gene coexpression, transcriptional and posttranscriptional regulation. Through network analysis, we elaborate the incidence mechanism of pituitary adenoma. The Pearson’s correlation coefficient was utilized to calculate the level of gene coexpression. By comparing pituitary adenoma samples with normal samples, pituitary adenoma-specific gene coexpression patterns were identified. For pituitary adenoma-specific coexpressed genes, we integrated transcription factor (TF) and microRNA (miRNA) regulation to construct a complex regulatory network from the transcriptional and posttranscriptional perspectives. Network module analysis identified the synergistic regulation of genes by miRNAs and TFs in pituitary adenoma. We identified 142 pituitary adenoma-specific active genes, including 43 TFs and 99 target genes of TFs. Functional enrichment of these 142 genes revealed that the occurrence of pituitary adenoma induced abnormalities in intracellular metabolism and angiogenesis process. These 142 genes were also significantly enriched in adenoma pathway. Module analysis of the systematic regulatory network found that three modules contained elements that were closely related to pituitary adenoma, such as FGF2 and SP1, as well as transcription factors and miRNAs involved in the tumourigenesis. These results show that in the occurrence of pituitary adenoma, miRNA, TF and genes interact with each other. Based on gene expression, the proposed method integrates interaction information from different levels and systematically explains the occurrence of pituitary tumours. It facilitates the tracing of the origin of the disease and can provide basis for early diagnosis of complex diseases or cancer without obvious symptoms.

  8. Analysis of regulatory networks constructed based on gene coexpression in pituitary adenoma.

    Gong, Jie; Diao, Bo; Yao, Guo Jie; Liu, Ying; Xu, Guo Zheng

    2013-12-01

    Gene coexpression patterns can reveal gene collections with functional consistency. This study systematically constructs regulatory networks for pituitary tumours by integrating gene coexpression, transcriptional and posttranscriptional regulation. Through network analysis, we elaborate the incidence mechanism of pituitary adenoma. The Pearson's correlation coefficient was utilized to calculate the level of gene coexpression. By comparing pituitary adenoma samples with normal samples, pituitary adenoma-specific gene coexpression patterns were identified. For pituitary adenoma-specific coexpressed genes, we integrated transcription factor (TF) and microRNA (miRNA) regulation to construct a complex regulatory network from the transcriptional and posttranscriptional perspectives. Network module analysis identified the synergistic regulation of genes by miRNAs and TFs in pituitary adenoma. We identified 142 pituitary adenoma-specific active genes, including 43 TFs and 99 target genes of TFs. Functional enrichment of these 142 genes revealed that the occurrence of pituitary adenoma induced abnormalities in intracellular metabolism and angiogenesis process. These 142 genes were also significantly enriched in adenoma pathway. Module analysis of the systematic regulatory network found that three modules contained elements that were closely related to pituitary adenoma, such as FGF2 and SP1, as well as transcription factors and miRNAs involved in the tumourigenesis. These results show that in the occurrence of pituitary adenoma, miRNA, TF and genes interact with each other. Based on gene expression, the proposed method integrates interaction information from different levels and systematically explains the occurrence of pituitary tumours. It facilitates the tracing of the origin of the disease and can provide basis for early diagnosis of complex diseases or cancer without obvious symptoms.

  9. Parâmetros astrofísicos de estrelas gigantes do aglomerado globular 47 Tucanae

    Alves-Brito, A.; Barbuy, B.

    2003-08-01

    Os aglomerados globulares são considerados laboratórios astrofísicos para a verificação da teoria de evolução estelar, bem como a trajetória químio-dinâmica das galáxias hospedeiras. Em particular, 47 Tucanae (NGC 104) configura-se como um dos mais extensivamente estudados aglomerados globulares da Galáxia devido a relativa proximidade ao Sol (R¤ = 4.5 kpc) e alta latitute galáctica (b = -44°,89). Neste trabalho, apresentamos a velocidade radial heliocêntrica e os parâmetros atmosféricos (Teff, logg, [Fe/H]) de 5 estrelas gigantes do aglomerado globular 47 Tucanae. Os espectros foram obtidos pelo espectrógrafo UVES (Ultaviolet Visual Echelle Spectrograph) de alta resolução (R = 60000) e alta razão sinal-ruído (S/N > 200), acoplado ao telescópio de 8,2m Kueyen do VLT (Very Large Telescope). Nós encontramos = -22,43 +/- 3,97 km/s, [Fe/H] ~ -0.7, 1,2 aglomerados globulares ricos em metais. Trabalho financiado pela FAPESP e pelo CNPq.

  10. Futures, fakes and discourses of the gigantic and miniature in ‘The World’ islands, Dubai

    Pamila Gupta

    2015-11-01

    Full Text Available This article takes the “island” as a key trope in tourism studies, exploring how ideas of culture and nature, as well as those of paradise (lost are central to its interpretation for tourists and tourist industries alike. Increasingly, however, island tourism is blurring the line between geographies of land and water, continent and archipelago, and private and public property. The case of ‘The World’ islands mega project off the coast of Dubai (UAE is used to chart the changing face and future of island tourism, exploring how spectacle, branding and discourses of the gigantic, miniature, and fake, particularly alongside technological mediations on a large-scale, reflect the postmodern neoliberal world of tourism and the liquid times in which we live. Artificial island complexes such as this one function as cosmopolitan ‘non-places’ at the same time that they reflect a resurgence in (British nascent nationalism and colonial nostalgia, all the whilst operating in a sea of ‘junkspace’. The shifting cartography of ‘the island’ is thus mapped out to suggest new forms of place-making and tourism’s evolving relationship to these floating islandscapes.

  11. Discovery of gigantic molecular nanostructures using a flow reaction array as a search engine

    Zang, Hong-Ying; de La Oliva, Andreu Ruiz; Miras, Haralampos N.; Long, De-Liang; McBurney, Roy T.; Cronin, Leroy

    2014-04-01

    The discovery of gigantic molecular nanostructures like coordination and polyoxometalate clusters is extremely time-consuming since a vast combinatorial space needs to be searched, and even a systematic and exhaustive exploration of the available synthetic parameters relies on a great deal of serendipity. Here we present a synthetic methodology that combines a flow reaction array and algorithmic control to give a chemical ‘real-space’ search engine leading to the discovery and isolation of a range of new molecular nanoclusters based on [Mo2O2S2]2+-based building blocks with either fourfold (C4) or fivefold (C5) symmetry templates and linkers. This engine leads us to isolate six new nanoscale cluster compounds: 1, {Mo10(C5)}; 2, {Mo14(C4)4(C5)2}; 3, {Mo60(C4)10}; 4, {Mo48(C4)6}; 5, {Mo34(C4)4}; 6, {Mo18(C4)9}; in only 200 automated experiments from a parameter space spanning ~5 million possible combinations.

  12. O serviço de enfermagem hospitalar - apresentando este gigante silencioso

    Gisela Maria Schebella Souto de Moura

    2001-09-01

    Full Text Available O artigo focaliza a importância do serviço de enfermagem nas organizações de saúde, metaforizando sua grandeza com a expressão "gigante" e seu pouco reconhecimento pela comunidade através do termo "silencioso". A abrangência e a complexidade de seu funcionamento é pontual na efetividade dos processos de cuidado em saúde, no entanto, sua estrutura e organização é pouco conhecida pelos demais profissionais de saúde e quase que totalmente desconhecida pela comunidade. O serviço de enfermagem congrega grande contingente de pessoal com diferentes níveis de formação. O planejamento, organização, estrutura e funcionamento deste serviço seguem as diretrizes emanadas da Teoria Geral da Administração e os conhecimentos desta área têm sido cada vez mais utilizados para atingir as metas e objetivos almejados pelas instituições de saúde. O ensaio, contudo, não deixa de abordar questões sobre o foco no cliente e qualidade do atendimento, apontando para a necessidade de repensar o modelo administrativo adotado buscando sempre alternativas sistêmicas e contingenciais.

  13. Discovery of gigantic molecular nanostructures using a flow reaction array as a search engine.

    Zang, Hong-Ying; de la Oliva, Andreu Ruiz; Miras, Haralampos N; Long, De-Liang; McBurney, Roy T; Cronin, Leroy

    2014-04-28

    The discovery of gigantic molecular nanostructures like coordination and polyoxometalate clusters is extremely time-consuming since a vast combinatorial space needs to be searched, and even a systematic and exhaustive exploration of the available synthetic parameters relies on a great deal of serendipity. Here we present a synthetic methodology that combines a flow reaction array and algorithmic control to give a chemical 'real-space' search engine leading to the discovery and isolation of a range of new molecular nanoclusters based on [Mo(2)O(2)S(2)](2+)-based building blocks with either fourfold (C4) or fivefold (C5) symmetry templates and linkers. This engine leads us to isolate six new nanoscale cluster compounds: 1, {Mo(10)(C5)}; 2, {Mo(14)(C4)4(C5)2}; 3, {Mo(60)(C4)10}; 4, {Mo(48)(C4)6}; 5, {Mo(34)(C4)4}; 6, {Mo(18)(C4)9}; in only 200 automated experiments from a parameter space spanning ~5 million possible combinations.

  14. Lower limb gigantism, lymphedema, and painful varicosities following a thigh vascular access graft.

    Thompson, Michael; Mathuram Thiyagarajan, Umasankar; Akoh, Jacob A

    2014-07-01

    Prosthetic arteriovenous grafts (AVGs) are associated with greater morbidity than autogenous arteriovenous fistulas (AVFs), but their use is indicated when AVF formation is not possible. This report adds to the literature a case of lower limb gigantism, painful varicosities, and lymphedema following long-term use of AVG in the upper thigh. The patient's past medical history included renal transplantation on the same side well before the AVG was inserted and right leg deep vein thrombosis. Suspicion of AVG thrombosis was excluded by Doppler ultrasound, which demonstrated an access flow of 1700 mL/min. A computed tomography (CT) scan of the abdomen and pelvis did not identify the cause of her symptoms. Whereas functional incompetence of the iliac vein valve might be responsible for the varicosities, the extent of hypertrophy in this case raises the suspicion of lymphatic blockage possibly secondary to groin dissection undertaken at the time of graft insertion, in addition to the previous dissection at the time of transplantation. This case highlights the need for minimal groin dissection during AVG insertion, particularly in patients with a history of previous abdominopelvic surgery.

  15. A Thermodynamic, kinematic and microphysical analysis of a jet and gigantic jet-producing Florida thunderstorm

    Lazarus, S. M.; Splitt, M. E.; Brownlee, James; Spiva, Nicholas; Liu, Ningyu

    2015-08-01

    This paper presents a meteorological analysis of a storm that produced two jets, four gigantic jets (GJ), and a starter, which were observed by two radars as well as the Kennedy Space Center 4-Dimensional Lightning Surveillance System on 3 August 2013 in Central Florida. The work is the first application of dual polarization data to a jet-producing storm and is the fifth case related to a tropical disturbance. The storm environment is consistent with the moist tropical paradigm that characterizes about three quarters of the surface and aircraft observed jet and GJ events. The most unstable (MU) convective available potential energy is not unusual for Florida summer convection and is below the climatological mean for these events. An unusual speed shear layer is located near the storm equilibrium level (EL) and the storm exhibits a tilted structure with CGs displaced upshear. The turbulence, as measured by the eddy dissipation rate, is extreme near the storm top during the event window, consistent with the GJ mixing hypothesis. The individual events are collocated with, and track along, the center axis of the divergent outflow at the EL and occur within the region of the coldest GOES IR temperatures—placing the events within the overshoot. The dual polarization data indicate a deep graupel column, extending above the mixed phase layer, to a 13 km altitude.

  16. Respiratory evolution facilitated the origin of pterosaur flight and aerial gigantism.

    Leon P A M Claessens

    Full Text Available Pterosaurs, enigmatic extinct Mesozoic reptiles, were the first vertebrates to achieve true flapping flight. Various lines of evidence provide strong support for highly efficient wing design, control, and flight capabilities. However, little is known of the pulmonary system that powered flight in pterosaurs. We investigated the structure and function of the pterosaurian breathing apparatus through a broad scale comparative study of respiratory structure and function in living and extinct archosaurs, using computer-assisted tomographic (CT scanning of pterosaur and bird skeletal remains, cineradiographic (X-ray film studies of the skeletal breathing pump in extant birds and alligators, and study of skeletal structure in historic fossil specimens. In this report we present various lines of skeletal evidence that indicate that pterosaurs had a highly effective flow-through respiratory system, capable of sustaining powered flight, predating the appearance of an analogous breathing system in birds by approximately seventy million years. Convergent evolution of gigantism in several Cretaceous pterosaur lineages was made possible through body density reduction by expansion of the pulmonary air sac system throughout the trunk and the distal limb girdle skeleton, highlighting the importance of respiratory adaptations in pterosaur evolution, and the dramatic effect of the release of physical constraints on morphological diversification and evolutionary radiation.

  17. Evolución de planetas gigantes y posibilidades de su detección directa

    Brunini, A.; Benvenuto, O. G.

    Desde la reciente detección de planetas gigantes orbitando estrellas cercanas de tipo solar por medio de efecto Doppler, uno de los principales problemas, en cuanto al estudio de los sistemas planetarios extrasolares, se refiere a la posibilidad de obtener evidencia directa de su existencia. Esto parece ser factible gracias a que en un futuro cercano entrarán en operación algunos telescopios especialmente adecuados a estos propósitos. Por tal motivo, hemos comenzado desde hace un tiempo un esfuerzo en cuanto al estudio de la evolución planetaria. A tales efectos hemos adaptado el código de evolución estelar de nuestro Observatorio al caso planetario. Las principales diferencias entre el caso estelar y el planetario se encuentran en la ecuación de estado. A tales fines hemos incluído la reciente ecuación de estado de Saumon, Chabrier y Van Horn, las opacidades radiativas de Guillot et al., procesos de quema de Deuterio, etc. También se ha considerado la posible existencia de fases de hielo y roca en el interior planetario. Por el momento hemos despreciado los efectos de la rotación planetaria. Con este código hemos computado la evolución de planetas con masas desde 10 hasta 0.3 masas de Júpiter. Utilizando nuestros resultados numéricos discutimos la detectabilidad de estos objetos en condiciones realistas.

  18. 99mTc(V)-DMSA. A useful radio isotopic material for the diagnosis of pituitary adenoma

    Suzuki, Shinichi; Yamamura, Koji; Chang, Chia-Cheng; Kojima, Yasuhiro; Yamamoto, Isao; Ikegami, Tadashi [Yokohama City Univ., Kanagawa (Japan). School of Medicine

    2000-06-01

    We compared images of pituitary adenoma, parasellar tumors, and non-pituitary adenoma using the tumor-seeking agent technetium-99m-labeled pentavalent dimercaptosuccinic acid (99mTc(V)-DMSA) and evaluated the relationship between 99mTc(V)-DMSA uptake and pituitary hormone level. Fifteen patients with pituitary adenoma were studied: 3 non-functioning adenoma, 6 prolactinoma, 4 GH secreting adenoma, and 2 ACTH secreting adenoma. As a control group, we studied 6 patients without adenoma who had undergone a pathological examination. Planar and SPECT images were obtained 2-hours after intravenous injection of approximately 740 MBq 99mTc(V)-DMSA. Uptake ratios between normal background and tumor lesion were calculated. Three non-functioning adenoma (100%), five prolactinoma (83%), three GH secreting adenoma (75%) and no ACTH secreting adenoma (0%) significantly concentrated 99mTc(V)-DMSA. One of the non-adenomatous tumors, a Rathke's cleft cyst concentrated 99mTc(V)-DMSA in the pituitary while the others did not. The 99mTc(V)-DMSA scintigraphy showed an overall sensitivity of 73% (11/15) in detecting pituitary adenomas. Uptake ratios were higher in hormone-secreting adenoma than non-secreting adenoma. We were able to detect residual tumors and distinguish pituitary adenoma from surgical non-tumoral lesion with 99mTc(V)-DMSA. These results suggest that 99mTc(V)-DMSA imaging is useful in detecting pituitary adenoma and noninvasively differentiating tumor types in parasellar lesion. (author)

  19. Human Pituitary Adenoma Proteomics: New Progresses and Perspectives

    Zhan, Xianquan; Wang, Xiaowei; Cheng, Tingting

    2016-01-01

    Pituitary adenoma (PA) is a common intracranial neoplasm that impacts on human health through interfering hypothalamus–pituitary–target organ axis systems. The development of proteomics gives great promises in the clarification of molecular mechanisms of a PA and discovery of effective biomarkers for prediction, prevention, early-stage diagnosis, and treatment for a PA. A great progress in the field of PA proteomics has been made in the past 10 years, including (i) the use of laser-capture microdissection, (ii) proteomics analyses of functional PAs (such as prolactinoma), invasive and non-invasive non-functional pituitary adenomas (NFPAs), protein post-translational modifications such as phosphorylation and tyrosine nitration, NFPA heterogeneity, and hormone isoforms, (iii) the use of protein antibody array, (iv) serum proteomics and peptidomics, (v) the integration of proteomics and other omics data, and (vi) the proposal of multi-parameter systematic strategy for a PA. This review will summarize these progresses of proteomics in PAs, point out the existing drawbacks, propose the future research directions, and address the clinical relevance of PA proteomics data, in order to achieve our long-term goal that is use of proteomics to clarify molecular mechanisms, construct molecular networks, and discover effective biomarkers. PMID:27303365

  20. Discrimination of prolactinoma from hyperprolactinemic non-functioning adenoma.

    Hong, Jae Won; Lee, Mi Kyung; Kim, Sun Ho; Lee, Eun Jig

    2010-02-01

    The objective of this study was to evaluate characteristics that discriminate prolactinoma from non-functioning pituitary macroadenoma with hyperprolactinemia. We included 117 patients with hyperprolactinemic pituitary macroadenomas. Patients were divided into three groups according to treatment outcomes and pathologic results: (A) prolactinoma that responded to dopamine agonist (DA) treatment (PRDA); (B) prolactinoma requiring surgical treatment (PRS); and (C) non-functioning pituitary adenoma with hyperprolactinemia (NFPAH). Old age, low serum prolactin levels, and extrasellar extension were associated with NFPAH. Most patients with NFPAH had serum prolactin levels less than 100 ng/ml. Visual defects and GH deficiency were more common in patients with NFPAH compared with patients with PRS and PRDA, without difference of tumor size. Galactorrhea and amenorrhea were less frequent in patients with NFPAH than in patients with PRS and PRDA. Post-operative remission of hyperprolactinemia was achieved in 100% of patients with NFPAH and in 72.5% of patients with PRS. DA administration was required in 25.5% of patients with PRS; however, no patients with NFPAH required DA administration. In conclusion, old age, extrasellar tumor extension with relatively low prolactin levels, visual defect, and GH deficiency were considered suggestive of non-functioning pituitary adenoma rather than prolactinoma in hyperprolactinemic pituitary macroadenoma.

  1. Human pituitary adenoma proteomics: new progresses and perspectives

    Xianquan eZhan

    2016-05-01

    Full Text Available Pituitary adenoma (PA is a commonly intracranial neoplasm that impacts on human health through interfering hypothalamus-pituitary-target organ axis systems. The development of proteomics gives great promises in clarification of molecular mechanisms of a pituitary adenoma and discovery of effective biomarkers for prediction, prevention, early-stage diagnosis and treatment of a PA. A great progress in the field of PA proteomics has been made in the past ten years, including (i the use of laser capture microdissection, (ii proteomics analyses of functional PAs (FPAs, such as prolactinoma, invasive and noninvasive nonfunctional PAs (NFPAs, protein post-translational modifications (PTMs including phosphorylation and tyrosine nitration, NFPA heterogeneity, and hormone isoforms, (iii the use of protein antibody array, (iv serum proteomics and peptidomics, (v integration of proteomics and other omics data, and (vi proposal of multi-parameter systematic strategy for a PA. This review will summarize those progresses of proteomics in PAs, point out the existing drawbacks, propose the future research directions, and address the clinical relevance of PA proteomics data, in order to achieve our long-term goal that is use of proteomics to clarify molecular mechanisms, construct molecular networks, and discover effective biomarkers.

  2. Testosterone-secreting adrenal adenoma in a peripubertal girl

    Kamilaris, T.C.; DeBold, C.R.; Manolas, K.J.; Hoursanidis, A.; Panageas, S.; Yiannatos, J.

    1987-11-13

    A 15-year-old girl who presented with primary amenorrhea and virilization had an adrenocortical adenoma that secreted predominantly testosterone. To the authors' knowledge, she is the first peripubertal and second youngest patient with a testosterone-secreting adrenal tumor described. Serum dehydroepiandrosterone sulfate and urinary 17-ketosteroid an 17-hydroxycorticosteroid levels were normal. A tumor was located by a computed tomographic (CT) scan and by uptake of 6-..beta..-(/sup 75/Se) selenomethylnorcholesterol. Microscopic examination of the tumor showed typical features of an adrenocortical adenoma with no histologic features characteristic of Leydig cells. Postoperatively, her hirsutism regressed, she rapidly went through puberty, and regular monthly menstruation started four months later. Finding the source of testosterone in a virilized patient can be difficult. Eleven of the 14 previously described patients with testosterone-secreting adrenal tumors initially underwent misdirected surgery on the ovaries. Review of these cases revealed that results of hormone stimulation and suppression tests are unreliable and that these tumors are usually large. Therefore, CT scanning of the adrenal glands is recommended in all patients suspected of having a testosterone-secreting tumor.

  3. Acute appendicitis following endoscopic mucosal resection of cecal adenoma.

    Nemoto, Yukako; Tokuhisa, Junya; Shimada, Nagasato; Gomi, Tatsuya; Maetani, Iruru

    2015-07-21

    Endoscopic mucosal resection (EMR) allows the removal of flat or sessile lesions, laterally spreading tumors, and carcinoma of the colon or the rectum limited to the mucosa or the superficial submucosa. Acute appendicitis is the most common abdominal emergency requiring emergency surgery, and it is also a rare complication of diagnostic colonoscopy and therapeutic endoscopy, including EMR. In the case presented here, a 53-year-old female underwent colonoscopy due to a positive fecal occult blood test and was diagnosed with cecal adenoma. She was referred to our hospital and admitted for treatment. The patient had no other symptoms. EMR was performed, and 7 h after the surgery, the patient experienced right -lower abdominal pain. Laboratory tests performed the following day revealed a WBC count of 16000/mm(3), a neutrophil count of 14144/mm(3), and a C-reactive protein level of 2.20 mg/dL, indicating an inflammatory response. Computed tomography also revealed appendiceal wall thickening and swelling, so acute appendicitis following EMR was diagnosed. Antibiotics were initiated leading to total resolution of the symptoms, and the patient was discharged on the sixth post-operative day. Pathological analysis revealed a high-grade cecal tubular adenoma. Such acute appendicitis following EMR is extremely rare, and EMR of the cecum may be a rare cause of acute appendicitis.

  4. Pituitary null cell adenoma in a domestic llama (Lama glama).

    Chalkley, M D; Kiupel, M; Draper, A C E

    2014-07-01

    Pituitary gland neoplasia has been reported rarely in camelids. A 12-year-old neutered male llama (Lama glama) presented with lethargy, inappetence and neurological signs. On physical examination, the llama was mentally dull and exhibited compulsive pacing and circling to the left. Complete blood count and serum biochemistry revealed haemoconcentration, mild hypophosphataemia, hyperglycaemia, hypercreatininaemia and hyperalbuminaemia. Humane destruction was elected due to rapid clinical deterioration and poor prognosis. Post-mortem examination revealed a pituitary macroadenoma and bilateral internal hydrocephalus. Microscopically, the pituitary tumour was composed of neoplastic chromophobic pituitary cells. Ultrastructural studies revealed similar neoplastic cells to those previously described in human null cell adenomas. Immunohistochemically, the neoplastic cells were strongly immunoreactive for neuroendocrine markers (synaptophysin and chromogranin A), but did not exhibit immunoreactivity for epithelial, mesenchymal, neuronal and all major pituitary hormone markers (adrenocorticotropic hormone, follicle stimulating hormone, growth hormone, luteinizing hormone, melanocyte-stimulating hormone, prolactin and thyroid stimulating hormone), consistent with the diagnosis of a pituitary null cell adenoma. This is the first report of pituitary neoplasia in a llama.

  5. Radiologic findings of tubular adenoma of the breast

    Jeong, Mi Gyoung; Oh, Ki Keun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-10-01

    Tubular adenoma (TA) is known as a rare lesion of the breast which is difficult to diagnosis preoperatively because of its rarity and similarity to fibroadenoma. Hence, our purpose is to suggest the characteristic sonographic features for its correct diagnosis. We retrospectively analyzed the clinical data and mammographic and sonographic findings. of seven patients(mean age, 23) who during the previous five years had presented at our hospital with pathologically-proven tubular adenoma. TA was misdiagnosed as fibroadenoma, since on physical examination of these young females, the lesions presented a palpable, non-tender mass. Mammographically, they showed a well defined mass similar to fibroadenoma. However, sonographic findings were characteristic of TA and compared to fibroadenoma, showed a well demarcated and smooth bordered mass with transverse long axis, posterior enhancement and homogeneous lower internal echogenecity. No case showed lateral wall refractive shadowing. In young females, the clinical and mammographic findings of TA are similar to those of fibroadenoma. However, sonographic findings of TA can, be helpful in the differential diagnosis of this entity and fibroadenoma.

  6. Liver cell adenoma with malignant transformation: A case report

    Masahiro Ito; Makoto Sasaki; Chun-Yang Wen; Masahiro Nakashima; Toshihito Ueki; Hiromi Ishibashi; Michitami Yano; Masayoshi Kage; Masamichi Kojiro

    2003-01-01

    A 57-year-old woman was referred to our hospital because of a liver mass detected by computed tomography. She had taken oral contraceptives for only one month at the age of thirty. Physical examination revealed no abnormalities, and laboratory data, including hepatic function tests, were within the normal range, with the exception of elevated levels of those serum proteins induced by the absence of vitamin K or by raised levels of the antagonist (PIVKA)-Ⅱ (3 502 AU/ml).Abdominal ultrasonography revealed a hyperechoic mass measuring 10x10 cm in the left posterior segment of the liver. Because hepatocellular carcinoma could not be completely excluded, this mass was resected. The tumor consisted of sheets of uniform cells with clear cytoplasm,perinuclear eosinophilic granules and round nuclei. These histological findings were consistent with liver cell adenoma.Background hepatic tissue appeared normal. After resection of the tumor, serum PIVKA-Ⅱ fell to within the normal range.An area of hepatocellular carcinoma (HCC) with a midtrabecular pattern was immunohistochemically found, which was positive for PIVKA-Ⅱ. Sinusoidal endothelial cells were CD34-positive, containing scattered PIVKA-Ⅱ positive cells.This tumor was therefore finally diagnosed as liver cell adenoma with focal malignant transformation to HCC.

  7. Differential gene expression by fiber-optic beadarray and pathway in adrenocorticotrophin-secreting pituitary adenomas

    JIANG Zhi-quan; GUI Song-bo; ZHANG Ya-zhuo

    2010-01-01

    Background Adrenocorticotrophin (ACTH)-secreting pituitary adenomas account for approximately 7%-14% of all pituitary adenomas, but its pathogenesis is still enigmatic. This study aimed to explore mechanisms underlying the pathogenesis of ACTH-secreting pituitary adenomas.Methods We used fiber-optic beadarray to examine gene expression in three ACTH-secreting adenomas compared with three normal pituitaries. Four differentially expressed genes from the three ACTH-secreting adenomas and three normal pituitaries were chosen randomly for validation by reverse transcriptase-real time quantitative polymerase chain reaction (RT-qPCR). We then analyzed the differentially expressed gene profile with Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway.Results Fiber-optic beadarray analysis showed that the expression of 28 genes and 8 expressed sequence tags (ESTs)were significantly increased and the expression of 412 genes and 31 ESTs were significantly decreased. Bioinformatic and pathway analysis showed that the genes HIGD1B, EPS8, HPGD, DAPK2, and IGFBP3 and the transforming growth factor (TGF)-β signaling pathway and extracellular matrix (ECM)-receptor interaction pathway may play important roles in tumorigenesis and progression of ACTH-secreting pituitary adenomas.Conclusions Our data suggest that numerous aberrantly expressed genes and several pathways are involved in the pathogenesis of ACTH-secreting pituitary adenomas. Fiber-optic beadarray combined with pathway analysis of differential gene expression appears to be a valid method of investigating tumour pathogenesis.

  8. Identification of an epigenetic biomarker panel with high sensitivity and specificity for colorectal cancer and adenomas

    Lind Guro E

    2011-07-01

    Full Text Available Abstract Background The presence of cancer-specific DNA methylation patterns in epithelial colorectal cells in human feces provides the prospect of a simple, non-invasive screening test for colorectal cancer and its precursor, the adenoma. This study investigates a panel of epigenetic markers for the detection of colorectal cancer and adenomas. Methods Candidate biomarkers were subjected to quantitative methylation analysis in test sets of tissue samples from colorectal cancers, adenomas, and normal colonic mucosa. All findings were verified in independent clinical validation series. A total of 523 human samples were included in the study. Receiver operating characteristic (ROC curve analysis was used to evaluate the performance of the biomarker panel. Results Promoter hypermethylation of the genes CNRIP1, FBN1, INA, MAL, SNCA, and SPG20 was frequent in both colorectal cancers (65-94% and adenomas (35-91%, whereas normal mucosa samples were rarely (0-5% methylated. The combined sensitivity of at least two positives among the six markers was 94% for colorectal cancers and 93% for adenoma samples, with a specificity of 98%. The resulting areas under the ROC curve were 0.984 for cancers and 0.968 for adenomas versus normal mucosa. Conclusions The novel epigenetic marker panel shows very high sensitivity and specificity for both colorectal cancers and adenomas. Our findings suggest this biomarker panel to be highly suitable for early tumor detection.

  9. Discriminatory power of MRI for differentiation of adrenal non-adenomas vs adenomas evaluated by means of ROC analysis: Can biopsy be obviated?

    Slapa, R.Z.; Jakubowski, W.; Krolicki, L. [Department of Imaging, Warsaw Medical School (Poland); Januszewicz, A. [Department of Hypertension, National Institute of Cardiology, Warsaw (Poland); Kasperlik-Zaluska, A.A. [Department of Endocrinology, Center for Postgraduate Medical Education, Warsaw (Poland); Dabrowska, E.; Feltynowski, T. [Department of Hypertension, Warsaw Medical School, Warsaw (Poland); Fijuth, J. [Department of Teleradiotherapy, Institute of Oncology, Warsaw (Poland); Tarnawski, R. [Department of Radiotherapy, Institute of Oncology, Gliwice Branch, Gliwice (Poland)

    2000-01-01

    The purpose of our study was to evaluate the discriminatory power of MRI in high-field magnet (1.5 T) for differentiation of adrenal non-adenomas vs adenomas assessing the following parameters separately and in combination: mean diameter of adrenal mass; previously described and new ratios as well as index calculated from signal intensity (SI) on SE T2-weighted images, chemical shift imaging (CSI), and Gd-DTPA-enhanced dynamic studies. One hundred eight adrenal masses (36 non-hyperfunctioning adenomas, 27 pheochromocytomas, 23 aldosterone-secreting adenomas, 20 malignant masses and 2 cortisol-secreting adenomas) in 95 patients were evaluated with SE sequences, CSI and Gd-DTPA dynamic studies. Indices and ratios of SI for all examined MRI methods were calculated and examined retrospectively for significance of differences between the groups with calculation of sensitivity and specificity. Receiver operating characteristics (ROC) analysis of calculated parameters in combination was performed. The multifactorial analysis of all four parameters, including size of the tumor, T2{sub liver} index, CSI ratio reflecting lipid content in the tumor and Wo{sub max/last} ratio reflecting maximal washout of contrast agent from the tumor had 100 % sensitivity and 100 % specificity in characterization of adrenal non-adenoma. The best performance of combination of mean tumor diameter with single MRI SI parameter was achieved in combination with T2{sub liver} index for all adrenal masses (area under ROC 0.987) and CSI ratio for non-hyperfunctioning adrenal masses (area under ROC 0.991). Magnetic resonance imaging enables sensitive and specific diagnosis of adrenal non-adenoma. (orig.)

  10. Polymorphisms in the adenomatous polyposis coli (APC) gene and advanced colorectal adenoma risk.

    Wong, Hui-Lee; Peters, Ulrike; Hayes, Richard B; Huang, Wen-Yi; Schatzkin, Arthur; Bresalier, Robert S; Velie, Ellen M; Brody, Lawrence C

    2010-09-01

    While germline mutations in the adenomatous polyposis coli (APC) gene cause the hereditary colon cancer syndrome (familial adenomatous polyposis (FAP)), the role of common germline APC variants in sporadic adenomatous polyposis remains unclear. We studied the association of eight APC single nucleotide polymorphisms (SNPs), possibly associated with functional consequences, and previously identified gene-environment (dietary fat intake and hormone replacement therapy (HRT) use) interactions, in relation to advanced colorectal adenoma in 758 cases and 767 sex- and race-matched controls, randomly selected from the screening arm of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Cases had at least one verified advanced adenoma of the distal colon; controls, a negative sigmoidoscopy. We did not observe an association between genotypes for any of the eight APC SNPs and advanced distal adenoma risk (P(global gene-based)=0.92). Frequencies of identified common haplotypes did not differ between cases and controls (P(global haplotype test)=0.97). However, the risk for advanced distal adenoma was threefold higher for one rare haplotype (cases: 2.7%; controls: 1.6%) (odds ratio (OR)=3.27; 95% confidence interval (CI)=1.08-9.88). The genetic association between D1822V and advanced distal adenoma was confined to persons consuming a high-fat diet (P(interaction)=0.03). Similar interactions were not observed with HRT use. In our large, nested case-control study of advanced distal adenoma and clinically verified adenoma-free controls, we observed no association between specific APC SNPs and advanced adenoma. Fat intake modified the APC D1822V-adenoma association, but further studies are warranted.

  11. Measurement of Ki-67 antigen in 159 pituitary adenomas using the MIB-1 monoclonal antibody

    C.B. Pizarro

    2004-02-01

    Full Text Available Pituitary adenomas sometimes show rapid growth and recurrence, and about one third invade the structures surrounding the sella turcica. In an attempt to determine aggressive behavior at an early stage, we used the MIB-1 antibody to identify the Ki-67 antigen. The present study was designed to evaluate pituitary adenomatous tissue in terms of secretion and proliferation and to correlate the Ki-67 index with hormone phenotype and invasive behavior. Material from 159 patients submitted to one or more resections of pituitary adenomas was evaluated. Forty-two non-secretory adenomas and 43 adenomas immunoreactive for growth hormone, 19 for prolactin, 18 for growth hormone and prolactin, 16 for adrenocorticotropic hormone (ACTH, and 21 cases of plurihormonal/gonadotropin adenomas were detected by immunohistochemistry. The MIB-1 antibody was positive in 139 samples and the Ki-67 index ranged from 0.16 to 15.48% (mean = 1.22 ± 2.09%, with no significant difference between genders, age groups, or secretory and non-secretory status. The Ki-67 index was higher in ACTH-secreting adenomas. Invasive pituitary adenomas had a significantly higher Ki-67 index (2.01 ± 3.15% than macroadenomas with or without supra-sellar extension (1.12 ± 1.87%; P = 0.02. The index was not significantly different in the subgroup of adenomas with invasion of the cavernous sinus compared to groups with other types of invasion. We conclude that tumoral proliferative activity evaluated by the detection of the Ki-67 antigen is significantly higher in invasive than noninvasive adenomas, information which can be useful in therapeutic postoperative management since index cut-off values associated with aggressive behavior can be established.

  12. First-pass perfusion computed tomography: Initial experience in differentiating adrenal adenoma from metastasis

    Qiao Zhongwei [Department of Radiology, Rui Jin Hospital, Shanghai Jiao Tong, University School of Medicine, Shanghai 200025 (China); Department of Radiology, Children' s Hospital of Fudan University, Shanghai 201102 (China); Xia Chunmei [Department of Physiology and Pathophysiology, Shanghai Medical, College, Fudan University, Shanghai 200032 (China); Zhu Yanbo; Shi Weiping [Department of Radiology, Rui Jin Hospital, Shanghai Jiao Tong, University School of Medicine, Shanghai 200025 (China); Miao Fei [Department of Radiology, Rui Jin Hospital, Shanghai Jiao Tong, University School of Medicine, Shanghai 200025 (China)], E-mail: fmiao818@gmail.com

    2010-03-15

    Objective: To differentiate adrenal adenoma from metastasis in patients using perfusion computed tomography (PCT) imaging. Methods: Thirty-two patients with adrenal masses underwent first-pass PCT imaging. Of these patients, twenty-one were diagnosed with adrenal adenoma, and the others with metastases. Perfusion maps of blood volume (BV), blood flow (BF), mean transit time (MTT) and permeability surface-area production (PS) were generated with an Advantage Windows workstation using the CT perfusion 3.0 software (General Electric Medical Systems, Milwaukee, WI). Histopathologic sections immunostained for CD34 were quantitatively evaluated for microvessel density (MVD). Results: The perfusion parameters such as BV, BF and PS were statistically significant different between the two groups, with adenomas showing higher mean BV (12.18 versus 3.86), BF (97.51 versus 45.99) and PS (21.73 versus 10.93) compared with metastases (p < 0.05). For BV, a cutoff point of 7.30 was found to have a sensitivity of 95.2% and a specificity of 100% to differentiate between adenoma and metastasis. The sensitivity and specificity were 81.0 and 80.0%, respectively, for BF with a cutoff point of 71.96; and 85.7 and 86.7%, respectively, for PS with a cutoff point of 12.70 to differentiate adenoma and metastasis. A comparison of MVD counts from adenomas with those from metastases showed a significant difference (p < 0.05). However, no significant differences were observed in the four perfusion parameters and MVD between lipid rich and lipid poor adenomas. Conclusion: PCT may be useful for evaluating the neovascularization of adrenal masses and differentiating adenoma from metastasis on the basis of PCT parameters. Adenomas show higher BV, BF and PS compared with metastases. According our data, the optimal threshold BV is 7.30, resulting in a sensitivity of 95.2% and a specificity of 100% for the differentiation of adenoma from metastasis. Adrenal adenomas have similar hemodynamic profiles

  13. Advanced age is a risk factor for proximal adenoma recurrence following colonoscopy and polypectomy

    Pommergaard, H-C; Burcharth, J; Rosenberg, J

    2016-01-01

    BACKGROUND: Knowledge of risk factors for recurrence of colorectal adenomas may identify patients who could benefit from individual surveillance strategies. The aim of this study was to identify risk factors for recurrence of colorectal adenomas in a high-risk population. METHODS: Data were used ...... of inclusion in the study were independent risk factors for recurrence. CONCLUSION: In contrast to current guidelines, advanced age is not a reason to discontinue adenoma surveillance in patients with an anticipated live expectancy in which recurrence can arise....

  14. Endoscopic Endonasal Extended Approaches for the Management of Large Pituitary Adenomas.

    Cappabianca, Paolo; Cavallo, Luigi Maria; de Divitiis, Oreste; de Angelis, Michelangelo; Chiaramonte, Carmela; Solari, Domenico

    2015-07-01

    The management of giant and large pituitary adenomas with wide intracranial extension or infrasellar involvement of nasal and paranasal cavities is a big challenge for neurosurgeons and the best surgical approach indications are still controversial. Endoscopic extended endonasal approaches have been proposed as a new surgical technique for the treatment of such selected pituitary adenomas. Surgical series coming from many centers all around the world are flourishing and results in terms of outcomes and complications seem encouraging. This technique could be considered a valid alternative to the transcranial route for the management of giant and large pituitary adenomas.

  15. Pleomorphic adenoma of the cheek in a child: A case report

    Jagadishkumar, Kalenahalli; Anilkumar, Mathod Ganeshrao; Krishna Kumar, Halasahalli Chowdegowda; Maggad, Rangaswamy

    2014-01-01

    Salivary gland tumors are rare in children and, when they do arise, they mainly affect the major salivary glands. Minor salivary gland tumors are rare in children and are responsible for less than 10% of the cases. Pleomorphic adenoma is the most common tumor of the salivary glands. The most common sites of pleomorphic adenoma of the minor salivary glands are the palates, followed by the lips and the cheeks. Pleomorphic adenoma of the cheek is rare in children and only few cases have been reported so far. PMID:25225569

  16. Pleomorphic adenoma of the cheek in a child: A case report

    Kalenahalli Jagadishkumar

    2014-01-01

    Full Text Available Salivary gland tumors are rare in children and, when they do arise, they mainly affect the major salivary glands. Minor salivary gland tumors are rare in children and are responsible for less than 10% of the cases. Pleomorphic adenoma is the most common tumor of the salivary glands. The most common sites of pleomorphic adenoma of the minor salivary glands are the palates, followed by the lips and the cheeks. Pleomorphic adenoma of the cheek is rare in children and only few cases have been reported so far.

  17. Vulvar lactating adenoma associated to a fibroadenoma: common neoplasms in an uncommon site.

    Dhaoui, Amen; Nfoussi, Haifa; Kchir, Nidhameddine; Haouet, Slim

    2012-01-01

    Ectopic breast tissue is defined as glands located outside of the breast. Ectopic breast tissue should be excised because it may develop benign (fibroadenoma) or malignant pathologic processes. Less than forty cases of fibroadenomas have been reported in the literature. Although lactation changes can occur, lactating adenoma in the vulva are extremely rare. Only four cases have been reported. We report a case of a young woman who presented with vulvar mass during her lactation. The mass was excised, and histology confirmed vulvar lactating adenoma associated with fibroadenoma. This is the first case of vulvar heterotopic breast lesion associating lactating adenoma and fibroadenoma.

  18. Polymorphisms in WNT6 and WNT10A and Colorectal Adenoma Risk

    Galbraith, Rachel L.; Poole, Elizabeth M; Duggan, David; Muehling, Jill; Hsu, Li; Makar, Karen; Xiao, Liren; Potter, John D.; Ulrich, Cornelia M.

    2011-01-01

    The WNT/β-catenin signaling pathway upregulates transcription of genes involved in cell proliferation and cancer progression; it has been implicated in colorectal adenoma formation. To date, no studies have examined polymorphisms in WNT genes or WNT gene–environment interactions in relation to adenoma risk. Within a colonoscopy-based case-control study of 628 adenoma cases and 516 polyp-free controls, we analyzed two tagSNPs in WNT6 (rs6747776 G > C, rs6754599 G > C) and WNT10A (rs7349332 G >...

  19. Aspirin, Calcitriol, and Calcium Do Not Prevent Adenoma Recurrence in a Randomized Controlled Trial

    Pommergaard, Hans Christian; Burcharth, Jakob; Rosenberg, Jacob

    2016-01-01

    BACKGROUND & AIMS: Chemopreventive strategies might be used to reduce the recurrence of colorectal adenomas and the incidence of colorectal cancer. We performed a randomized, double-blind, placebo-controlled trial to determine whether a combination of acetylsalicylic acid (aspirin), calcitriol......, more than 1 adenoma of any size, or an adenoma of any size and first-degree relatives with colorectal cancer. Subjects were assigned randomly to groups given 0.5 μg calcitriol, 75 mg acetylsalicylic acid, and 1250 mg calcium carbonate (n = 209), or placebo (n = 218), each day for 3 years. The primary...

  20. New color images of sprites, halos and gigantic jets from the International Space Station

    Yair, Y.; Rubanenko, L.; Mezuman, K.; Elhalel, G.; Pariente, M.; Glickman-Pariente, M.; Ziv, B.; Takahashi, Y.; Inoue, T.

    2012-12-01

    During July-August 2011, Expedition 28/29 JAXA astronaut Satoshi Furukawa conducted TLE observations from the International Space Station in conjunction with the "Cosmic Shore" program produced by NHK. An EMCCD normal video-rate color TV camera was used to conduct directed observations from the Earth-pointing Copula module. The target selection was based on the methodology developed for the MEIDEX sprite campaign on board the space shuttle Columbia in January 2003 (Ziv et al., 2004). We used the Aviation Weather Center (http://aviationweather.gov) daily significant weather forecast maps (SIGWX) to select regions with high probability for convective activity and thunderstorm such that they were within the camera FOV as deduced from the ISS trajectory and distance to the limb (2240 km). For increasing the chance for successful observations, only storms with predicted "Frequent Cb" and cloud tops above 45 Kft (~14 km) were selected. Additionally, we targeted tropical storms and hurricanes over the oceans. The observation geometry was pre-determined and uploaded daily to the ISS with pointing options to limb, oblique or nadir, based on the predicted location of the storm with regards to the ISS. The pointing angle was rotated in real-time according to visual eyesight by the astronaut. We present results of 10 confirmed TLEs: 8 sprites, 1 sprite halo and 1 gigantic jet, out of displaced form the lightning light and (b) from oblique view of a sprite halo, enable the calculation of dimensions and volumes occupied by these TLEs. Since time stamping on the ISS images was accurate within 1 s, matching with ELF and WWLLN data for the parent lightning location is limited. Nevertheless, the results prove that the ISS is an ideal platform for lightning and TLE observations, and careful operational procedures greatly enhance the value of observation time.;

  1. Giant retroperitoneal lipoma: a case report Lipoma gigante do retroperitônio: relato de caso

    Carlos Augusto Real Martinez

    2003-12-01

    Full Text Available BACKGROUND: Retroperitoneal lipoma is an extremely rare neoplasm. AIMS: The authors report a case of giant retroperitoneal lipoma in a 32-year-old white female, with a history of pain and an abdominal mass over a 2-year period. Total abdominal ultrasonography and barium enema showed a large mass located in the retroperitoneal space behind the ascending colon. Laparotomy showed a large encapsulated tumor measuring 20 x 13 x 10 cm and weighing 3.400 g. The histological study revealed a benign neoplasm of fatty cells. CONCLUSION: The patient remains well 17 years after surgery, without recurrentce of the disease.RACIONAL: O lipoma é a neoplasia mesenquimal mais freqüente, raramente localizada no retroperitônio. Na maioria das vezes, o diagnóstico diferencial pré-operatório com os lipossarcomas de baixo grau de malignidade é difícil de ser estabelecido. OBJETIVO: Apresentar um caso de lipoma gigante retroperitoneal em mulher de 32 anos que há 2 anos apresentava história de dor e tumor abdominal palpável. A ultra-sonografia abdominal e o enema opaco mostraram grande massa localizada no retroperitônio, que deslocava o ceco e o cólon ascendente. A laparotomia mostrou tumor encapsulado com 20 x 13 x 10 cm e 3.400 g de peso. O estudo histopatológico mostrou presença de lipoma retroperitonial. A paciente encontra-se bem, sem recidiva da doença, 17 anos após a cirurgia.

  2. Similarity Analysis of the Streamer Zone of Blue Jets and Gigantic Blue Jets

    Gennady, M.; Popov, N. A.; Shneider, M.

    2015-12-01

    Multiple observations of Blue Jets (BJ) and Gigantic Blue Jets (GBJ) show that BJ emits a fan of streamers similar to a laboratory leader. Moreover, in the exponential atmosphere those long streamers grow preferentially upward, producing a narrow cone confined by the aperture angle. Petrov and Petrova [1999] and Pasko and George [2002] noticed that BJ are similar to the streamer zone of a leader (streamer corona) and conducted modeling studies based on the streamers fractal structure. Objective of this paper is to study the fractal dimension of the bunch of streamer channels emitted by BJ, at different altitude and under the varying reduced electric field. This similarity analysis has been done in three steps: First we described the dendritic structure of streamers in corona discharge applying the fractal theory by Popov [2002]. Then using this model and the data from existing laboratory experiments we obtained that the fractal dimension of the branching streamer channels D=2. We estimated next the packing factor of the streamers using the kinetic simulations that describe development of a group of streamers that propagate in a discharge gap while interact with each other. Finally the model was used to analyze some GBJ images available from the literature. The model output includes evaluation of the total number of streamer channels in the GBJs along with estimates of the aperture angle and of the average distance between the brunches. In addition the analysis allows us to obtain the mean streamer velocity for the studied GBJs and check the velocity against the observations. V.P. Pasko and J.J. George, J. Geophys. Res. 107, 1458, 2002 N.I. Petrov and G.N. Petrova, Tech Phys. Lett., 44, 472, 1999 N.A. Popov, Plasma Phys. Reports, 28, 615, 2002.

  3. Establishment and characterization of pleomorphic adenoma cell systems: an in-vitro demonstration of carcinomas arising secondarily from adenomas in the salivary gland

    Shimizu Yoshiko

    2009-07-01

    Full Text Available Abstract Background Among the salivary gland carcinomas, carcinoma in pleomorphic adenoma has been regarded as a representative carcinoma type which arises secondarily in the background of a pre-existent benign pleomorphic adenoma. It is still poorly understood how and which benign pleomorphic adenoma cells transform into its malignant form, carcinoma ex pleomorphic adenoma. Methods We have established five cell systems from a benign pleomorphic adenoma of the parotid gland of a 61-year-old woman. They were characterized by immunofluorescence, classical cytogenetics, p53 gene mutational analysis, fluorescence in-situ hybridization, and histopathological and immunohistochemical examinations of their xenografts, to demonstrate their potency of secondary transformation. Results We established and characterized five cell systems (designated as SM-AP1 to SM-AP5 from a benign pleomorphic adenoma of the parotid gland. SM-AP1 to SM-AP3 showed polygonal cell shapes while SM-AP4 and SM-AP5 were spindle-shaped. SM-AP1-3 cells were immunopositive for keratin only, indicating their duct-epithelial or squamous cell differentiation, while SM-AP4/5 cells were positive for both keratin and S-100 protein, indicating their myoepithelial cell differentiation. Chromosome analyses showed numeral abnormalities such as 5n ploidies and various kinds of structural abnormalities, such as deletions, translocations, derivatives and isodicentric chromosomes. Among them, der(9t(9;13(p13.3;q12.3 was shared by all five of the cell systems. In addition, they all had a common deletion of the last base G of codon 249 (AGG to AG_ of the p53 gene, which resulted in generation of its nonsense gene product. Transplanted cells in nude mice formed subcutaneous tumors, which had histological features of squamous cell carcinoma with apparent keratinizing tendencies. In addition, they had ductal arrangements or plasmacytoid appearances of tumor cells and myxoid or hyaline stromata

  4. Cisto hidático pulmonar gigante: relato de um caso Giant hydatid lung cyst: a case report

    Roger Klein Moreira

    2001-06-01

    Full Text Available Os autores relatam o caso de um paciente do sexo masculino, com 55 anos de idade, branco, com diagnóstico radiológico e histopatológico pós-cirúrgico de cisto hidático pulmonar gigante. A epidemiologia, fisiopatologia e características radiológicas desta doença são discutidas.The authors report a case of a 55-year-old white male patient with radiological and postsurgical histopathological diagnosis of a giant lung hydatid cyst. The epidemiological, physiopathological and radiological findings of this disease are discussed.

  5. Anemia hemolítica autoinmune en un niño con hepatitis de células gigantes

    Jessica Gómez

    2012-12-01

    Full Text Available La asociación de anemia hemolítica autoinmune (AHAI con hepatitis de células gigantes (HCG es un trastorno raro en la infancia. Son pocos los casos reportados y la gran mayoría fallecen a pesar de transplante hepático. La AHAI usualmente precede el desarrollo de la afección hepática. El diagnóstico temprano de esta asociación y el inicio de terapia inmunosupresora previene la progresión de la enfermedad.

  6. Anemia hemolítica autoinmune en un niño con hepatitis de células gigantes

    Jessica Gómez; Kathia Valverde

    2012-01-01

    La asociación de anemia hemolítica autoinmune (AHAI) con hepatitis de células gigantes (HCG) es un trastorno raro en la infancia. Son pocos los casos reportados y la gran mayoría fallecen a pesar de transplante hepático. La AHAI usualmente precede el desarrollo de la afección hepática. El diagnóstico temprano de esta asociación y el inicio de terapia inmunosupresora previene la progresión de la enfermedad.

  7. Submaxilectomía: causas y complicaciones. Revisión de 160 casos

    Daniel García Molina

    2014-04-01

    Conclusiones: En nuestro centro la causa más frecuente de submaxilectomía la constituyen la sialoadenitis crónica y la sialolitiasis. Las neoplasias más frecuentes son el adenoma pleomorfo y el carcinoma adenoide quístico, en consonancia con diferentes estudios de otros países. Los tumores benignos son más frecuentes, en contraste con otros estudios previos.

  8. Progress in the diagnosis and classification of pituitary adenomas

    Luis V Syro

    2015-06-01

    Full Text Available Pituitary adenomas are common neoplasms. Their classification is based upon size, invasion of adjacent structures, sporadic or familial cases, biochemical activity, clinical manifestations, morphological characteristics, response to treatment and recurrence. Although they are considered benign tumors, some of them are difficult to treat due to their tendency to recur, despite standardized treatment. Functional tumors present other challenges for normalizing their biochemical activity. Novel approaches for early diagnosis as well as different perspectives on classification may help to identify subgroups of patients with similar characteristics, creating opportunities to match each patient with the best personalized treatment option. In this paper we present the progress in the diagnosis and classification of different subgroups of patients with pituitary tumors that may be managed with specific considerations according to their tumor subtype.

  9. A Different Pattern of Brunner Gland Adenoma on Endoscopic Ultrasonography

    Gokhan Aksakal

    2016-01-01

    Full Text Available Brunner gland adenomas (BGA are benign and rare tumors of small intestine. They are seen at a rate of %10.6 of all benign duodenal tumors. Symptoms can be variable and abdominal pain, nausea, vomiting, hematemesis and melena can be seen in some cases. Diagnosis is difficult with mucosal biopsies, becasue of the location in submucosa and generally made by endoscopic resection material. It should be distinguished from lipoma, leiyomyoma, neurogenic and carcinoid tumors through endoscopic and radiologic methods. Endosonography (EUS is helpful for diagnosis due to detection of  originate from which layer of duodenum wall, echogenity and tissue homogeneity of lesion. In this article, we reported a BGA located with EUS and resected with endoscopic polypectomy. BGA was reported before as generally heterogeneus-hypoechoic and characterised with cystic areas, however, in our case, BGA was detected as a different echo pattern on EUS.

  10. Laparoscope resection of ectopic corticosteroid-secreting adrenal adenoma.

    Wang, Xian-Ling; Dou, Jing-Tao; Gao, Jiang-Ping; Zhong, Wen-Wen; Jin, Du; Hui, Lüzhao; Lu, Ju-Ming; Mu, Yi-Ming

    2012-01-01

    Tumors originating from ectopic adrenal tissue are relatively rare. In this article, we describe a case with Cushing's syndrome caused by an ectopic adrenal adenoma. A 38 year-old male patient presenting with cushingoid appearance for 2 years was diagnosed to have ACTH-independent Cushing's syndrome based on endocrinological evaluation. Mutiple radiological examinations detected bilateral adrenal atrophy. When the images were investigated in a more expanded scope, a 3.0×3.5×5.3 cm mass was detected in the anterior of left renal hilum and left renal vein. The mass was successfully resected with intraoperative endoscopy and pathological evaluation revealed an ectopic adrenal tumor. It is suggested that when the endocrinlogically confirmed adrenal neoplasm could not be well and definitely localized, the possibility of ectopic adrenal should be presumed and further radiography examinations should extend to the field where ectopic adrenal usually presents.

  11. Simple mucin-type carbohydrate antigens in pleomorphic adenomas

    Therkildsen, M H; Mandel, U; Christensen, M

    1993-01-01

    Simple mucin-type carbohydrate structures, T, Tn and sialosyl-Tn, are regarded as general markers of carcinomas in several epithelial tissues as a result of incomplete synthesis with precursor accumulation. The structures have a very limited distribution in normal tissues and secretions, including...... saliva and salivary glands. The expression of simple mucin-type carbohydrate structures and ABH(O) variants was studied in paraffin-embedded and frozen tissue sections from 37 pleomorphic adenomas with associated normal parotid tissue, using immunohistology and a panel of MAbs with well......-defined specificity for T, Tn, sialosyl-Tn, and blood group H and A variants hereof. The immature Tn and sialosyl-Tn antigen structures were expressed in the epithelial ductular structures of the tumors, whereas they were almost absent from normal parotid tissue, indicating aberrant glycosylation with accumulation...

  12. Recurrence of chromophobe pituitary adenomas after operation and postoperative radiotherapy

    Salmi, J.; Pelkonen, R. (Third Department of Medicine, University of Helsinki, Finland); Grahne, B. (Department of Otorhinolaryngology, University oF Helsinki, finland); Valtonen, S. (Department of Neurosurgery, University of Helsinki, Finland)

    1982-01-01

    The rate of recurrence is reported in a prospective study of 56 patients (28 men, 28 women) with large chromophobe pituitary adenoma (with or without hyperprolactinemia). The surgical approach was transfrontal in 44 and transseptospehnoidal in 12 patients. Cryoapplication was combined with the transsphenoidal operation. All but one patient received postopertive pituitary irradiation. Altogether, 11 (20 %) clinical relapses (10 men) occurred between 0.5 and 6 years after the transfrontal operation. Patients that relapsed had had larger tumors than those remaining in remission. Occurence of the tumors appeared with a deterioration of the visual field defect in 9 patients. There were no differences in the degrees of hypopituitarism in patients who relapsed as compared to patients remaining in remission.

  13. Molecular cytogenetics of pituitary adenomas, assessed by FISH technique.

    Kontogeorgos, George

    2004-01-01

    Fluorescent in situ hybridization (FISH) represents a moden molecular pathology technique, alternative to conventional cytogenetics (karyotyping). In addition to metaphase spreads, it can be applied directly to interphase nuclei. The latter makes the FISH technique powerful for pathologists for it integrates molecular genetics and classic cytogenetics and brings them together to a single framework for morphologic evaluation. Interphase FISH can be applied to imprints from fresh tissue or to paraffin sections after proteinase K digestion. Centromeric, telomeric and locus DNA-sequence specific probes can be used to identify aneuploidy or gene mutations. Several protocols combine molecular cytogenetics with classic karyotyping. Other sophisticated, FISH-based protocols have been introduced. Among them, comparative genomic hybridization is very important for it can detect non-balanced chromosomal aberrations of uncultured tumor cells and provide overall genomic information in a single experiment. This review presents the principles and applications of FISH technique for the investigation of the cytogenetic background of pituitary adenomas.

  14. Crystalline structures in human pancreatic beta cell adenoma.

    Mori, H; Kawai, T; Tanaka, T; Fujii, M; Takahashi, M; Miyashita, T

    1978-05-01

    An electron microscopic observation on a pancreatic tumor removed from a 34-year-old woman revealed the fine structural morphology of a functional beta cell adenoma. Characteristic PAS positive crystalline structures were frequently observed in the cytoplasm of the tumor cells. They were not bounded by a membrane and had a rectangular or irregular hexagonal shape. Highly regular patterns were seen as such as lattice or honeycomb and parallel ripple structures. They are similar to the Reinke's crystal or crystalline structures reported in human hepatocytes suffering from several different diseases and considered as a protein-carbohydrate complex. Occasionally, small paracrystalline structures appeared to indicate an immature type of these structures in the opaque fine fibrillar mass. Crystalline or paracrystalline structures were not detected in the normal pancreatic tissue removed with the tumor from the patient.

  15. Análisis de un registro de adenomas pituitarios

    Carolina Albiero

    2010-10-01

    Full Text Available Dada la complejidad que reviste el enfoque diagnóstico y terapéutico de los tumores pituitarios, el registro y análisis de la experiencia clínica acumulada es de gran ayuda en la toma de decisiones. En este trabajo se informan datos clínico-terapéuticos, extraídos de un registro computarizado, sobre 519 de un total de 670 pacientes con adenomas pituitarios. Trescientos cuarenta y cinco fueron mujeres (66% y 174 varones (34%, de 14 a 80 años de edad. El diagnóstico final fue: acromegalia en 176, enfermedad de Cushing en 153, prolactinoma en 101 y adenoma clínicamente no-funcionante (ANF en 89. La edad media al momento del diagnóstico de acromegalia fue 43.9 ± 13.5 (16-80, para enfermedad de Cushing 35.7 ± 12.9 (14-72, para prolactinomas 30.0 ± 13.4 (15-79 y para ANF 52.1 ± 15.2 (17-79 años. La creación de un registro institucional de tumores de hipófisis es un instrumento de gran utilidad para el análisis de la experiencia adquirida y constituye una herramienta valiosa para mejorar la estrategia terapéutica, optimizar la relación costo/beneficio y mejorar el cuidado del paciente. Contribuye a la docencia médica, tanto en el pre como en el posgrado y da base a la realización de trabajos de investigación clínica, aportando a la difusión y transferencia de conocimientos.

  16. Temozolomide therapy in patients with aggressive pituitary adenomas or carcinomas.

    Losa, Marco; Bogazzi, Fausto; Cannavo, Salvo; Ceccato, Filippo; Curtò, Lorenzo; De Marinis, Laura; Iacovazzo, Donato; Lombardi, Giuseppe; Mantovani, Giovanna; Mazza, Elena; Minniti, Giuseppe; Nizzoli, Maurizio; Reni, Michele; Scaroni, Carla

    2016-02-01

    Temozolomide is effective in some patients with progressive pituitary adenoma or carcinoma. We report a survey study of Italian patients treated with Temozolomide because of aggressive pituitary adenoma or carcinoma resistant to standard therapies. Italian endocrinologists were surveyed and asked to participate into the study. A questionnaire was sent to all those who agreed and had used Temozolomide in at least one patient with pituitary tumor. Database was closed in December 2013. A literature review was also performed. Thirty-one patients were included into the analysis. Mean age at start of Temozolomide treatment was 58.3 ± 1.9 years (± standard error). Six of the 31 (19.4%) Italian patients had a pituitary carcinoma. Twenty-five patients (80.6%) had disease control during Temozolomide treatment, while 6 patients (19.4%) had disease progression. Median follow-up after beginning Temozolomide was 43 months. Thirteen patients had tumor growth after stopping Temozolomide. The 2-year progression-free survival was 47.7% (95% CI 29.5-65.9%), while the 2-year disease control duration was 59.1% (95% CI 39.1-79.1%). Eleven patients died of progressive disease and other two patients of unrelated causes. The 2-year and 4-year overall survival rates were 83.9% (95% CI 70.7-97.1%) and 59.6% (95% CI 40.0-79.2%), respectively. Temozolomide is an additional effective therapeutic option for the treatment of aggressive pituitary tumors. The drug is well tolerated and causes few severe adverse effects. Recurrence of the tumor can occur after an initial positive response and usually portends a grim outcome.

  17. Frequency of coexistent carcinoma in sessile serrated adenoma/polyps and traditional serrated adenomas removed by endoscopic resection

    Saiki, Hirotsugu; Nishida, Tsutomu; Yamamoto, Masashi; Hayashi, Shiro; Shimakoshi, Hiromi; Shimoda, Akiyoshi; Amano, Takahiro; Sakamoto, Aisa; Otake, Yuriko; Sugimoto, Aya; Takahashi, Kei; Mukai, Kaori; Matsubara, Tokuhiro; Nakajima, Sachiko; Fukui, Koji; Inada, Masami; Yamamoto, Katsumi; Tokuda, Ryozo; Adachi, Shiro

    2016-01-01

    Background and study aims: Sessile serrated adenoma/polyps (SSA/Ps) have a different potential than traditional adenomatous polyps for developing into malignant colorectal cancer. However, little is known about the coexistent cancer rate. Here, we evaluate the frequency of carcinoma in serrated polyps removed by endoscopic resection (ER). Patients and methods: This was a retrospective single-center cohort study of consecutive patients with colorectal polyps who underwent ER from March 2003 to October 2014. We determined the frequency of serrated polyps among all resected colorectal polyps and analyzed the clinicopathological findings as well as the frequency and characteristics of coexistent carcinoma in the serrated polyps resected by ER based on pathology reports. Results: A total of 21,048 polyps from 15,326 patients were identified, including 15,984 traditional adenomatous polyps (75.9 %), 621 SSA/Ps (3.0 %), 136 traditional serrated adenomas (TSAs) (0.6 %), 1,121 hyperplastic polyps (5.3 %), and 3,186 polyps of other types (15.1 %). The clinical and endoscopic findings of SSA/Ps revealed a male predominance (68.6 %), with 61.7 % of the polyps located in the proximal colon. Males accounted for 77.2 % of all patients with TSAs, and 77.2 % of these polyps were located in the distal colon. The mean sizes of the SSA/Ps and TSAs were 8.8 and 10.7 mm, respectively. Among the SSA/Ps, 8 (1.3 %) cases had coexistent carcinoma, and 1 (0.7 %) patient with TSA showed coexistent carcinoma. In the patients with SSA/Ps, female sex and a tumor size ≥ 10 mm were predictive factors for coexistent carcinoma. Conclusions: The frequency of SSA/Ps with carcinoma was lower than that for traditional adenoma. Female sex and tumor size ≥ 10 mm were significant predictive factors for coexistent carcinoma. PMID:27092327

  18. El maíz blanco gigante Cusco, una propuesta estratégica para su exportación a España

    2007-01-01

    El maíz blanco gigante Cusco es una variedad representativa del maíz amiláceo, cuyas características principales son su singular tamaño (15 mm), su forma (plano circular) y su rendimiento. Su cultivo se ubica de manera exclusiva en el Valle Sagrado de los Incas (Cusco), lo que le ha permitido la obtención de la denominación de origen. La tesis ha delineado un conjunto de estrategias orientadas a desarrollar la oferta exportable del maíz blanco gigante Cusco hacia el mercado español como...

  19. Identification of a subtype-specific ENC1 gene related to invasiveness in human pituitary null cell adenoma and oncocytomas.

    Feng, Jie; Hong, Lichuan; Wu, Yonggang; Li, Chuzhong; Wan, Hong; Li, Guilin; Sun, Yilin; Yu, Shenyuan; Chittiboina, Prashant; Montgomery, Blake; Zhuang, Zhengping; Zhang, Yazhuo

    2014-09-01

    Non-functioning pituitary adenomas (NFPAs) may be locally invasive. Surgery is a treatment option, but unlike the case for functional pituitary adenomas, there are almost no drug treatments available for NFPAs. Markers of invasiveness are needed to guide therapeutic decision-making and identify potential adjuvant drugs. Owing to the highly heterogeneous nature of NFPAs, little is known regarding the subtype-specific gene expression profiles associated with invasiveness. To identify important biomarkers of invasiveness, we selected 23 null cell adenomas and 20 oncocytomas. These tumors were classified as invasive or non-invasive adenomas based on magnetic resonance imaging, pathology slides and surgical findings. Firstly, we observed that there were significant differences in expression between invasive (n = 3) and non-invasive (n = 4) adenomas by gene expression microarray. A total of 1,188 genes were differentially expressed in the invasive and non-invasive adenomas. Among these 1,188 genes, 578 were upregulated and 610 were downregulated in invasive adenomas. Secondly, the expression of ENC1, which displayed the significant alterations, was further confirmed by qRT-PCR and Western blot analysis in all 43 tumor samples and three normal pituitary glands. Low levels of ENC1 were found in tumor samples, while high levels were detected in normal pituitary glands. Interestingly, the ENC1 expression level was low in invasive null cell adenomas compared with non-invasive adenomas, but this relationship was not observed in invasive oncocytomas. Immunohistochemistry also demonstrated that the staining of ENC1 was different between invasive and non-invasive null cell adenomas. In addition, bioinformatics studies, including gene ontology and protein interaction analyses, were also performed to better understand the critical role of ENC1 in the development and progression of null cell adenomas and oncocytomas. Consequently, ENC1 may be an important biomarker for null cell

  20. Endoscopic mucosal resection of flat and sessile colorectal adenomas: Our experience with long-term follow-ups

    Grgov Saša

    2014-01-01

    Full Text Available Bacground/Aim. Endoscopic mucosal resection (EMR or mucosectomy is a removing method of flat or sessile lesions, laterally spreading tumors and carcinoma of the colon or the rectum limited to mucosa or the surface part of the submucosa. The aim of the study was to estimate the efficacy and safety of EMR in removing flat and sessile colorectal adenomas. Methods. This prospective study involved 140 patients during the period of 8 years. A total of 187 colorectal adenomas were removed using the EMR method “inject and cut with snare”. Results. The approximate size of mucosectomised adenomas was 13.6 mm (from 8 mm to 60 mm. There was a total of 48 (25.7% flat adenomas and 139 (74.3% sessile adenomas, (p < 0.01. Using “en bloc” and “piecemeal” resection, 173 (92.5% and 14 (7.5% of colorectal adenomas were removed, respectively. In all the cases, a complete removal of colorectal adenomas was achieved. Two (1.4% patients had adenoma removal with intramucosal carcinoma each. In the average follow-up period of 21.2 ± 17.8 months, 2 (1.4% patients had adenoma relapse after EMR. Considering complications, there was bleeding in 1 (0.7% patient with a big rectum adenoma removed with EMR. Furthermore, one (0.7% patient had a postcoagulation syndrome after cecal adenoma was removed by EMR. Conclusion. EMR is an efficient, safe and minimally invasive technique of removing flat and sessile adenomas in the colon and the rectum, with a very low percentage of adenoma recurrence over a long period of monitoring.

  1. Magnetic resonance imaging of the pituitary adenoma: Analysis of the enhancement patterns

    Yang, Ik; Choi, Woo Suk; Shin, In Soo; Ryu, Kyung Nam; Yoon, Yup [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1993-11-15

    The magnetic resonance images (MRI) of 30 patients with surgically or biochemically confirmed pituitary adenomas (20 macroadenomas, 10 microadenomas) were retrospectively evaluated. Ten patients had hyperprolactinaemia, another eight had acromegaly, another eight had nonfunctioning adenoma and four had cushing disease. The examinations were performed at a1.5 T superconducting MR system using a multisection spin-echo technique with 3 mm thick sections and a 256 X 224 matrix. TI weighted sagittal and coronal images were obtained before and within 30 minutes after the administration of Gd-DTPA (0.1 mmol/kg). Analysis of the MRI was focused on the signal intensity and enhancement patterns of the pituitary adenoma before and after Gd-DTPA administration. Compared with endocrinological diagnosis, macroadenoma showed heterogeneous enhancement in 55%, rim enhancement in 35% and homogeneous enhancement in 10%. Conclusively, the enhancement patterns of the pituitary adenoma did not correlate with the subtypes made according to hormone production.

  2. Basal cell adenoma of the parotid gland. Case report and review of the literature.

    González-García, Raúl; Nam-Cha, Syong H; Muñoz-Guerra, Mario F; Gamallo-Amat, C

    2006-03-01

    Basal cell adenoma of the salivary glands is an uncommon type of monomorphous adenoma. Its most frequent location is the parotid gland. It usually appears as a firm and mobile slow-growing mass. Histologically, isomorphic cells in nests and interlaced trabecules with a prominent basal membrane are observed. It is also characterized by the presence of a slack and hyaline stroma and the absence of myxoid or condroid stroma. In contrast to pleomorphic adenoma, it tends to be multiple and its recurrence rate after surgical excision is high. Due to prognostic implications, differential diagnosis with basal cell adenocarcinoma, adenoid cystic carcinoma and basaloid squamous cell carcinoma is mandatory. We describe a case of basal cell adenoma of the parotid gland. We also review the literature and discuss the diagnosis and management of this rare entity.

  3. Carcinoma ex pleomorphic adenoma originating from ectopic salivary gland in the neck region: case report

    Vayısoğlu, Yusuf; Arpaci, Rabia Bozdogan; Eti, Can; Pütürgeli, Tuğçe; Gorur, Kemal; Ozcan, Cengiz

    2015-01-01

    Carcinoma ex pleomorphic adenoma (CEPA) is the malignant salivary gland tumor originating from primary (de novo) or recurrent pleomorphic adenoma. Although parotid gland is the most common site, it can also be seen in submandibular gland or minor salivary glands. It can be seen rarely in head and neck region, such as oral cavity, trachea, nasal cavity and lacrimal gland. Although pleomorphic adenoma cases originating from ectopic salivary gland tissue in the neck region are present in the English literature, there is no published pleomorphic adenoma ex carcinoma case. In this case report we presented a CEPA as a 7.5 cm long neck mass in a 72-year-old woman originating from the submandibular region apart from submandibular gland. Difficulties in diagnosis and way to appropriate treatment are discussed with current literature. PMID:26645012

  4. Parathyroid Adenoma Located on Anterior Mediastinum and Hungry Bone Syndrome ; Case Report

    Ali Celik

    2013-10-01

    Full Text Available   Anterior mediastinum is a rare localization for ectopic parathyroid adenoma. This localization seen about 1-2 % in the patient that looked for primary  ypherparathyroidism etiology. On a 33 - years old male patient who had searched for primary   perparathyroidism etiology, an anterior mediastinal lesion which referred to be an ectopic parathyroid adenoma was detected via Tc-99m MIBI. After, total mass excision was performed via sternotomy, pathologic examination reported as parathyroid adenoma. In early postoperative period, hungry bone syndrome was occured. After treatment, the patient whose clinic and laboratory results was normal discharged uneventful. The ectopic paratroid adenomas and their surgical  options and postoperative management has reviewed with literature knowladge  due to this case.

  5. Infiltrating adenocarcinoma arising in a villous adenoma of the anal canal

    Marni Colvin; Aris Delis; Erika Bracamonte; Hugo Villar; Luis R Leon Jr

    2009-01-01

    Primary neoplasms arising in the anal canal are relatively unusual. In particular, adenomas and adenocarcinomas are distinctly rare entities in this region. We describe an infiltrating, well-differentiated adenocarcinoma arising in a villous adenoma from the distal anal canal, in an otherwise healthy patient at low risk for gastrointestinal malignancy. This is the case of an octogenarian man with a several year history of hemorrhoids and intermittent rectal bleeding, more recently complaining of continuous hematochezia. Examination revealed a blood-covered pedunculated mass with a long stalk protruding from the anus. The lesion was amputated at the bedside. Microscopic evaluation revealed an infiltrating well-differentiated adenocarcinoma, arising from a villous adenoma. This was further evaluated under anesthesia and complete excision of distal anal tissue was performed. Our report is the first describing the possible malignant degeneration of a villous adenoma in the anal canal.

  6. [The expression of keratins Nos. 8, 17 and vimentin in pleomorphic adenoma of the salivary glands].

    Gel'shteĭn, V I; Chipysheva, T A; Ermilova, V D; Bannikov, G A

    1989-01-01

    In the normal salivary gland, the monoclonal antibody to keratin 8 immuno-morphologically identifies the epithelium that covers acini and ducts. The monoclonal antibodies to keratin 17 and vimentin detect normal myoepithelium. The two keratins are found both in the epithelioid and mesenchyma-like components of pleomorphic adenoma, suggesting a single epithelial nature of this tumor. In all the morphological components of the pleomorphic adenoma, there are cells that combine protein expression of intermediate filaments normally labelling different cell subpopulations. This fact provides support for the hypothesis that the pleomorphic adenoma originates from bipotent precursor cells. A particular phenotype of pleomorphic adenoma elements is realized under the control of the local density of cells and microenvironment, as a result of which the cells expressing vimentin predominate in the mesenchymal component, keratin 8 in the epithelial tubular one.

  7. A randomized trial on folic acid supplementation and risk of recurrent colorectal adenoma

    Background: Evidence from observational studies suggests that inadequate folate status enhances colorectal carcinogenesis, but results from some randomized trials do not support this hypothesis. Objective: To assess the effect of folic acid supplementation on recurrent colorectal adenoma, we conduc...

  8. Treatment of Aggressive Prolactin-Secreting Pituitary Adenomas with Adjuvant Temozolomide Chemotherapy: A Review.

    Moisi, Marc; Cruz, Aurora S; Benkers, Tara; Rostad, Steven; Broyles, Frances Broyles; Yuen, Kevin; Mayberg, Marc

    2016-01-01

    Most prolactin-secreting pituitary adenomas demonstrate slow growth and are effectively managed with medical/surgical therapy. Rarely, these tumors can behave aggressively with rapid growth and invasion of local tissues, and are refractory to medical, surgical, or radio-surgical therapies. We report a case of a prolactin-secreting adenoma in a young woman, which became progressively aggressive and refractory to usual treatment modalities, but responded to treatment with the chemotherapeutic agent temozolomide. In addition, we review the literature for treatment of refractory adenomas with temozolomide. The clinical and pathologic characteristics of aggressive prolactin-secreting adenomas are reviewed, as well as their response to dopamine agonists, surgery, radiotherapy, and chemotherapy.

  9. Pigmented hepatocellular adenoma with complete CD34 immunostaining pattern: A diagnostic dilemma

    Mukul Vij

    2012-01-01

    Full Text Available WHO defines hepatocellular adenoma (HCA as a benign tumor composed of cells closely resembling normal hepatocytes, which are arranged in plates separated by sinusoids. It is more common in women. The present concerns a 41 years female who was found to have a mass lesion in liver on ultrasound while undergoing routine evaluation for dyspepsia. Computed tomography scan of abdomen showed 10 × 8 cm lesion in liver. Extended left hepatectomy was performed. Grossly hepatic cut surface showed circumscribed tumor with dark gray or black color. Microscopy revealed hepatocellular adenoma with abundant Dubin Johnson like pigment deposition. CD34 immunostaining showed complete sinusoidal pattern. We labeled the tumor as pigmented hepatic adenoma with complete CD34 staining pattern. To the best of author′s knowledge only eight cases of pigmented hepatocellular adenoma are described in world literature.

  10. Transsphenoidal approach for pituitary adenomas in patients with McCune-Albright syndrome.

    Dou, Wanchen; Di, Xiao; Wang, Renzhi; Zhu, Huijuan; Yao, Yong; Deng, Kan; Feng, Ming; Li, Guilin; Wei, Junji

    2013-06-01

    The feasibility of transsphenoidal approach under a guidance of neuronavigation was explored to remove pituitary adenomas for patients with McCune-Albright syndrome (MAS). From August, 2008 to July, 2010, there were 5 patients diagnosed with MAS associated with a pituitary adenoma in our department of Peking Union Medical College Hospital. All the patients underwent transsphenoidal surgery for the removal of pituitary adenomas with the assistant of neuronavigation and all the procedures went uneventfully. Four of the five patients have got cured radiologically by imaging and 3 of them have got cured based on endocrinological criteria. Transsphenoidal approach under the neuronavigational guidance is a safe and effective management for the MAS patients with pituitary adenomas.

  11. Adenoma of nonpigmented epithelium in ciliary body:literature review and case report

    2007-01-01

    Adenomas of the nonpigmented ciliary epithelium (NPCE) are often clinically indistinguishable from amelanotic malignant melanomas of the ciliary body or metastatic carcinomas. This paper reports a case study of a distinctive variant of adenoma of the NPCE, which clinically appears as epiretinal membrane in the macular region. Histopathologic studies have revealed this is an adenoma of the NPCE. Identification of this clinic feature is important because it will miss the diagnosis of the adenoma of the NPCE. In this case study, B-scan ultrasonography as well as computerized tomography (CT) has been used to provide help in diagnosing the ciliary body tumor. Because of their anterior location in the ciliary body, partial lamellar sclerouvectomy is an effective method of treatment.

  12. Brunner's gland adenoma of duodenum:A case report and literature review

    Yu-Ping Gao; Jian-Shan Zhu; Wen-Jun Zheng

    2004-01-01

    AIM: To analyze the clinicopathological features of Brunner's gland adenoma of the duodenum.METHODS: A rare case of Brunner's gland adenoma of the duodenum was described and related literature was reviewed.RESULTS: Brunner's gland adenoma of the duodenum appeared to be nodular hyperplasia of the normal Brunner's gland with an unusual admixture of normal tissues, including ducts, adipose tissue and lymphoid tissue. We suggested that it might be designated as a duodenal hamartoma rather than a true neoplasm.CONCLUSION: The most common location of the lesion is the posterior wall of the duodenum near the junction of its first and second portions. It can result in gastrointestinal hemorrhage and duodenal obstruction. Endoscopic polypectomy is a worthy treatment for benign Brunner's gland adenomas,as malignant changes in these tumors have never been proven.

  13. McCune-Albright syndrome combined with gigantism: clinical characteristics and long-term follow-up%McCune-Albright综合征伴巨人症临床特点及长期随访研究

    许岭翎; 朱惠娟; 李梅; 王鸥; 姜艳; 张化冰; 柴晓峰; 冯凯; 李乃适

    2014-01-01

    Objective To investigate the clinical characteristics,causes of disease and responses to treatment in McCuneAlbright syndrome patients combined with gigantism.Methods Long-term follow-up were performed on two cases of McCune-Albright syndrome combined with gigantism,and in combination with literatures the clinical characteristics were analyzed and discussed.Results Both patients underwent neuronavigator assisted transsphenoidal resection of pituitary tumor.After operation,the levels of GH and IGF-1 were significantly decreased.In case 2,GH and IGF-1 levels returned to normal without recurrence during 3-year follow-up.In case 1,treatment of bromocriptine and long-acting somatostatin were performed;growth was notably inhibited and the levels of GH and IGF-1 were significantly decreased.Both patients received bisphosphonate therapy,and bone lesion progression was effectively controlled.Both patients were diagnosed with hypogonadism at the follow-up.Conclusion Treatment of this disease is a long procedure.Clinician should select individualized and comprehensive treatment measures according to the characteristics of patients.Neuronavigation in transsphenoidal resection of pituitary adenoma operation,long-acting somatostatin and bisphosphonate therapy are important measures to control the disease.%目的 探讨伴有巨人症的McCune-Albright综合征患者的临床特点、病程以及对治疗的反应.方法 长期随访北京协和医院收治的2例伴有巨人症的McCune-Albright综合征患者的临床治疗及实验室检查情况.结果 2例患者均接受了神经导航下经蝶入路垂体瘤切除手术,术后生长激素(GH)、胰岛素样生长因子-1(IGF-1)均明显下降,其中例2完全降至正常,随诊3年未见垂体瘤复发迹象;例1术后接受了溴隐亭和长效生长抑素的治疗,生长速度明显降低,GH和IGF-1下降.2例患者均接受了双膦酸盐治疗,骨骼病变进展均得到了有效控制.2例患者均在病程中出现

  14. Immunohistochemical detection of estrogen receptor alpha in pituitary adenomas and its correlation with cellular replication.

    Pereira-Lima, Julia F S; Marroni, Caroline P; Pizarro, Cristina B; Barbosa-Coutinho, Ligia M; Ferreira, Nelson P; Oliveira, Miriam C

    2004-03-01

    With the aim of evaluating the relationship between pituitary tumorigenesis and the presence of estrogen receptor-alpha (ERalpha) by immunohistochemistry (IH) and their relevance to patients' clinical presentation, hormonal phenotypes of adenomas, preoperative neuroimaging findings, and the index of cellular replication MIB-1, a study was conducted with material from 91 women and 67 men with pituitary adenomas. The patients had acromegaly (29.7%), Cushing's disease (14.6%), hyperprolactinemic syndrome (20.9%), and clinically nonfunctioning tumors (34.8%). Of the patients, 14.6% had microadenomas, 52.5% had macroadenomas with or without suprasellar growth, 28.5% had invasive macroadenomas and in 4.4% the adenoma was not visualized. IH showed that 43 were positive for growth hormone (GH), 16 for corticotropin (ACTH), 18 for prolactin (PRL), 18 for PRL+GH, 6 for luteinizing hormone (LH) and follicle-stimulating hormone (FSH), 15 had a plurihormonal reaction, and 42 had nonfunctioning adenomas. The presence of ERalpha was positive in 9/158 adenomas with a median value for the percentage of labeled cells of 42.89%, and in 6/16 controls (autopsy samples) with a median value for the percentage of labeled cells of 0.024%. ERalpha was significantly more prevalent in controls than in patients with adenomas (37.5 versus 5.7%; p = 0.001); however, the mean ERalpha concentration in adenomas was significantly greater than in controls (42.89 versus 0.024%; p < 0.001). No significant difference in the concentration of ERalpha was found across the clinical presentations, hormonal phenotypes or findings of preoperative CT. Among the ERalpha-positive adenomas, ERalpha values were significantly greater in invasive macroadenomas (80%) than in microadenomas (3.33%). MIB-1 values did not differ significantly between ERalpha-positive and -negative adenomas, nor did the correlation between ERalpha values and the MIB-1 index attain significance in the total sample, even when only ERalpha

  15. Sonography of intrathyroid parathyroid adenomas: Are there distinctive features that allow for preoperative identification?

    Heller, Matthew T., E-mail: hellermt@upmc.edu [University of Pittsburgh Medical Center, Department of Radiology, 200 Lothrop St, Suite 3950 PUH S. Tower, Pittsburgh, PA 15213 (United States); Yip, Linwah, E-mail: yipl@upmc.edu [University of Pittsburgh Medical Center, Department of Endocrine Surgery, Kaufmann Building, 3471 Fifth Ave, Suite 101, Pittsburgh, PA 15213 (United States); Tublin, Mitchell E., E-mail: tublme@upmc.edu [University of Pittsburgh Medical Center, Department of Radiology, 200 Lothrop St, Suite 3950 PUH S. Tower, Pittsburgh, PA 15213 (United States)

    2013-01-15

    Objective: The purpose of our study was to determine if intra-thyroid parathyroid adenomas can be accurately identified by applying proposed criteria to preoperative ultrasound examinations in patients with primary hyperparathyroidism. Materials/methods: Fifty-three patients with pathology proven intra-thyroid parathyroid adenomas and pre-operative ultrasounds were identified from a surgical database for a blinded, retrospective review. A contemporary, age-matched cohort of 54 patients with extra-thyroid parathyroid adenomas was identified as a control. A total of 64 patients within these cohorts had co-existing thyroid nodules. Proposed ultrasound criteria for identifying a parathyroid adenoma included solid composition, profound hypoechogenicity, and presence of a feeding polar vessel. Parathyroid adenomas were classified as extra-thyroid or intra-thyroid (partial or complete) based on their relationship with the thyroid gland during ultrasound evaluation and results were compared to surgical and histopathology reports as the gold standard. The results from the blinded, retrospective review during which the proposed, specific ultrasound criteria were applied were compared to the initial, pre-operative reports during which the proposed criteria were not applied. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the blinded, retrospective review and initial, pre-operative reports were calculated. Additionally, in patients with co-existing thyroid nodules, an attempt was made to differentiate parathyroid adenomas from the thyroid nodules. Results: Application of the proposed ultrasound criteria during blinded retrospective review yielded a sensitivity and specificity for detecting intra-thyroid parathyroid adenomas of 76% and 92%, respectively. The sensitivity and specificity of ultrasound for detecting intra-thyroid parathyroid adenomas on the initial reports was 29% and 95%, respectively. The sensitivity and

  16. AMACR is associated with advanced pathologic risk factors in sporadic colorectal adenomas

    Sotiris; Lakis; Theodora; Papamitsou; Constantina; Pana

    2010-01-01

    AIM: To analyze α-methylacyl CoA racemase (AMACR) expression in relation to various dysplasia phenotypes and clinicopathological parameters of sporadic colorectal adenomas.METHODS: Fifty-f ive cases of sporadic colorectal adenomas were categorized according to the Vienna classif ication for Gastrointestinal Neoplasia.These corresponded to a total of 98 different intra-lesion microscopic f ields that were further independently assigned a histological grade based on the old nomenclature (mild,moderate,severe ...

  17. Advancing Treatment of Pituitary Adenomas through Targeted Molecular Therapies: The Acromegaly & Cushing Disease Paradigms

    Michael Anthony Mooney

    2016-07-01

    Full Text Available The current treatment of pituitary adenomas requires a balance of conservative management, surgical resection, and in select tumor types, molecular therapy. Acromegaly treatment is an evolving field where our understanding of molecular targets and drug therapies has improved treatment options for patients with excess growth hormone levels. We highlight the use of molecular therapies in this disease process and advances in this field, which may represent a paradigm shift for the future of pituitary adenoma treatment.

  18. Advancing Treatment of Pituitary Adenomas through Targeted Molecular Therapies: The Acromegaly and Cushing Disease Paradigms

    Mooney, Michael A.; Simon, Elias D.; Little, Andrew S.

    2016-01-01

    The current treatment of pituitary adenomas requires a balance of conservative management, surgical resection, and in select tumor types, molecular therapy. Acromegaly treatment is an evolving field where our understanding of molecular targets and drug therapies has improved treatment options for patients with excess growth hormone levels. We highlight the use of molecular therapies in this disease process and advances in this field, which may represent a paradigm shift for the future of pituitary adenoma treatment. PMID:27517036

  19. Incidentally detected carcinoma ex pleomorphic adenoma of parotid gland by F-18 FDG PET/CT

    Kong, Eun Jung; Chun, Kyung Ah; Cho, Ihn Ho [Yeungnam Univ. Hospital, Daegu (Korea, Republic of)

    2016-03-15

    A 62-year-old man underwent FDG PET/CT to determine the initial stage of gastric carcinoma, and the scan revealed an incidental FDG-avid mass in the left parotid gland. He subsequently underwent surgery, and the final diagnosis was of carcinoma ex pleomorphic adenoma with cervical lymph node metastasis. The patient underwent left total parotidectomy with left selective neck dissection 2 months later, and the histopathologic report confirmed carcinoma ex pleomorphic adenoma with cervical lymph node metastasis.

  20. Resection and radiofrequency ablation of multiple liver adenomas secondary to anti-conceptive pills.

    Hashimoto, Luis; Dabbs, Andy; Sewell, Patrick; Doherty, Mike

    2004-01-01

    A case of multiple hepatic adenomas associated with birth control pills in a 25-year-old female is presented. Her only complaint was abdominal pain, and an elevated alkaline phosphatase was the only laboratory abnormality. The largest adenoma was located in the caudate lobe and was resected. The other two were small, located deep in the right lobe, and treated with radiofrequency ablation. Currently, the patient is asymptomatic and her alkaline phosphatase has returned to normal levels.

  1. Detection of Colorectal Adenomas Using a Bioactivatable Probe Specific for Matrix Metalloproteinase Activity

    Margie L. Clapper

    2011-08-01

    Full Text Available A significant proportion of colorectal adenomas, in particular those that lack an elevated growth component, continue to escape detection during endoscopic surveillance. Elevation of the activity of matrix metalloproteinases (MMPs, a large family of zinc endopeptidases, in adenomas serves as a biomarker of early tumorigenesis. The goal of this study was to assess the feasibility of using a newly developed near-infrared bioactivatable probe (MMPSense 680 that reports the activity of a broad array of MMP isoforms to detect early colorectal adenomas. Adenomatous polyposis coli (Apc+/Min-FCCC mice that spontaneously develop multiple colorectal adenomas were injected with MMPSense 680, and the colons were imaged in an IVIS Spectrum system ex vivo. Image analyses were correlated with histopathologic findings for all regions of interest (ROIs. The biochemical basis of fluorescent signal was investigated by immunohistochemical staining of MMP-7 and -9. A strong correlation (Kendall = 0.80 was observed between a positive signal and the presence of pathologically confirmed colonic adenomas; 92.9% of the 350 ROIs evaluated were classified correctly. The correlation between two independent observers was 0.87. MMP-7 expression was localized to epithelial cells of adenomas and microadenomas, whereas staining of MMP-9 was found in infiltrating polymorphonuclear leukocytes within the adenomas. MMPSense 680 identifies colorectal adenomas, both polypoid and nonpolypoid, in Apc+/Min-FCCC mice with high specificity. Use of this fluorescent probe in combination with colonoscopy could aid in preventing colorectal neoplasias by providing new opportunities for early detection and therapeutic intervention.

  2. CT and MR images of pleomorphic adenoma in major and minor salivary glands

    Kakimoto, Naoya [Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: kakimoto@dent.osaka-u.ac.jp; Gamoh, Shoko [Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: margot@dent.osaka-u.ac.jp; Tamaki, Junko [Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: tamako@dent.osaka-u.ac.jp; Kishino, Mitsunobu [Department of Oral Pathology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: mkishino@dent.osaka-u.ac.jp; Murakami, Shumei [Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: shumei@dent.osaka-u.ac.jp; Furukawa, Souhei [Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: furu@dent.osaka-u.ac.jp

    2009-03-15

    Purpose: To investigate the CT and MR imaging features of pleomorphic adenoma in the head and neck area. Materials and methods: Our materials of this study consisted of 50 pleomorphic adenomas from 50 patients which were all histopathologically diagnosed. The CT and MR images were retrospectively evaluated. The following features were evaluated: the detectability of the lesion, the tumor margin, the border of the lesion, the aspect of the lesion, the contrast between the lesion and surrounding tissue, the signal intensity of the lesion, the enhancement of contrast medium, the aspect of the lesion after the injection of contrast medium, the detectability of the capsule, and the detectability of bone resorption of the lesion. Results: The tumor detectabilities were 77% on axial plain CT images and 90% on axial CE CT images, respectively. On CT images, pleomorphic adenoma tended to show a well-defined margin, a smooth border, an inhomogeneous aspect, a low or high contrast, and intermediate or high signal intensity. After contrast medium administration, pleomorphic adenoma tended to show a slightly high enhancement and either an inhomogeneous or a periphery enhancement on the CE CT images. The capsule could be hardly detected on CT images. The tumor detectabilities were 86% on axial T1-weighted MR images, 88% on axial T2-weighted MR images, and 85% on axial CE T1-weighted MR images, respectively. On MR images, pleomorphic adenomas tended to show well-defined margin, a lobulate border, an inhomogeneous aspect, a high contrast, and intermediate or high signal intensity. After contrast medium administration, pleomorphic adenoma tended to show a high enhancement and either an inhomogeneous or a periphery enhancement on MR images. The capsule could be detected in many cases on MR images. Conclusions: It was possible to detect the capsule in pleomorphic adenoma using MR images. The pleomorphic adenomas in head and neck area should be evaluated with MR images.

  3. Pituitary mammosomatotroph adenomas develop in old mice transgenic for growth hormone-releasing hormone

    Asa, S L; Kovacs, K; Stefaneanu, L

    1990-01-01

    It has been shown that mice transgenic for human growth hormone-releasing hormone (GRH) develop hyperplasia of pituitary somatotrophs and mammosomatotrophs, cells capable of producing both growth hormone and prolactin, by 8 months of age. We now report for the first time that old GRH-transgenic m......-transgenic mice, 16 to 24 months of age, develop pituitary mammosomatotroph adenomas. These findings provide conclusive evidence that protracted stimulation of secretory activity can cause proliferation, hyperplasia and adenoma of adenohypophysial cells....

  4. Urinary Steroid Profiling for the Preoperative Identification of Adrenocortical Adenomas with Regression and Myelolipomatous Changes

    Blanes, Alfredo; Perna, Victoria; Taylor, Norman; Dworakowska, Dorota; Schulte, Klaus-Martin; Salvador J. Diaz-Cano

    2014-01-01

    Background: Adrenocortical neoplasms are classically divided into adenomas (ACA) and carcinomas (ACC). Heterogeneous appearance and greater size are criteria to suggest malignancy, along with the urinary steroid profile (USP). The presence of regression and myelolipomatous changes in adenomas (ACA-RML) can contribute to confusion with ACC and its USP remains unknown. Objective: To evaluate the features of ACA-RML in comparison with other adrenocortical neoplasms. Design: We selected consecuti...

  5. A clinicopathological and immunohistochemical study of clinically non-functioning pituitary adenomas: A single institutional experience

    Rishi Arvind

    2010-01-01

    Full Text Available Background : Non-functioning pituitary adenomas (NFPA are characterized by the lack of clinical syndrome as compared to functioning adenomas (FA but not all functioning adenomas have clinical effects. Their exact incidence varies in different series. Materials and Methods : This study was undertaken to analyze the hormonal profile of NFPA at the immunohistochemical level in the Indian population and to see if any differences exist from the earlier studies. Their biological aggressiveness was also studied by MIB-1 labeling index (MIB-! LI and Epidermal Growth Factor Receptor (EGFR expression. These parameters along with their clinical behavior were correlated with radiological features of invasiveness and size. Results : Of the 151 pituitary adenomas diagnosed during a period of one and half years, 77 (51% were NFPA with a male predominance. There was increase in the incidence of NFPA with increase in age. Immunopositivity for various hormones was observed in 64 (83% cases, either singly or in various combinations. On the basis of immunohistochemistry, NFPA were classified into three subtypes; gonadotroph adenomas, silent adenomas, and null cell adenomas. Gonadotroph adenomas were the commonest subtype. In general, NFPA showed low MIB-1LI but invasive NFPA had LI on the higher side, however, this difference was not significant. We observed EGFR positivity in two cases only; therefore the tumorigenesis mechanism may be different in NFPA. Conclusion : Although non-functional at the clinical level immunohistochemistry showed reactivity for various hormones. If a battery of immunostains including seven hormones is studied, a significant number of cases are shifted to the functional group.

  6. THE ROLE OF CALCIUM ION IN THE PATHOGENESIS OF HUMAN PITUITARY GH-SECRETING ADENOMAS

    邓洁英; 史轶蘩; 尹娟娟

    1996-01-01

    To study the role of Ca2+ in the pathogenesis of pituitary growth hormone secreting adenornas,the function of Ca2+ in 23 cases of human pituitary GH-secreting adenoma was investigated in monolayer cell culture.It was found that Ca2- channel blockers nicardipin and nifedipin inhibited hasal and growth hormone releasing hormone (GRH)-stimulated GH secretion in 87.5% and 100.0% of the GH adenomas.respectively,demonstrating that in most human pituitary GH agonist octreotide regulated the processes of GH secretion via Ca2+ had defects in different steps including receptor.postreceptor Ca2+ channel and Ca2+-GH secreting coupling in 6(66.6%)and 5(55.5%) cases of 9 GH adenomas respectively.Among them,the defects in GRH receptor and SRIF regulated Ca2+ channel are the main causes of the dysfunction of GH adenomas.These defects may be related to GH hypersecretion in GH adenomas.Our data provides advance evidences for intrinsic defects of GH adenomas.

  7. Matrix metalloproteinase-9 and -2 and tissue inhibitor of matrix metalloproteinase-2 in invasive pituitary adenomas

    Liu, Hong-Yan; Gu, Wei-Jun; Wang, Cheng-Zhi; Ji, Xiao-Jian; Mu, Yi-Ming

    2016-01-01

    Abstract The extracellular matrix is important for tumor invasion and metastasis. Normal function of the extracellular matrix depends on the balance between matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). The objective of this meta-analysis was to assess the relationship between expression of MMP-9, MMP-2, and TIMP-2 and invasion of pituitary adenomas. We searched Pubmed, Embase, and the Chinese Biomedical Database up to October 2015. RevMan 5.1 software (Cochrane Collaboration, Copenhagen, Denmark) was used for statistical analysis. We calculated the standardized mean difference (SMD) for data expressed as mean ± standard deviation because of the difference in the detection method. Twenty-four studies (1320 patients) were included. MMP-9 expression was higher in the patients with invasive pituitary adenomas (IPAs) than patients with noninvasive pituitary adenomas (NIPAs) with detection methods of IHC [odds ratio (OR) = 5.48, 95% confidence interval (CI) = 2.61–11.50, P prolactinomas and nonfunctioning pituitary adenomas was also no difference (OR = 1.03, 95% CI = 0.48–2.20, P = 0.95). The results indicated that MMP-9 and -2 may be correlated with invasiveness of pituitary adenomas, although their relationship with functional status of pituitary adenomas is still not clear. TIMP-2 expression in IPAs needs to be investigated further. PMID:27310993

  8. Hypertriglyceridemia is positively correlated with the development of colorectal tubular adenoma in Japanese men

    Masafumi Tabuchi; Joji Kitayama; Hirokazu Nagawa

    2006-01-01

    AIM: To determine the real association between serum lipid levels and colonic polyp formation.METHODS: We performed a large scale retrospective study to analyze the correlation between the incidence of colorectal adenoma or carcinoma and the fasting serum levels of total cholesterol (TC) and triglycerides (TG) in patients who underwent total colonoscopy for screening for colon cancer.RESULTS: Both levels were significantly elevated in patients with adenomas as compared with patients without any neoplastic lesion (TC 207.6±29.5 vs199.5±34.3, n=4883, p<0.001; TG 135.0±82.2 vs 108.7±71.5, n= 4874, p< 0.001). The difference was significant in patients with tubular adenoma but not in those with villous or serrated adenoma. Multiple logistic regression analysis including age and sex revealed that TG was an independent correlation factor in male (p < 0.01), but not in female patients. The level of TG in patients with invasive carcinoma did not show a significant elevation from that in patients with adenoma. These findings suggest that hypertriglyceridemia is an independent risk factor for colonic adenoma in men.CONCLUSION: Although a high level of serum triglyceride does not appear to be mechanically involved in the development of carcinoma, reduction of serum TG and intensive surveillance with total colonoscopy may have benefit in men with hypertriglyceridemia.

  9. Helicobacter pylori infection with intestinal metaplasia: An independent risk factor for colorectal adenomas

    Yan, Ye; Chen, Yi-Na; Zhao, Qian; Chen, Chao; Lin, Chun-Jing; Jin, Yin; Pan, Shuang; Wu, Jian-Sheng

    2017-01-01

    AIM To explore the association between Helicobacter pylori (H. pylori) infection status, intestinal metaplasia (IM), and colorectal adenomas. METHODS We retrospectively reviewed 1641 individuals aged ≥ 40 years who underwent physical examination, laboratory testing, 13C-urea breath testing, gastroscopy, colonoscopy, and an interview to ascertain baseline characteristics and general state of health. Histopathological results were obtained by gastric and colorectal biopsies. RESULTS The prevalence of H. pylori infection and adenomas was 51.5% (845/1641) and 18.1% (297/1641), respectively. H. pylori infection was significantly correlated with an increased risk of colorectal adenomas (crude OR = 1.535, 95%CI: 1.044-1.753, P = 0.022; adjusted OR = 1.359, 95%CI: 1.035-1.785, P = 0.028). Individuals with IM had an elevated risk of colorectal adenomas (crude OR = 1.664, 95%CI: 1.216-2.277, P = 0.001; adjusted OR = 1.381, 95%CI: 0.998-1.929, P = 0.059). Stratification based on H. pylori infection stage and IM revealed that IM accompanied by H. pylori infection was significantly associated with an increased risk of adenomas (crude OR = 2.109, 95%CI: 1.383-3.216, P = 0.001; adjusted OR = 1.765, 95%CI: 1.130-2.757, P = 0.012). CONCLUSION H. pylori-related IM is associated with a high risk of colorectal adenomas in Chinese individuals. PMID:28293091

  10. Immunohistochemical analysis of p53 and ras p21 expression in colorectal adenomas and early carcinomas.

    Ieda, S; Watatani, M; Yoshida, T; Kuroda, K; Inui, H; Yasutomi, M

    1996-01-01

    To further investigate whether multiple genetic changes are involved in the development of colorectal cancer, we performed an immunohistochemical analysis of p53 and ras p21 protein expression in 139 specimens of colorectal adenoma with varying degrees of dysplasia, 57 specimens of early cancer with an adenomatous component, and 12 specimens of superficial early cancer without any adenomatous component. Positive p53 staining was found in 15% of the adenomas with moderate dysplasia and in 42% of the adenomas with severe dysplasia or intramucosal carcinoma (IMCA). Positive immunostaining of p53 was observed to be significantly correlated with the degree of dysplasia and the depth of invasion, as was the expression of ras p21. However, a closer correlation was observed with the increasing size of the adenomas. Furthermore, p53 staining was positive in 42% of the 12 superficial early cancer specimens, while ras staining was positive in only 1 specimen (8%). These results indicate that p53 gene overexpression may play some biological role in both the adenoma-to-carcinoma sequence and in de novo cancer development, whereas ras p21 expression may not be as involved in de novo cancer development as in the malignant conversion of colorectal adenomas.

  11. Can single-phase dual-energy CT reliably identify adrenal adenomas?

    Helck, A.; Hummel, N.; Meinel, F.G.; Johnson, T.; Nikolaou, K.; Graser, A. [University of Munich, Institute for Clinical Radiology, Munich (Germany)

    2014-07-15

    To evaluate whether single-phase dual-energy-CT-based attenuation measurements can reliably differentiate lipid-rich adrenal adenomas from malignant adrenal lesions. We retrospectively identified 51 patients with adrenal masses who had undergone contrast-enhanced dual-energy-CT (140/100 or 140/80 kVp). Virtual non-contrast and colour-coded iodine images were generated, allowing for measurement of pre- and post-contrast density on a single-phase acquisition. Adrenal adenoma was diagnosed if density on virtual non-contrast images was ≤10 HU. Clinical follow-up, true non-contrast CT, PET/CT, in- and opposed-phase MRI, and histopathology served as the standard of reference. Based on the standard of reference, 46/57 (80.7 %) adrenal masses were characterised as adenomas or other benign lesions; 9 malignant lesions were detected. Based on a cutoff value of 10 HU, virtual non-contrast images allowed for correct identification of adrenal adenomas in 33 of 46 (71 %), whereas 13/46 (28 %) adrenal adenomas were lipid poor with a density ≥10 HU. Based on the threshold of 10 HU on the virtual non-contrast images, the sensitivity, specificity, and accuracy for detection of benign adrenal lesions was 73 %, 100 %, and 81 % respectively. Virtual non-contrast images derived from dual-energy-CT allow for accurate characterisation of lipid-rich adrenal adenomas and can help to avoid additional follow-up imaging. (orig.)

  12. Clinical results of LINAC-based stereotactic radiosurgery for pituitary adenoma

    Muramatsu, Julia; Yoshida, Masanori; Shioura, Hiroki; Kawamura, Yasutaka; Ito, Harumi; Takeuchi, Hiroaki; Kubota, Toshihiko [Fukui Medical Univ., Matsuoka (Japan); Maruyama, Ichiro [The Wakasa Wan Energy Research Center, Tsuruga, Fukui (Japan)

    2003-05-01

    We retrospectively evaluated our clinical results of stereotactic radiosurgery (SRS) for pituitary adenoma. Between 1995 and 2000, 13 patients were treated with SRS for pituitary adenoma. In all cases, the tumors had already been surgically resected. The adenomas were functional in 5 and non-functional in 8 patients. The median follow-up period was 30 months. SRS was performed with the use of a dedicated stereotactic 10-MV linear accelerator (LINAC). The median dose to the tumor margin was 15 Gy. The dose to the optic apparatus was limited to less than 8 Gy. MR images of 12 patients revealed tumor complete response (CR) in one case and partial response (PR) in 9 cases; in the remaining two patients, tumor size decreased by less than 50%. There was no recognizable regrowth of any of the tumors. In two of four GH-secreting adenomas, hormonal overproduction normalized, while the other two showed reduced hormonal production. One PRL-secreting adenoma did not respond. Reduction of visual acuity and field was seen in one patient. This patient also had a brain infarction. None of the patients developed brain radionecrosis or radiation-induced hypopituitarism. Although further studies based on greater numbers of cases and longer follow-up periods are needed, our results suggest that SRS seems to be a safe, effective treatment for pituitary adenoma. (author)

  13. Pelletization of seeds of Raphanus sativus L. cv. Redondo Gigante with graphite for germination under water stress conditions

    Nobel Penteado Freitas

    2000-01-01

    Full Text Available The effect of water stress on germination of radish seeds is dependent on the presence of light. The effect of pelletization of radish seeds with powdered graphite on the tolerance to water stress under light was analysed. White light and far-red lights were filtered by graphite increasing slightly the tolerance of pelleted seeds to water stress of -0.77MPa. Although red light also inhibited seed germination the graphite had no effect. We propose the pelletization of seeds of Raphanus sativus, at least in cv redondo gigante with graphite as a pratice before planting to increase the tolerance to water stress.O efeito do estresse hídrico é dependente da presença de luz em sementes de rabanete. O efeito da peletização com grafite em pó foi analisado. Luz branca e vermelho-extremo são filtradas pelo grafite aumentando parcialmente a tolerância ao estresse hídrico de -0,77MPa em sementes peletizadas. Embora a luz vermelha também iniba a germinação em condições de estresse a peletização não teve efeito. Nós propomos a peletização de sementes de Raphanus saivus L. cv. redondo gigante como uma prática antes do plantio para aumentar a tolerância ao estresse hídrico.

  14. Paraganglioma pré-aórtico gigante Giant preaortic paraganglioma

    Sergio Renato Pais Costa

    2008-12-01

    Full Text Available INTRODUÇÃO: O paraganglioma é um tumor neuroendócrino raro que ocorre mais frequentemente em adultos jovens. Geralmente produz catecolaminas acarretando síndrome adrenérgica. No entanto, muito raramente, quando não-funcionante seus sintomas são mais frequentemente associados à massa abdominal ou mesmo dor. Nessas circunstâncias costumam representar diagnóstico difícil sendo confundidos com os sarcomas de retroperitônio. RELATO DO CASO: Paraganglioma pré-aórtico gigante não-funcionante em paciente com níveis baixos de catecolaminas (sérico e urinário. O diagnóstico pré-operatório foi dado por tomografia computadorizada, onde foi observada massa sólida, hipervascular com calcificações e área cística central. O paciente foi submetido à ressecção cirúrgica da massa com boa evolução pós-operatória. Um ano após a operação, o doente encontra-se vivo sem recidiva tumoral. CONCLUSÃO: Em que pese a raridade o paraganglioma pré-aortico não-funcionante deve ser lembrado com diagnóstico diferencial com os sarcomas de retroperitônio. Seu tratamento é cirúrgico e apresenta bom prognóstico.RACIONAL: Paraganglioma is a rare neuroendocrine tumor which often diagnosed in the young adult. Generally, paraganglioma produces catecholamines causing adrenergic syndrome. However, more rarely when tumor is nonfunctioning, their symptoms are more associated with an abdominal mass or even pain. In these circumstances, paraganglioma present a difficult diagnosis confounding with retroperitoneal sarcomas. CASE REPORT: The authors present a case of nonfunctioning giant preaortic paraganglioma. This patient had low levels of catecholamines (both seric and urinary. The preoperative diagnosis was done by means computed tomography. This lesion presented as well-vascularized tumor with calcifications and necrotic central area. The patient underwent a surgical resection with good postoperative outcome. To date, one year after surgical

  15. Climatic control on the growth of gigantic gypsum crystals within hypogenic caves (Naica mine, Mexico)?

    Garofalo, Paolo S.; Fricker, Mattias B.; Günther, Detlef; Forti, Paolo; Mercuri, Anna-Maria; Loreti, Mara; Capaccioni, Bruno

    2010-01-01

    Three hypogenic caves within the Naica mine of Mexico ( Cueva de los Cristales — CLC, Ojo de la Reina — OR, and Cueva de las Velas — CLV) host spectacular gypsum crystals up to 11 m in length. These caves are close to another shallow cave of the area ( Cueva de las Espadas — CLE), with which they cover a 160 m-deep vertical section of the local drainage basin. Similar to other hypogenic caves, all these caves lack a direct connection with the land surface and should be unrelated with climate. A record of multi-technique fluid inclusion data and pollen spectra from cave and mine gypsum indicates surprisingly that climatic changes occurring at Naica could have controlled fluid composition in these caves, and hence crystal growth. Microthermometry and LA-ICP-Mass Spectrometry of fluid inclusions indicate that the shallow, chemically peculiar, saline fluid (up to 7.7 eq. wt.%NaCl) of CLE could have formed from evaporation, during a dry and hot climatic period. The fluid of the deep caves was instead of low salinity (˜ 3.5 eq. wt.% NaCl) and chemically homogeneous, and was poorly affected by evaporation. We propose that mixing of these two fluids, generated at different depths of the Naica drainage basin, determined the stable supersaturation conditions for the gigantic gypsum crystals to grow. Fluid mixing was controlled by the hydraulic communication between CLE and the other deep caves, and must have taken place during cycles of warm-dry and fresh-wet climatic periods, which are known to have occurred in the region. Pollen grains from a 35 ka-old gypsum crystal of CLC corresponds to a fairly homogenous catchment basin made of a mixed broadleaf wet forest, which suggests precipitation during a fresh-wet climatic period and confirms our interpretation of the fluid inclusion data. The unusual combination of geological and geochemical factors of Naica suggests that other hypogenic caves found elsewhere may not host similar crystals. However, this work shows that

  16. Gigantic landslides versus glacial deposits: on origin of large hummock deposits in Alai Valley, Northern Pamir

    Reznichenko, Natalya

    2015-04-01

    As glaciers are sensitive to local climate, their moraines position and ages are used to infer past climates and glacier dynamics. These chronologies are only valid if all dated moraines are formed as the result of climatically driven advance and subsequent retreat. Hence, any accurate palaeoenvironmental reconstruction requires thorough identification of the landform genesis by complex approach including geomorphological, sedimentological and structural landform investigation. Here are presented the implication of such approach for the reconstruction of the mega-hummocky deposits formation both of glacial and landslide origin in the glaciated Alai Valley of the Northern Pamir with further discussion on these and similar deposits validity for palaeoclimatic reconstructions. The Tibetan Plateau valleys are the largest glaciated regions beyond the ice sheets with high potential to provide the best geological record of glacial chronologies and, however, with higher probabilities of the numerous rock avalanche deposits including those that were initially considered of glacial origin (Hewitt, 1999). The Alai Valley is the largest intermountain depression in the upper reaches of the Amudarja River basin that has captured numerous unidentified extensive hummocky deposits descending from the Zaalai Range of Northern Pamir, covering area in more than 800 km2. Such vast hummocky deposits are usually could be formed either: 1) glacially by rapid glacial retreat due to the climate signal or triggered a-climatically glacial changes, such as glacial surge or landslide impact, or 2) during the landslide emplacement. Combination of sediment tests on agglomerates forming only in rock avalanche material (Reznichenko et al., 2012) and detailed geomorphological and sedimentological descriptions of these deposits allowed reconstructing the glacial deposition in the Koman and Lenin glacial catchments with identification of two gigantic rock avalanches and their relation to this glacial

  17. Etiopatogenia de la arteritis de células gigantes Etiopathogenesis of giant cell arteritis

    J.M. Casas

    2003-04-01

    Full Text Available La arteritis de células gigantes es una vasculitis que afecta a arterias de diámetro medio y ancho, preferentemente aquellas del arco aórtico con distribución extracraneal, pero también la aorta y otras de sus ramas mayores. Se caracteriza por la presencia de infiltrados inflamatorios mononucleares en la proximidad de la lámina elástica interna constituidos por linfocitos y macrófagos, que en aproximadamente algo más del 50% de los casos contienen células gigantes multinucleadas. La morbilidad asociada a esta enfermedad se relaciona con fenómenos de isquemia distales a la estenosis luminal de las arterias inflamadas y en menor medida con la formación de aneurismas por el debilitamiento de la pared arterial. De etiología desconocida, su patogenia es inmune a través de la migración y localización de células T productoras de γ-INF en la capa adventicia de las arterias inflamadas, suponiéndose que éste es el lugar del estímulo inmune por un antígeno aún no identificado. El reclutamiento y activación de macrófagos por esta citocina constituye uno de los puntos más importantes de su patogenia. La destrucción por éstos del tejido elástico arterial es un fenómeno relevante, así como la producción de otros factores promotores de neoangiogénesis y proliferación de la neoíntima, responsable a través de la obliteración de la luz, de las manifestaciones isquémicas de la enfermedad. El proceso se acompaña de una importante repercusión sistémica caracterizada por una fuerte reacción de fase aguda y síntomas generales de enfermedad poco específicos. Por otra parte, un importante porcentaje de los pacientes presentan un cuadro de polimialgia reumática, entidad en histórica y controvertida relación con esta arteritis. En los últimos años se han producido importantes aportaciones al conocimiento de los mecanismos inmunes implicados en su patogenia.Giant cell arteritis is a vasculitis of large and medium size

  18. Pregnancy and liver adenoma management: PALM-study

    van Aalten Susanna M

    2012-06-01

    Full Text Available Abstract Background Hepatocellular adenoma (HCA in pregnant women requires special considerations because of the risk of hormone induced growth and spontaneous rupture, which may threaten the life of both mother and child. Due to scarcity of cases there is no evidence-based algorithm for the evaluation and management of HCA during pregnancy. Most experts advocate that women with HCA should not get pregnant or advise surgical resection before pregnancy. Whether it is justified to deny a young woman a pregnancy, as the biological behavior may be less threatening than presumed depends on the incidence of HCA growth and the subsequent clinical events during pregnancy. We aim to investigate the management and outcome of HCA during pregnancy and labor based on a prospectively acquired online database in the Netherlands. Methods/design The Pregnancy And Liver adenoma Management (PALM - study is a multicentre prospective study in three cohorts of pregnant patients. In total 50 pregnant patients, ≥ 18 years of age with a radiologically and/or histologically proven diagnosis of HCA will be included in the study. Radiological diagnosis of HCA will be based on contrast enhanced MRI. Lesions at inclusion must not exceed 5 cm. The study group will be compared to a healthy control group of 63 pregnant patients and a group of 63 pregnant patients with diabetes mellitus without HCA. During their pregnancy HCA patients will be closely monitored by means of repetitive ultrasound (US at 14, 20, 26, 32 and 38 weeks of gestation and 6 and 12 weeks postpartum. Both control groups will undergo US of the liver at 14 weeks of gestation to exclude HCA lesions in the liver. All groups will be asked to fill out quality of life related questionnaires. Discussion The study will obtain information about the behaviour of HCA during pregnancy, the clinical consequences for mother and child and the impact of having a HCA during pregnancy on the health related quality

  19. Differentiation of pituitary adenomas from other sellar and parasellar tumors by {sup 99m}Tc(V)-DMSA scintigraphy

    Yamamura, Koji [Yokohama City Univ. (Japan). Medical Center; Suzuki, Shinichi; Yamamoto, Isao [Yokohama City Univ. (Japan). School of Medicine

    2003-04-01

    Pentavalent technetium-99m dimercaptosuccinic acid [{sup 99m}Tc(V)-DMSA] scintigraphy was evaluated for the differentiation of pituitary adenomas, especially non-functioning adenomas, from other sellar and parasellar lesions. Diffuse {sup 99m}Tc(V)-DMSA accumulation within the tumor was found in seven of seven non-functioning, three of four growth hormone-secreting, and seven of eight prolactin-secreting adenomas, but only partial accumulation in only two of 16 non-pituitary adenomas and normal pituitary glands. There were no significant relationship between tumor-to-background ratios and tumor size or serum hormone level. {sup 99m}Tc(V)-DMSA scintigraphy showed overall sensitivity of 81% (17/21 cases) for detecting pituitary adenomas, in particular 100% for non-functioning adenomas. {sup 99m}Tc(V)-DMSA may be useful for detecting pituitary adenomas, especially non-functioning adenomas, and for the differentiation of non-functioning pituitary adenomas from other sellar and parasellar lesions. (author)

  20. Loss of expression and promoter methylation of SLIT2 are associated with sessile serrated adenoma formation.

    Beggs, Andrew D; Jones, Angela; Shepherd, Neil; Arnaout, Abed; Finlayson, Caroline; Abulafi, A Muti; Morton, Dion G; Matthews, Glenn M; Hodgson, Shirley V; Tomlinson, Ian P M

    2013-05-01

    Serrated adenomas form a distinct subtype of colorectal pre-malignant lesions that may progress to malignancy along a different molecular pathway than the conventional adenoma-carcinoma pathway. Previous studies have hypothesised that BRAF mutation and promoter hypermethylation plays a role, but the evidence for this is not robust. We aimed to carry out a whole-genome loss of heterozygosity analysis, followed by targeted promoter methylation and expression analysis to identify potential pathways in serrated adenomas. An initial panel of 9 sessile serrated adenomas (SSA) and one TSA were analysed using Illumina Goldengate HumanLinkage panel arrays to ascertain regions of loss of heterozygosity. This was verified via molecular inversion probe analysis and microsatellite analysis of a further 32 samples. Methylation analysis of genes of interest was carried out using methylation specific PCR (verified by pyrosequencing) and immunohistochemistry used to correlate loss of expression of genes of interest. All experiments used adenoma samples and normal tissue samples as control. SSA samples were found on whole-genome analysis to have consistent loss of heterozygosity at 4p15.1-4p15.31, which was not found in the sole TSA, adenomas, or normal tissues. Genes of interest in this region were PDCH7 and SLIT2, and combined MSP/IHC analysis of these genes revealed significant loss of SLIT2 expression associated with promoter methylation of SLIT2. Loss of expression of SLIT2 by promoter hypermethylation and loss of heterozygosity events is significantly associated with serrated adenoma development, and SLIT2 may represent a epimutated tumour suppressor gene according to the Knudson "two hit" hypothesis.

  1. ACTH-Independent Cushing’s Syndrome with Bilateral Micronodular Adrenal Hyperplasia and Ectopic Adrenocortical Adenoma

    Louiset, Estelle; Gobet, Françoise; Libé, Rossella; Horvath, Anelia; Renouf, Sylvie; Cariou, Juliette; Rothenbuhler, Anya; Bertherat, Jérôme; Clauser, Eric; Grise, Philippe; Stratakis, Constantine A.; Kuhn, Jean-Marc; Lefebvre, Hervé

    2010-01-01

    Context: Bilateral micronodular adrenal hyperplasia and ectopic adrenocortical adenoma are two rare causes of ACTH-independent Cushing’s syndrome. Objective: The aim of the study was to evaluate a 35-yr-old woman with ACTH-independent hypercortisolism associated with both micronodular adrenal hyperplasia and ectopic pararenal adrenocortical adenoma. Design and Setting: In vivo and in vitro studies were performed in a University Hospital Department and academic research laboratories. Intervention: Mutations of the PRKAR1A, PDE8B, and PDE11A genes were searched for in leukocytes and adrenocortical tissues. The ability of adrenal and adenoma tissues to synthesize cortisol was investigated by immunohistochemistry, quantitative PCR, and/or cell culture studies. Main Outcome Measure: Detection of 17α-hydroxylase and 21-hydroxylase immunoreactivities, quantification of CYP11B1 mRNA in adrenal and adenoma tissues, and measurement of cortisol levels in supernatants by radioimmunological assays were the main outcomes. Results: Histological examination of the adrenals revealed nonpigmented micronodular cortical hyperplasia associated with relative atrophy of internodular cortex. No genomic and/or somatic adrenal mutations of the PRKAR1A, PDE8B, and PDE11A genes were detected. 17α-Hydroxylase and 21-hydroxylase immunoreactivities as well as CYP11B1 mRNA were detected in adrenal and adenoma tissues. ACTH and dexamethasone activated cortisol secretion from adenoma cells. The stimulatory action of dexamethasone was mediated by a nongenomic effect involving the protein kinase A pathway. Conclusion: This case suggests that unknown molecular defects can favor both micronodular adrenal hyperplasia and ectopic adrenocortical adenoma associated with Cushing’s syndrome. PMID:19915020

  2. Folic acid supplementation inhibits recurrence of colorectal adenomas: A randomized chemoprevention trial

    Richard Jaszewski; Adhip PN Majumdar; Sabeena Misra; Martin Tobi; Nadeem Ullah; Jo Ann Naumoff; Omer Kucuk; Edi Levi; Bradley N Axelrod; Bhaumik B Patel

    2008-01-01

    AIM: To determine whether folic acid supplementation will reduce the recurrence of colorectal adenomas,the precursors of colorectal cancer, we performed a double-blind placebo-controlled trial in patients with adenomatous polyps.METHODS: In the current double-blind, placebo-controlled trial at this VA Medical Center, patients with colorectal adenomas were randomly assigned to receive either a daily 5 mg dose of folic acid or a matched identical placebo for 3 years. All polyps were removed at baseline colonoscopy and each patient had a follow up colonoscopy at 3 years. The primary endpoint was a reduction in the number of recurrent adenomas at 3 years.RESULTS: Of 137 subjects, who were eligible after confirmation of polyp histology and run-in period to conform compliance, 94 completed the study; 49 in folic acid group and 45 in placebo group. Recurrence of adenomas at 3-year was compared between the two groups. The mean number of recurrent polyps at 3-year was 0.36 (SD, 0.69) for folic acid treated patients compared to 0.82 (SD, 1.17) for placebo treated subjects, resulting in a 3-fold increase in polyp recurrence in the placebo group. Patients below 70 years of age and those with left-sided colonic adenomas or advanced adenomas responded better to folic acid supplementation.CONCLUSION: High dose folic acid supplementation is associated with a significant reduction in the recurrence of colonic adenomas suggesting that folic acid may be an effective chemopreventive agent for colorectal neoplasia.

  3. Local IGFBP-3 mRNA expression, apoptosis and risk of colorectal adenomas

    Omofoye Oluwaseun

    2008-05-01

    Full Text Available Abstract Background IGF binding protein-3 (IGFBP-3 regulates the bioavailability of insulin-like growth factors I and II, and has both anti-proliferative and pro-apoptotic properties. Elevated plasma IGFBP-3 has been associated with reduced risk of colorectal cancer (CRC, but the role of tissue IGFBP-3 is not well defined. We evaluated the association between tissue or plasma IGFBP-3 and risk of colorectal adenomas or low apoptosis. Methods Subjects were consenting patients who underwent a clinically indicated colonoscopy at UNC Hospitals and provided information on diet and lifestyle. IGFBP-3 mRNA in normal colon was assessed by real time RT-PCR. Plasma IGFBP-3 was measured by ELISA and apoptosis was determined by morphology on H & E slides. Logistic regression was used to compute odds ratio (OR and 95% confidence intervals. Results We observed a modest correlation between plasma IGFBP-3 and tissue IGFBP-3 expression (p = 0.007. There was no significant association between plasma IGFBP-3 and adenomas or apoptosis. Tissue IGFBP-3 mRNA expression was significantly lower in cases than controls. Subjects in the lowest three quartiles of tissue IGFBP-3 gene expression were more likely to have adenomas. Consistent with previous reports, low apoptosis was significantly associated with increased risk of adenomas (p = 0.003. Surprisingly, local IGFBP-3 mRNA expression was inversely associated with apoptosis. Conclusion Low expression of IGFBP-3 mRNA in normal colonic mucosa predicts increased risk of adenomas. Our findings suggest that local IGFBP-3 in the colon may directly increase adenoma risk but IGFBP-3 may act through a pathway other than apoptosis to influence adenoma risk.

  4. Loss of expression and promoter methylation of SLIT2 are associated with sessile serrated adenoma formation.

    Andrew D Beggs

    2013-05-01

    Full Text Available Serrated adenomas form a distinct subtype of colorectal pre-malignant lesions that may progress to malignancy along a different molecular pathway than the conventional adenoma-carcinoma pathway. Previous studies have hypothesised that BRAF mutation and promoter hypermethylation plays a role, but the evidence for this is not robust. We aimed to carry out a whole-genome loss of heterozygosity analysis, followed by targeted promoter methylation and expression analysis to identify potential pathways in serrated adenomas. An initial panel of 9 sessile serrated adenomas (SSA and one TSA were analysed using Illumina Goldengate HumanLinkage panel arrays to ascertain regions of loss of heterozygosity. This was verified via molecular inversion probe analysis and microsatellite analysis of a further 32 samples. Methylation analysis of genes of interest was carried out using methylation specific PCR (verified by pyrosequencing and immunohistochemistry used to correlate loss of expression of genes of interest. All experiments used adenoma samples and normal tissue samples as control. SSA samples were found on whole-genome analysis to have consistent loss of heterozygosity at 4p15.1-4p15.31, which was not found in the sole TSA, adenomas, or normal tissues. Genes of interest in this region were PDCH7 and SLIT2, and combined MSP/IHC analysis of these genes revealed significant loss of SLIT2 expression associated with promoter methylation of SLIT2. Loss of expression of SLIT2 by promoter hypermethylation and loss of heterozygosity events is significantly associated with serrated adenoma development, and SLIT2 may represent a epimutated tumour suppressor gene according to the Knudson "two hit" hypothesis.

  5. Prevalence of adenomas and hyperplastic polyps in mismatch repair mutation carriers among CAPP2 participants: report by the colorectal adenoma/carcinoma prevention programme 2

    Liljegren, Annelie; Barker, Gail; Elliott, Faye;

    2008-01-01

    the chemoprevention study were the focus of this study. The number, histology, size, and location of polyps found at the participants' first ever colonoscopy were analyzed in a cross-sectional study. RESULTS: Seventy-four patients (10.6%) were found to have at least one adenoma at first colonoscopy, whereas 37 (5...

  6. TSH RECEPTOR GENETIC ALTERATIONS IN THE AUTONOMOUSLY FUNCTIONING THYROID ADENOMAS

    施秉银; 李雪萍; 李社莉; 薛明战; 王毅; 徐莉

    2004-01-01

    Objective To determine the relationship between TSH receptor gene mutations and autonomously functioning thyroid adenomas (AFTAs). Methods The thyroid samples from 14 cases of diagnosed AFTAs were analyzed, with normal thyroid specimens adjacent to the tumors as controls. The 155 base pairs DNA fragments which encompassed the third cytoplasmic loop and the sixth transmembrane segments in the TSH receptor gene exon 10 were amplified by Polymerase chain reaction (PCR) and analyzed by the single-strand conformation polymorphism (SSCP). Direct sequencing of the PCR products was performed with Prism Dye Terminator Cycle Sequencing Core Kit. Results 6 of 14 AFTA specimens displayed abnormal migration in SSCP analysis. In sequence analysis of 3 abnormally migrated samples, one base substitution at nucleotide 1957 (A to C) and two same insertion mutations of one adenosine nucleotide between nucleotide 1972 and 1973 were identified. No mutations were found in controls. Conclusion This study confirmed the presence of TSH receptor gene mutations in AFTAs; both one-point substitution mutation and one-base insertion mutation were found to be responsible for the pathogenesis of AFTAs.

  7. Somatostatin and dopamine receptor regulation of pituitary somatotroph adenomas.

    Ben-Shlomo, Anat; Liu, Ning-Ai; Melmed, Shlomo

    2017-02-01

    Somatostatin and dopamine receptors are expressed in normal and tumoral somatotroph cells. Upon receptor stimulation, somatostatin and the somatostatin receptor ligands octreotide, lanreotide, and pasireotide, and to a lesser extent, dopamine and the dopamine analogs bromocriptine and cabergoline, suppress growth hormone (GH) secretion from a GH-secreting pituitary somatotroph adenoma. Somatostatin and dopamine receptors are Gαi-protein coupled that inhibit adenylate cyclase activity and cAMP production and reduce intracellular calcium concentration and calcium flux oscillations. Although their main action on somatotroph cells is acute inhibition of GH secretion, they also may inhibit GH production and possibly somatotroph proliferation. These receptors have been reported to create complexes that exhibit functions distinct from that of receptor monomers. Somatostatin suppression of GH is mediated mainly by somatostatin receptor subtype 2 and to a lesser extent by SST5. Human somatostatin receptor subtype 5 has also been shown to harbor mutations associated with GH levels, somatotroph tumor behavior, and somatostatin receptor ligand (SRL) responsiveness. Reviewing current knowledge of somatostatin and dopamine receptor expression and signaling in normal and tumoral somatotroph cells offers insights into mechanisms underlying SRL and dopamine agonist effectiveness in patients with acromegaly.

  8. Experimental induction of parathyroid adenomas in the rat

    Wynford-Thomas, V.; Wynford-Thomas, D.; Williams, E.D.

    1983-01-01

    Neonatal inbred Wistar albino rats were given either 5 or 10 microCi radioiodine (/sup 131/I) within 24 hours of birth. After weaning, animals were placed on diets high, normal, or deficient in vitamin D3 (cholecalciferol) for periods up to 2 years. In animals aged 12 months and older, adenomas were found in 0 of 67 unirradiated controls, in 22 of 67 given 5 microCi /sup 131/I, and in 25 of 67 given to microCi /sup 131/I. The incidence of tumors in irradiated animals was highest (55%) in those on a low-vitamin D diet and lowest (20%) in those on a high-vitamin D diet. Plasma calcium levels were significantly increased by the high-vitamin D diet, but the low-vitamin D diet did not lead to any significant decrease as compared to the calcium levels of the normal vitamin D diet group. Small but significant calcium increases were found in tumor-bearing animals. These findings indicate that parathyroid tumors in the rat can be induced by radiation and that their incidence is strongly influenced by dietary vitamin D content. The possibility that metabolites of vitamin D3 may influence parathyroid growth and tumor formation directly is discussed.

  9. Experimental induction of parathyroid adenomas in the rat

    Wynford-Thomas, V.; Wynford-Thomas, D.; Williams, E.D.

    1983-01-01

    Neonatal inbred Wistar albino rats were given either 5 or 10 mCi radioiodine (/sup 131/I) within 24 hours of birth. After weaning, animals were placed on diets high, normal, or deficient in vitamin D3 (cholecalciferol) for periods up to 2 years. In animals aged 12 months and older, adenomas were found in 0 of 67 unirradiated controls, in 22 of 67 given 5 mCi /sup 131/I, and in 25 of 67 given 10 mCi /sup 131/I. The incidence of tumors in irradiated animals was highest (55%) in those on a low-vitamin D diet and lowest (20%) in those on a high-vitamin D diet. Plasma calcium levels were significantly increased by the high-vitamin D diet, but the low-vitamin D diet did not lead to any significant decrease as compared to the calcium levels of the normal vitamin D diet group. Small but significant calcium increases were found in tumor-bearing animals. These findings indicate that parathyroid tumors in the rat can be induced by radiation and that their incidence is strongly influenced by dietary vitamin D content. The possibility that metabolites of vitamin D3 may influence parathyroid growth and tumor formation directly is discussed.

  10. Reporting a Rare Case of Pleomorphic Adenoma of the Breast

    Tahere Khamechian

    2014-01-01

    Full Text Available Pleomorphic adenoma (PA is the most common tumor type in the salivary gland. PA is uncommon in the breast tissue. Only 73 cases of PA of the breast have been reported in the world literature. We are reporting the 74th case of PA of the breast. A 61-year-old woman was referred to Shahid Beheshti Hospital Obstetric Clinic with bloody painless discharge from the right nipple. A bean size mass was detected immediately below the right nipple. After an excisional biopsy, the pathologist found proliferation in epithelial and myoepithelial cells that had small and multiple nuclei, myxoid and chondroid stroma. Immunohistochemistry stain was positive for S-100 and patchy for GFAP in tumor cells and for SMA around the tubule-glandular and tumor cell aggregates and suggested PA of the breast. It is essential for the pathologists to consider PA of the breast as a differential diagnosis of a rounded circumscribed mass in the juxta-areolar areas. Careful paraffin sections should be performed to avoid an unnecessary mastectomy.

  11. Histological and Immunohistochemical Revision of Hepatocellular Adenomas: A Learning Experience

    S. Fonseca

    2013-01-01

    Full Text Available Light has been shed on the genotype/phenotype correlation in hepatocellular adenoma (HCA recognizing HNF1α-inactivated HCA (H-HCA, inflammatory HCA (IHCA, and β-catenin-activated HCA (b-HCA. We reviewed retrospectively our surgical HCA series to learn how to recognize the different subtypes histopathologically and how to interpret adequately their immunohistochemical staining. From January 1992 to January 2012, 37 patients underwent surgical resection for HCA in our institution. Nine had H-HCA (25% characterized by steatosis and loss of L-FABP expression; 20 had IHCA (55.5% showing CRP and/or SAA expression, sinusoidal dilatation, and variable inflammation; and 1 patient had both H-HCA and IHCA. In 5 patients (14%, b-HCA with GS and β-catenin nuclear positivity was diagnosed, two already with hepatocellular carcinoma. Two cases (5.5% remained unclassified. One of the b-HCA showed also the H-HCA histological and immunohistochemical characteristics suggesting a subgroup of β-catenin-activated/HNF1α-inactivated HCA, another b-HCA exhibited the IHCA histological and immunohistochemical characteristics suggesting a subgroup of β-catenin-activated/inflammatory HCA. Interestingly, three patients had underlying vascular abnormalities. Using the recently published criteria enabled us to classify histopathologically our retrospective HCA surgical series with accurate recognition of b-HCA for which we confirm the higher risk of malignant transformation. We also underlined the association between HCA and vascular abnormalities.

  12. Middle ear adenoma. A tumor displaying mucinous and neuroendocrine differentiation.

    Wassef, M; Kanavaros, P; Polivka, M; Nemeth, J; Monteil, J P; Frachet, B; Tran Ba Huy, P

    1989-10-01

    Middle ear adenoma (MEA) is a distinctive, rare entity that appears to be derived from the lining epithelium of the middle ear mucosa. We report four cases of MEA displaying the typical histologic growth pattern. Two distinct tumor cell immunophenotypes were identified in all cases; the first type exhibited positivity with anti-epithelial membrane antigen and anti-keratin antibodies, and the second type showed immunoreactivity with anti-keratin, anti-vimentin, and anti-neuron-specific enolase antibodies. Ultrastructural studies revealed bidirectional mucinous and neuroendocrine differentiation, demonstrated by the presence of two distinct cell types containing apically located mucous granules and basally concentrated neuroendocrine granules, respectively. The presence of neuroendocrine differentiation was supported by the immunohistochemical detection of vasoactive intestinal polypeptide in the tumor cells in one case and neuron-specific enolase in three cases. These findings suggest that the potential for mixed mucinous/neuroendocrine differentiation described in other endodermally derived tumors also exists in middle ear mucosa. We also believe that the rare lesions diagnosed as primary carcinoid tumors of the middle ear might in fact be MEA with predominant or only neuroendocrine differentiation. The clinical course of our four cases and our review of the pertinent literature confirm the benign nature of MEA and indicate that these tumors should be treated by complete local excision without additional therapy.

  13. Stereotactic Irradiation of GH-Secreting Pituitary Adenomas

    G. Minniti

    2012-01-01

    Full Text Available Radiotherapy (RT is often employed in patients with acromegaly refractory to medical and/or surgical interventions in order to prevent tumour regrowth and normalize elevated GH and IGF-I levels. It achieves tumour control and hormone normalization up to 90% and 70% of patients at 10–15 years. Despite the excellent tumour control, conventional RT is associated with a potential risk of developing late toxicity, especially hypopituitarism, and its role in the management of patients with GH-secreting pituitary adenomas remains a matter of debate. Stereotactic techniques have been developed with the aim to deliver more localized irradiation and minimize the long-term consequences of treatment, while improving its efficacy. Stereotactic irradiation can be given in a single dose as stereotactic radiosurgery (SRS or in multiple doses as fractionated stereotactic radiotherapy (FSRT. We have reviewed the recent published literature on stereotactic techniques for GH-secreting pituitary tumors with the aim to define the efficacy and potential adverse effects of each of these techniques.

  14. The role of the seed coat in the light sensivity in Raphanus sativus L. cv. redondo gigante seeds O papel do tegumento na sensibilidade à luz em sementes de Raphanus sativus L. cv. redondo gigante

    Maura Lúcia Costa Gonçalves

    1997-07-01

    Full Text Available The role of the seed coat in the light sensitivity of seeds of Raphanus sativus L. cv. redondo gigante was analysed by germination tests of intact and naked seeds. Far-red light caused high inhibition of seed germination, while under white and red lights low inhibition was found. Naked seeds presented no light sensitivity with high percentage germination under light and darkness. However, incubation of naked seeds in -0.6MPa polyethylene glycol solution resulted in light inhibition as observed in intact seeds. The analysis of the seed coat transmitted light indicated that the filtered light presented the same photoequilibrium of phytochrome when compared to the white light, with a decrease of only 33% in the light irradiance which reaches the embryo.O papel do tegumento sobre a sensibilidade à luz em sementes de Raphanus sativus L. cv. redondo gigante foi analisado por testes de germinação de sementes intactas e nuas. A luz vermelho-extremo inibiu fortemente a germinação, enquanto as luzes branca e vermelha apresentaram baixa inibição. Por outro lado, sementes nuas não apresentaram sensibilidade à luz, com alta porcentagem de germinação tanto na luz como no escuro. Entretanto, a incubação das sementes nuas em condições de estresse em solução de polietilenoglicol a -0,6MPa, resultou em inibição na luz, como observadas em sementes intactas. A análise da luz transmitida pelo tegumento das sementes indicou que a luz filtrada apresenta o mesmo fotoequilíbrio teórico do fitocromo obtido na luz branca, com um decréscimo em apenas 33% da irradiância que atinge o embrião.

  15. Deficiency of Adenomatous Polyposis Coli protein in sporadic colorectal adenomas and its associations with clinical phenotype and histology

    Martin Bortlík; Ivana Vítková; Martina Pape(z)ová; Milada Kohoutová; Ale(s) Novotn(y); Stanislav Adamec; Petra Chalupná; Milan Luká(s)

    2006-01-01

    AIM: To evaluate the frequency of the loss of the Adenomatous Polyposis Coli (APC) protein and to compare the APC status with the characteristics of colorectal adenomas.METHODS: Immunohistochemical analysis of the APC protein was performed on 118 adenomas and the results were compared with parameters of malignant potential,location of adenomas, macroscopic appearance and age of the patients.RESULTS: A complete loss of the APC protein was found in 28 (24%) adenomas, while 90 (76%) were APC positive. The mean size of adenomas was 13.5 ± 14.2 mm (95% CI 10.5-16.5) in APC-positive, and 13.8 ± 15.5mm (95% CI 7.8-19.8) in APC-negative adenomas (P = 0.364). Statistical analysis revealed no difference between APC-positive and negative adenomas as to the histological type (P = 0.327) and grade of dysplasia (P =0.494). We found that even advanced adenomas did not differ in their APC status from the non-advanced tumors (P = 0.414). Finally, no difference was found when the location (P = 0.157), macroscopic appearance (P =0.571) and age of patients (P = 0.438) were analysed and compared between both APC positive and negative adenomas.CONCLUSION: Most adenomas expressed full-length APC protein, suggesting that protein expression is not a reliable marker for assessment of APC gene mutation.Complete loss of APC protein did not influence morphology, location, or appearance of adenomas, nor was it affected by the patient's age.

  16. Molecular biological examination of somatotroph pituitary adenomas related to clinical data from patients with acromegaly

    2010-01-01

    Definition and epidemiology The first historical description of acromegaly could be the story of David and Goliath described both in The Old Testament and in the Koran. Goliath was a giant, but David defeated him by sneaking up on him, maybe in his visual field defect, and hitting him with a stone in the forehead using a sling. The connection between gigantism and the pituitary, hence with the possibility of visual disturbances, was not recognized until 1884, published in a book by Fritzsc...

  17. LIDERAZGO, LA COMPETENCIA ESENCIAL QUE TRANSFORMÓ UNA EMPRESA COLOMBIANA EN UN GIGANTE INTERNACIONAL: EL CASO DE CEMENTOS ARGOS

    HÉCTOR OCHOA DÍAZ

    2011-01-01

    Full Text Available Cementos Argos ha sido catalogado como uno de los gigantes de la industria cementera colombiana por su gran capacidad de consolidación en el mercado nacional y sus estrategias de internacionalización poco convencionales. Esta investigación documenta la experiencia internacional de Argos bajo la perspectiva de las teorías de internacionalización de mayor aceptación en laliteratura internacional, haciendo uso del enfoque metodológico de los estudios de caso. Como resultado se encontró que las estrategias de fidelización,aunadas al rediseño organizacional resultado del liderazgo de la alta gerencia, han sido herramientas vitales para asegurar el crecimiento de la compañía en los mercados local y externo.

  18. An Interesting Case of Life-Threatening Hypercalcemia Secondary to Atypical Parathyroid Adenoma versus Parathyroid Carcinoma

    Ankur Mishra

    2014-01-01

    Full Text Available Context. Severe hypercalcemia is a life-threatening condition. Atypical parathyroid adenoma and parathyroid carcinomas are uncommon causes which can be difficult to differentiate. Objective. We report a case of a 36-year-old male with very high serum calcium due to a possible atypical parathyroid adenoma versus parathyroid carcinoma. Case Illustration. A serum calcium level of 23.2 mg/dl was noted on admission. He was initially treated with IV hydration, pamidronate, and salmon calcitonin to lower his calcium levels. He also underwent a surgical en bloc resection of parathyroid mass. Pathology showed a mixed picture consistent with possible atypical adenoma versus parathyroid carcinoma. However, due to the possible involvement of the recurrent laryngeal nerve, parathyroid carcinoma was more likely. Also after operation the patient developed hungry bones syndrome and his calcium was replaced vigorously. He continues to be on calcium, vitamin D, and calcitriol supplementation. Results. A review of the literature was conducted to identify previous studies pertaining to parathyroid adenomas and parathyroid cancer. Conclusion. We thereby conclude that hypercalcemia requires very careful monitoring especially after operation. Also it can be very difficult to distinguish between atypical parathyroid adenomas and parathyroid carcinomas as in our case and no clear cut guidelines yet exist to differentiate the two based on histology.

  19. Acromegaly due to a Macroinvasive Plurihormonal Pituitary Adenoma and a Rectal Carcinoid Tumor

    Sang Ouk Chin

    2015-09-01

    Full Text Available A macroinvasive pituitary adenoma with plurihormonality usually causes acromegaly and hyperprolactinemia, and also accompanies with neurologic symptoms such as visual disturbances. However, its concurrent presentation with a rectal carcinoid tumor is rarely observed. This study reports the history, biochemical, colonoscopic and immunohistochemical results of a 48-year-old female with acromegaly and hyperprolactinemia. Despite the large size and invasive nature of the pituitary adenoma to adjacent anatomical structures, she did not complain of any neurologic symptoms such as visual disturbance or headache. Immunohistochemical staining of the surgical specimen from the pituitary adenoma revealed that the tumor cells were positive for growth hormone (GH, prolactin (PRL, and thyroid stimulating hormone (TSH. Staining for pituitary-specific transcription factor-1 (Pit-1 was shown to be strongly positive, which could have been possibly contributing to the plurihormonality of this adenoma. Colonoscopy found a rectal polyp that was identified to be a carcinoid tumor using immunohistochemical staining. A macroinvasive pituitary adenoma with concomitant rectal carcinoid tumor was secreting GH, PRL, and TSH, which were believed to be in association with over-expression of Pit-1. This is the first case report of double primary tumors comprising a plurihormonal pituitary macroadenoma and rectal carcinoid tumor.

  20. HYALINIZING TRABECULAR ADENOMA FEIGNING PAPILLARY CARCINOMA THYROID: CASE REPORT WITH REVIEW OF LITERATURE

    Kandukuri Mahesh

    2014-05-01

    Full Text Available Hyalinizing Trabecular Adenoma (HTA of the thyroid is a rare neoplasm that was first described by Carney in 1987. It is a tumor of follicular derivation with peculiar nuclear, architectural, histochemical, and immunohistochemical features. We report a case of Hyalinizing trabecular adenoma in a 36-year-old woman with enlarged thyroid lobe. Ultrasonographic features and fine needle aspiration cytology (FNAC of the enlarged thyroid was performed and the diagnosis given was Papillary carcinoma of the thyroid. The patient underwent total thyroidectomy, with a histopathological diagnosis of hyalinizing trabecular Adenoma (HTA. We present this case in view of its rarity and to discuss the clinical and diagnostic approach, including the role of FNAC, and the pathologic features of HTA with special reference to the possible differential diagnosis and also review of literature. Although rare cases of malignant Hyalinizing trabecular adenoma (HTA have been documented, this tumor should be considered a benign neoplasm or at most, a neoplasm of extremely low malignant potential, however invasion of the capsule should be considered on histopathology. An awareness of hyalinizing trabecular adenomas and their characteristic features is valuable for their recognition and management as well as for the possible prevention of over diagnosis and over treatment for benign disease

  1. Basal cell adenoma in the parotid: a bizarre myoepithelial-derived stroma rich variant.

    Huang, Yong

    2014-01-01

    Basal cell adenoma (BCA) is a specific entity that lacks the myxochondroid stromal component of a pleomorphic adenoma. There are six histopathological types of BCA: solid, tubular, trabecular, membranous, cribriform, and myoepithelial-derived stroma rich. Myoepithelial-derived stroma rich variant is so rare, especially with cellular atypia. Herin we describe a rare case of BCA arising in the parotid on a 25-year-old man. A well-demarcated nodule arising in the parotid that was composed of basaloid cells, forming small duct-like or tubular structures containing basement membrane-like material, as well as highly cellular elongated cells with hyperchromatic, enlarged, pleomorphic, and bizarre nuclei. Immunohistochemically, S100 protein and p63 highlighted the basal aspect of the peripheral epithelial cells and peripheral spindle and bizarre cells, while CK7 expressed on the luminal cells. We made a diagnosis of "basal cell adenoma, myoepithelial-derived stroma rich variant, with bizarre myoepithelial proliferation". The differential diagnosis includes cellular pleomorphic adenoma, basal cell adenocarcinoma, and carcinoma ex pleomorphic adenoma. After follow-up for 3 years, there was no evidence of recurrence. Further pathological characteristics of this disease are discussed.

  2. Preoperative diagnosis of tubular adenoma of breast - 10 years of experience

    Sanjay Sengupta

    2014-01-01

    Full Text Available Background: Tubular adenomas are rare benign neoplasms of female breast affecting women, predominantly of child-bearing age group. Definitive diagnosis of this tumor is usually achieved after histopathological study. Clinical, radiological, and even cytological features are often insufficient for accurate diagnosis. Aim: The aim of the present study was planned to analyze clinical and radiological features of histologically confirmed cases of tubular adenoma of breast to find out a clue for accurate preoperative cytological diagnosis. Materials and Methods: In our 10-year research program, all histologically confirmed tubular adenoma cases of breast were studied. Clinico-radio-cytological features, if available, were analyzed and tabulated. Results: Thirty-three cases of tubular adenoma of breast were studied. Radiological and cytological assessments are available for 12 and 26 cases, respectively. Tubular adenoma could be diagnosed in only two cases (7.7% by cytological assessment, but in none by radiological assessment. Conclusions: Clinico-cyto-radiological assessment could identify the benign nature of the tumors in most cases, but final confirmation was possible only after histopathological study.

  3. Segmentation of pituitary adenoma: a graph-based method vs. a balloon inflation method.

    Egger, Jan; Zukić, Dženan; Freisleben, Bernd; Kolb, Andreas; Nimsky, Christopher

    2013-06-01

    Among all abnormal growths inside the skull, the percentage of tumors in sellar region is approximately 10-15%, and the pituitary adenoma is the most common sellar lesion. A time-consuming process that can be shortened by using adequate algorithms is the manual segmentation of pituitary adenomas. In this contribution, two methods for pituitary adenoma segmentation in the human brain are presented and compared using magnetic resonance imaging (MRI) patient data from the clinical routine: Method A is a graph-based method that sets up a directed and weighted graph and performs a min-cut for optimal segmentation results: Method B is a balloon inflation method that uses balloon inflation forces to detect the pituitary adenoma boundaries. The ground truth of the pituitary adenoma boundaries - for the evaluation of the methods - are manually extracted by neurosurgeons. Comparison is done using the Dice Similarity Coefficient (DSC), a measure for spatial overlap of different segmentation results. The average DSC for all data sets is 77.5±4.5% for the graph-based method and 75.9±7.2% for the balloon inflation method showing no significant difference. The overall segmentation time of the implemented approaches was less than 4s - compared with a manual segmentation that took, on the average, 3.9±0.5min.

  4. Polymorphisms in WNT6 and WNT10A and colorectal adenoma risk.

    Galbraith, Rachel L; Poole, Elizabeth M; Duggan, David; Muehling, Jill; Hsu, Li; Makar, Karen; Xiao, Liren; Potter, John D; Ulrich, Cornelia M

    2011-01-01

    The WNT/β-catenin signaling pathway upregulates transcription of genes involved in cell proliferation and cancer progression; it has been implicated in colorectal adenoma formation. To date, no studies have examined polymorphisms in WNT genes or WNT gene-environment interactions in relation to adenoma risk. Within a colonoscopy-based case-control study of 628 adenoma cases and 516 polyp-free controls, we analyzed two tagSNPs in WNT6 (rs6747776 G > C, rs6754599 G > C) and WNT10A (rs7349332 G > A, rs10177996 A > G). The WNT6 rs6747776 homozygous minor allele (CC) was associated with increased risk of colorectal adenoma (OR = 2.75, 95% CI: 1.03-7.31). We observed a statistically significant interaction between WNT6 rs6747776 and the proportion of calories from total fat (P-int = 0.02), where the highest risk was observed among those with minor alleles and lowest fat intake. We also detected a marginally significant (0.05 rs7349332 polymorphism. Our results suggest that genetic variability in the WNT pathway may play a role in colorectal adenoma formation or may partly mediate the increased risk of colorectal cancer associated with fat intake.

  5. Divertículo gigante de colon: presentación de un caso Giant colonic diverticulum: case report

    Ezequiel Ochoa

    2008-12-01

    Full Text Available El divertículo gigante de colon (DGC es una rara complicación de la enfermedad diverticular. Se considera divertículo gigante cuando su diámetro supera los 4 cm. Descrito por primera vez en la literatura francesa en el año 1946, se han publicado hasta la fecha 155 casos. Nuestro paciente, de 59 años, refirió clínica de dolor abdominal leve de 4 meses de evolución. Se le solicitó un estudio de colon por enema, el que reveló una formación sacular de 15 cm en colon sigmoideo, de contenido aéreo y cuello corto, a través del cual se opacificó la cavidad con la sustancia baritada, confirmando el diagnóstico de DGC. Al paciente se le realizó, además, tomografía computada y resonancia magnética. El diagnóstico se confirmó con cirugía y estudio histopatológico. Se practicó una resección sigmoidea con DGC y anastomosis colorrectal lateroterminal. El estudio anatomopatológico informó DGC tipo II.Giant colonic diverticulum is a rare diverticular disease complication. It is considered giant when its diameter is longer than 4 cms. It was reported the first time by french authors in 1946 and there is 155 cases reported in world literature. Our patient aged 59 years old, referred four month of abdominal pain. A barium enema was made showing a sigmoid cavity with air and fill of barium contrast with short neck continuing with the colon lumen. It was also studied with CT and MRI. The diagnosis was confirmed by surgery and histopathologic exam. The pathologic report informed giant colonic diverticulum type II.

  6. On the shoulders of giants: Harvey Cushing's experience with acromegaly and gigantism at the Johns Hopkins Hospital, 1896-1912.

    Pendleton, Courtney; Adams, Hadie; Salvatori, Roberto; Wand, Gary; Quiñones-Hinojosa, Alfredo

    2011-03-01

    A review of Dr. Cushing's surgical cases at Johns Hopkins Hospital revealed new information about his early operative experience with acromegaly. Although in 1912 Cushing published selective case studies regarding this work, a review of all his operations for acromegaly during his early years has never been reported. We uncovered 37 patients who Cushing treated with surgical intervention directed at the pituitary gland. Of these, nine patients who presented with symptoms of acromegaly, and one with symptoms of gigantism were selected for further review. Two patients underwent transfrontal 'omega incision' approaches, and the remaining eight underwent transsphenoidal approaches. Of the 10 patients, 6 were male. The mean age was 38.0 years. The mean hospital stay was 39.4 days. There was one inpatient death during primary interventions (10%) and three patients were deceased at the time of last follow-up (33%). The mean time to death, calculated from the date of the primary surgical intervention, and including inpatient and outpatient deaths, was 11.3 months. The mean time to last follow-up, calculated from the day of discharge, was 59.3 months. At the time of last follow-up, two patients reported resolution of headache; four patients reported continued visual deficits, and two patients reported ongoing changes in mental status. This review analyzes the outcomes for 10 patients who underwent surgical intervention for acromegaly or gigantism, and offers an explanation for Cushing's transition from the transfrontal "omega incision" to the transsphenoidal approach while practicing at the Johns Hopkins Hospital.

  7. Aggressive tumor growth and clinical evolution in a patient with X-linked acro-gigantism syndrome.

    Naves, Luciana A; Daly, Adrian F; Dias, Luiz Augusto; Yuan, Bo; Zakir, Juliano Coelho Oliveira; Barra, Gustavo Barcellos; Palmeira, Leonor; Villa, Chiara; Trivellin, Giampaolo; Júnior, Armindo Jreige; Neto, Florêncio Figueiredo Cavalcante; Liu, Pengfei; Pellegata, Natalia S; Stratakis, Constantine A; Lupski, James R; Beckers, Albert

    2016-02-01

    X-linked acro-gigantism (X-LAG) syndrome is a newly described disease caused by microduplications on chromosome Xq26.3 leading to copy number gain of GPR101. We describe the clinical progress of a sporadic male X-LAG syndrome patient with an Xq26.3 microduplication, highlighting the aggressive natural history of pituitary tumor growth in the absence of treatment. The patient first presented elsewhere aged 5 years 8 months with a history of excessive growth for >2 years. His height was 163 cm, his weight was 36 kg, and he had markedly elevated GH and IGF-1. MRI showed a non-invasive sellar mass measuring 32.5 × 23.9 × 29.1 mm. Treatment was declined and the family was lost to follow-up. At the age of 10 years and 7 months, he presented again with headaches, seizures, and visual disturbance. His height had increased to 197 cm. MRI showed an invasive mass measuring 56.2 × 58.1 × 45.0 mm, with compression of optic chiasma, bilateral cavernous sinus invasion, and hydrocephalus. His thyrotrope, corticotrope, and gonadotrope axes were deficient. Surgery, somatostatin analogs, and cabergoline did not control vertical growth and pegvisomant was added, although vertical growth continues (currently 207 cm at 11 years 7 months of age). X-LAG syndrome is a new genomic disorder in which early-onset pituitary tumorigenesis can lead to marked overgrowth and gigantism. This case illustrates the aggressive nature of tumor evolution and the challenging clinical management in X-LAG syndrome.

  8. EXPRESSION OF TGF-β1 AND TGF-β R II IN COLORECTAL ADENOMAS OF VARYING STAGES

    2001-01-01

    To study the function of transforming growth factor β1 (TGF-β1)and transforming growth factor-β type II receptor (TGF-βR II) in varying stages of colorectal adenoma during neoplastic transformation,fifty-five cases of resected colorectal adenomas were examined immunohistochemically.Our results showed that the expression of TGF-β1 ranged from high to low,with the progression of low-grade to high-grade dysplasia of adenomas to carcinoma.And there was significantly different expression of TGF-β1 between moderate and high dysplasia adenomas (P<0.05),but no significantly different expression of TGF-β R II was found among varying stages of adenomas.Our results suggested that the quantities of TGF-β1 secreted by adenoma cells decrease dramatically in moderate to severe dysplasia colorectal adenomas.It is the decreased secretion of TGF-β1,rather than the mutated TGF-βR II that may play an important role in transforming colorectal adenomas to adenocarcinomas.

  9. Incidence, causative mechanisms, and anatomic localization of stroke in pituitary adenoma patients treated with postoperative radiation therapy versus surgery alone

    Sattler, Margriet; Vroomen, Patrick; Sluiter, Wim J.; Schers, Henk J.; van den Berg, Gerrit; Langendijk, Johannes A.; Wolffenbuttel, Bruce H. R.; van den Bergh, Alphons C. M.; van Beek, Andre P.

    2013-01-01

    PURPOSE: To assess and compare the incidence of stroke and stroke subtype in pituitary adenoma patients treated with postoperative radiation therapy (RT) and surgery alone. METHODS AND MATERIALS: A cohort of 462 pituitary adenoma patients treated between 1959 and 2008 at the University Medical Cente

  10. The incidence of second tumours and mortality in pituitary adenoma patients treated with postoperative radiotherapy versus surgery alone

    Sattler, M.G.A.; van Beek, A.P.; Wolffenbuttel, B.H.R.; van den Berg, G.; Sluiter, W.J.; Langendijk, J.A.; van den Bergh, A.C.M.

    2012-01-01

    Background and purpose: To assess and compare the incidence of intra- and extracranial tumours and mortality in pituitary adenoma patients treated with postoperative radiotherapy and surgery alone. Patients and methods: A total of 462 pituitary adenoma patients were treated between 1959 and 2008 at

  11. Das gastral differenzierte Adenom (pyloric gland adenoma. Fact or Fiction?

    Vieth M

    2005-01-01

    Full Text Available Das gastral differenzierte Adenom des Magens wird in der englischen Literatur als "pyloric gland adenoma" bezeichnet. Der erste Bericht zu dieser Entität erschien 1976 als Buchbeitrag, allerdings wurde die Läsion damals als eine Adenom-artige Hyperplasie mukoider Drüsen beschrieben. Erst ab 1990 wurden Pylorusdrüsen-Adenome korrekt als gastral differenzierte Adenome identifiziert und diagnostische Kriterien entwickelt. Die Bezeichnung Pylorusdrüsen-Adenom spiegelt die Entstehung aus den tiefen gastralen Drüsenverbänden wieder. Sicher sind die Pylorusdrüsen-Adenome bereits im Routine-HE-Präparat zu diagnostizieren und durch die Immunhistochemie zu bestätigen. Typischerweise exprimieren die Pylorusdrüsen-Adenome Mucin 6, das sonst nur im tiefen Drüsenkörper gefunden werden kann, über die gesamte Breite der Läsion, oft bis zur Oberfläche. Das oberflächliche Mucin 5AC ist oft nur auf eine schmale oberflächliche Zone beschränkt; die Expression kann jedoch stark variieren. Eine Kombination mit Anteilen gewöhnlicher tubulärer Adenome (intestinale Differenzierung kann beobachtet werden. Überproportional häufig ist die Magen-Corpusschleimhaut älterer Patientinnen mit Autoimmungastritis betroffen. Die Häufigkeit von Pylorusdrüsen-Adenomen wird mit 2,7 % aller Magenpolypen angegeben und ist damit nicht so selten wie vermutet. Die wenigen vorhandenen Publikationen zu diesem Thema deuten darauf hin, daß diese Entität meist fehlinterpretiert wird. Pylorusdrüsen-Adenome können im gesamten Gastrointestinaltrakt entstehen. Die klinische Bedeutung liegt in der hohen Rate (30 % der malignen Entartung. Allerdings handelt es sich hierbei vorwiegend um hochdifferenzierte Frühkarzinome mit entsprechend guter Prognose nach endoskopischer Abtragung.

  12. Molecular and cellular mechanisms of aldosterone producing adenoma development

    Sheerazed eBoulkroun

    2015-06-01

    Full Text Available Primary aldosteronism (PA is the most common form of secondary hypertension with an estimated prevalence of ~10% in referred patients. PA occurs as a result of a dysregulation of the normal mechanisms controlling adrenal aldosterone production. It is characterized by hypertension with low plasma renin and elevated aldosterone and often associated with hypokalemia. The two major causes of PA are unilateral aldosterone producing adenoma (APA and bilateral adrenal hyperplasia, accounting together for ~95% of cases. In addition to the well-characterized effect of excess mineralocorticoids on blood pressure, high levels of aldosterone also have cardiovascular, renal and metabolic consequences. Hence, long-term consequences of PA include increased risk of coronary artery disease, myocardial infarction, heart failure and atrial fibrillation. Despite recent progress in the management of patients with PA, critical issues related to diagnosis, subtype differentiation and treatment of non-surgically correctable forms still persist. A better understanding of the pathogenic mechanisms of the disease should lead to the identification of more reliable diagnostic and prognostic biomarkers for a more sensitive and specific screening and new therapeutic options. In this review we will summarize our current knowledge on the molecular and cellular mechanisms of APA development. On one hand, we will discuss how various animal models have improved our understanding of the pathophysiology of excess aldosterone production. On the other hand, we will summarize the major advances made during the last few years in the genetics of APA due to transcriptomic studies and whole exome sequencing. The identification of recurrent and somatic mutations in genes coding for ion channels (KCNJ5 and CACNA1D and ATPases (ATP1A1 and ATP2B3 allowed highlighting the central role of calcium signaling in autonomous aldosterone production by the adrenal.

  13. Middle ear adenoma with neuroendocrine differentiation: relate of two cases and literature review

    Bittencourt, Aline Gomes; Tsuji, Robinson Koji; Cabral, Francisco; Pereira, Larissa Vilela; Fonseca, Anna Carolina de Oliveira; Alves, Venâncio; Bento, Ricardo Ferreira

    2013-01-01

    Summary Introduction: Adenomas with neuroendocrine differentiation are defined as neuroendocrine neoplasms, and they are rarely found in the head and neck. Objective: To describe two cases of a middle ear adenoma with neuroendocrine differentiation, with a literature review. Case Report: Patient 1 was a 41-year-old woman who presented with a 3-year history of left aural fullness associated with ipsilateral “hammer beating” tinnitus. Patient 2 was a 41-year-old male who presented with unilateral conductive hearing loss. Conclusion: Adenoma with neuroendocrine differentiation of the middle ear is a rare entity, but it should be considered in patients with tinnitus, aural fullness, and a retrotympanic mass and remembered as a diferential diagnosis of tympanic paraganglioma. PMID:25992031

  14. Pitfalls in Cytodiagnosis of Pleomorphic Adenoma of the Nasal Septum - A Rare Case Report

    Abhishek MG

    2010-10-01

    Full Text Available Pleomorphic adenoma is the most common benign mixed tumor of major salivary gland. Ectopic occurrence of pleomorphic adenoma are seen in minor salivary glands of pharynx, trachea, larynx and very rarely in nasal septum. We report a case of 40 year old female who presented with right sided nasal mass and mild nasal obstruction since six months. Cytologically a possibility of pleomorphic adenoma was made which was confirmed by histopathological study. We present this case due to 1 rarity in the nasal septum 2 pitfalls at cytology due to abundance (predominance of myoepithelial cells and scanty or even absent mesenchymal component and 3 under reporting in English literature to the best of our knowledge.

  15. PRELIMINARY APPLICATION OF COLOR DOPPLER FLOW IMAGING IN THE LOCALIZATION OF PARATHYROID ADENOMAS

    张缙熙; 李建初

    1994-01-01

    From December 1991 to April 1993,we performed color Doppler flow imaging(CDFI) in 11 patients with parathyroid adenoma,and all cases were confirmed by toperation and pathology.In all the parathyroid adenomas,vessels were clearly revealed at the periphery of the upper pole and /or anterior periphery,where arterial signals were elicited.These arteries had branches into the adenomas and originated from inferior thyroid arteries on the same side in most cases.The internal flow signals were increased markedly as compared to normal thyroid,and high-velocity arterial signals were detected.Because of the thyroid's rich blood supply and landmark peripheral vessels.CDFI can distinguish parathyroid foci from thyroid nodules,lymph nodes,and normal tissues and provide a sound basis for the diagnosis of small parathyroid foci.

  16. Rare carcinoma ex pleomorphic adenoma of the buccal minor salivary gland causing a therapeutic dilemma

    Yogesh Kini

    2012-01-01

    Full Text Available Carcinoma ex pleomorphic adenoma (CXPA, as a group, constitutes 12% of malignant salivary gland tumors. We present a case of CXPA of the buccal mucosa in a 17-year-old patient. The buccal mass was of a size of 3.0 cm located in the right cheek. Pleomorphic adenoma was the provisional diagnosis. The tumor was excised under local anesthesia. Histopathological evaluation revealed a pre-existing pleomorphic adenoma. However, on magnification, certain areas showed islands of dysplastic epithelial cells′ invading the fibrous capsule and CXPA was diagnosed. The patient was recalled and secondary surgery of the site performed. No tumor tissue could be detected in the secondary resection specimen. There is no sign of recurrence since 2 years.

  17. Gamma Knife radiosurgery in pituitary adenomas: Why, who, and how to treat?

    Castinetti, Frederic; Brue, Thierry

    2010-08-01

    Pituitary adenomas are benign tumors that can be either secreting (acromegaly, Cushing's disease, prolactinomas) or non-secreting. Transsphenoidal neurosurgery is the gold standard treatment; however, it is not always effective. Gamma Knife radiosurgery is a specific modality of stereotactic radiosurgery, a precise radiation technique. Several studies reported the efficacy and low risk of adverse effects induced by this technique: in secreting pituitary adenomas, hypersecretion is controlled in about 50% of cases and tumor volume is stabilized or decreased in 80-90% of cases, making Gamma Knife a valuable adjunctive or first-line treatment. As hormone levels decrease progressively, the main drawback is the longer time to remission (12-60 months), requiring an additional treatment during this period. Hypopituitarism is the main side effect, observed in 20-40% cases. Gamma Knife is thus useful in the therapeutic algorithms of pituitary adenomas in well-defined indications, mainly low secreting small lesions well identified on magnetic resonance imaging (MRI).

  18. Pituitary adenoma and vestibular schwannoma: Case report and review of the literature

    Niu Y

    2010-01-01

    Full Text Available The concurrence of the intracranial multiple primary tumors (MPTs consisting of acoustic neuroma (AN and pituitary adenoma is very rare. Here, we report a 42-year-old female who presented with left AN associated with pituitary adenoma. A total of three such cases have been reported before and which also presented with left AN with pituitary adenoma. Recently, a new "field cancerization" model has been proposed, which could explain MPTs and is consistent with the pathogenesis of such cases. The model also indicates that when a pituitary tumor or AN is detected separately, we might consider the development of "expanding field" after oncological treatment especially after radiotherapy in order to prevent the second field tumor occurring.

  19. Small intestinal tubular adenoma in a pediatric patient with Turner syndrome.

    Tang, Wen-Juan; Huang, Ying; Chen, Lian; Zheng, Shan; Dong, Kui-Ran

    2013-04-07

    Turner syndrome (TS) is a female chromosomal disorder caused by the lack of an X chromosome. The loss of this chromosome may result in the deficiency of tumor-suppressive or DNA repair genes, leading to tumorigenesis. Recombinant human growth hormone (GH) has been popularly used for treatment in TS patients for growth promotion. Although treatment with GH has been correlated with precancerous and cancerous lesions in TS children, its associations with gastric or colonic tumors, especially ileal tubular adenomas, have not been reported frequently. We here report a case of a 16-year-old patient with TS and tubular adenoma of the small intestine. Whether the ileal adenoma was caused by TS itself or GH therapy was discussed.

  20. Xanthomatous Hypophysitis Mimicking a Pituitary Adenoma: Case Report and Review of the Literature

    Laura Aste

    2010-01-01

    Full Text Available Background. Hypophysitis is an inflammatory disease of the pituitary gland that may mimic pituitary tumors clinically and radiologically. Case Description. We report a case of a xanthomatous hypophysitis initially diagnosed as pituitary adenoma. A 31-year-old woman presented with headache, diabetes insipidus, and amenorrhea. A head CT scan showed no intrasellar changes, while an MRI scan showed a sellar cystic mass. An endocrinological work up revealed mild hypocortisolism and diabetes insipidus (DI. Transsphenoidal surgery was performed. The intraoperative histological examination suggested a pituitary adenoma. The removed tissue showed central necrosis surrounded by accumulation of foamy cells and xanthomatous epithelioid cells. The patient made an uneventful postoperative recovery, Nevertheless, DI persisted and the adenohypophysis hypofunction did not recover. Conclusion. We describe an unusual inflammatory lesion of the pituitary gland mimicking an adenoma. A high level of clinical suspicion of inflammatory disorders is necessary for correct diagnosis and optimal management.

  1. Small intestinal tubular adenoma in a pediatric patient with Turner syndrome

    Tang, Wen-Juan; Huang, Ying; Chen, Lian; Zheng, Shan; Dong, Kui-Ran

    2013-01-01

    Turner syndrome (TS) is a female chromosomal disorder caused by the lack of an X chromosome. The loss of this chromosome may result in the deficiency of tumor-suppressive or DNA repair genes, leading to tumorigenesis. Recombinant human growth hormone (GH) has been popularly used for treatment in TS patients for growth promotion. Although treatment with GH has been correlated with precancerous and cancerous lesions in TS children, its associations with gastric or colonic tumors, especially ileal tubular adenomas, have not been reported frequently. We here report a case of a 16-year-old patient with TS and tubular adenoma of the small intestine. Whether the ileal adenoma was caused by TS itself or GH therapy was discussed. PMID:23599636

  2. Tubulovillous Adenoma in the Bladder in a Dual Pancreas-Kidney Transplant Patient

    Remondini, Taylor; Van Zyl, Stephan; Bismar, Tarek A.; Yilmaz, Serdar

    2017-01-01

    Abstract Background: A rare report of a tubulovillous adenoma arising in the setting of a dual pancreas-kidney transplant patient. Case Presentation: This adenoma was discovered in a 60-year-old male with a dual pancreas-kidney transplant that presented with urinary retention and gross hematuria. Management of this patient required both transurethral resection of the tumor as well as a laparotomy after recurrence. Follow-up with cystoscopy has shown no further recurrence of the tumor. Conclusion: This case adds to the few cases documented of adenomas arising in bladders augmented with gastrointestinal tract tissue. The tumor may reflect growth from donor duodenal graft tissue, however, the metaplasia of urothelial tissue cannot be fully ruled out. Based on this case, our understanding of these rare tumors and their clinical course is deepened. PMID:28265591

  3. Massive Multinodular Head and Neck Recurrence of Parotid Gland Pleomorphic Adenoma: A Case Report

    Pierre Philouze

    2014-01-01

    Full Text Available Introduction. The optimal initial management of parotid pleomorphic adenomas reduces the risk of recurrence and malignant transformation. Surgery of recurrence can be difficult in multinodular disseminated forms. Case Report. A 67-years-old patient was referred for management of a large multifocal recurrence of a pleomorphic adenoma operated on 23 years ago. The clinical and radiological assessment found parapharyngeal, infratemporal, and prestyloid invasion, with nodules in the sternocleidomastoid muscle. Excision by transmandibular approach was performed. The pathologist found a multinodular recurrent pleomorphic adenoma without criteria of malignancy. Postoperative radiotherapy was performed. Discussion. Multinodular forms and incomplete resections are the most important factors that are thought to predispose to recurrence. A precise analysis of the extension by preoperative MRI is essential. Adjuvant radiotherapy can be given in these recurrent multifocal forms.

  4. TFF3 knockout in human pituitary adenoma cell HP75 facilitates cell apoptosis via mitochondrial pathway.

    Gao, Feng; Pan, Suxia; Liu, Bing; Zhang, Huanzhi

    2015-01-01

    Trefoil factor 3 (TFF3), a regulatory protein composed of 59 amino acids, has been suggested to be involved in pathogenesis, proliferation, differentiation, invasion, migration and apoptosis in multiple malignant tumors. This study thus investigated the effect of TFF3 knockout in human pituitary adenoma cell line HP75 on cell apoptosis and related pathways. RNA interference approach was used to knock down the expression of TFF3 protein. The gene silencing was validated by RNA denaturing gel electrophoresis and Western blotting. The effect of TFF3 knockout on cell apoptosis was analyzed by Western blotting and flow cytometry. TFF3 protein level in pituitary adenoma was about 3.61 ± 0.48 folds of that in normal tissues (P TFF3, the apoptotic ration was significantly elevated (P TFF3 protein knockout can facilitate apoptosis of human pituitary adenoma HP75 cells via mitochondrial pathway.

  5. TFF3 knockout in human pituitary adenoma cell HP75 facilitates cell apoptosis via mitochondrial pathway

    Gao, Feng; Pan, Suxia; Liu, Bing; Zhang, Huanzhi

    2015-01-01

    Trefoil factor 3 (TFF3), a regulatory protein composed of 59 amino acids, has been suggested to be involved in pathogenesis, proliferation, differentiation, invasion, migration and apoptosis in multiple malignant tumors. This study thus investigated the effect of TFF3 knockout in human pituitary adenoma cell line HP75 on cell apoptosis and related pathways. RNA interference approach was used to knock down the expression of TFF3 protein. The gene silencing was validated by RNA denaturing gel electrophoresis and Western blotting. The effect of TFF3 knockout on cell apoptosis was analyzed by Western blotting and flow cytometry. TFF3 protein level in pituitary adenoma was about 3.61 ± 0.48 folds of that in normal tissues (P TFF3, the apoptotic ration was significantly elevated (P TFF3 protein knockout can facilitate apoptosis of human pituitary adenoma HP75 cells via mitochondrial pathway. PMID:26823779

  6. 垂体微腺瘤的临床内分泌与病理免疫组化类型相关性研究%Micro pituitary adenomas clinical endocrine correlation with pathologic types of immunohistochemical study

    禹亚丽

    2014-01-01

    目的:对垂体微腺瘤的临床症状体征、内分泌与病理免疫组化类型相关性进行探讨。方法选取2010年1月至2012年12月在本院确诊的垂体微腺瘤患者84例,对其进行内分泌、影像学和病理检查,分析检查结果之间的关系。结果患者出现内分泌症状76例(90.47%),免疫组化阳性组内分泌症状发生率[92.59%(75/81)]较免疫组化阴性组[33.33%(1/3)]高,差异具有显著性(χ2=5.92,P<0.05),表明内分泌症状与免疫组化结果相符。血清泌乳素(PRL)阳性组血清PRL增高及闭经、溢乳或月经失调发生率高于PRL阴性组;生长激素(GH)阳性组血清GH增高及巨人症或肢端肥大发生率高于GH阴性组。结论垂体微腺瘤患者的临床表现、内分泌结果与病理免疫组化类型相关,可用来提高垂体微腺瘤的诊断率与治疗率。%Objective To explore the relationship between the clinical symptoms and endocrine of micro pituitary adenomas and pathological immunohistochemical type. Method We had Choosed 84 patients with micro pituitary adenomas from January 2010 to December 2012 in our hospital, then checked the endocrine, imaging and pathological of them, and analysis the relationship between the test results. Result There were 76 cases (90.47%) had endocrine symptoms in all patients, the immunohistochemical positive endocrine symptoms rate was 92.59%(75/81) , this rate was higher than the immunohistochemical negative group which rate was 33.33%(1/3), the difference was statistically signiifcant (χ2=5.92, P<0.05), this indicated that the endocrine symptoms consistent with immunohistochemical results. The increased serum PRL and amenorrhea, spilled milk or incidence of menstrual disorder rate of serum prolactin (PRL) positive group were higher than that of PRL negative groups; increased serum GH and gigantism or acromegaly fertilizer rates of growth hormone (GH) positive group were higher than GH

  7. Expression for peroxisome proliferator-activated receptor gamma in pituitary adenomas 38 cases for semi-quantitative immunohistochemical analysis

    Xiaojie Lu; Kailai Chen; Weiyang Ji; Qing Wang; Bing Li; Jiang'an Li; Jiyong Sun

    2008-01-01

    BACKGROUND:It has been reposed that peroxisome proliferator-activated receptor γ(PPAR γ)is highly expressed in lung cancer,colon cancer,and gastric cancer,as well as other tumors.OBJECTIVE:To study expression of PPAR γ in pituitary adenomas and analyze the role of PPAR γ in hormonal typing of pituitary adenomas.DESIGN,TIME AND SETTING:Semi-quantitative immunohistochemistry of pathological specimens.The experiment was conducted at the Department of Neurosurgery,Wuxi Second Hospital Affiliated to Nanjing Medical University between January 2002 and May 2005.MATERIALS:Surgical resection samples of pituitary adenomas from 38 cases(18 male and 20 female)were analyzed.Eight cases were determined to be invasive pituitary adenomas and 30 cases were non-invasive pituitary adenomas.Hormonal classification of the types of pituitary adenomas revealed somatotrophic adenomas in six cases,corticotrophic adenoma in five cases,prolactinomas in 13 cases,multi-hormone secreting adenomas in six cases,and eight cases of adenoma without altered endocrine function.Five autopsy specimens were collected dunng the same period from patients of matching age that died from unrelated diseases and were included as normal anterior pituitary controls.METHODS:Cell counts for positive immunohistochemical signals were recorded from histopathological sections.The percentage of positive cells was reported as a semi-quantitative analysis.MAIN OUTCOME MEASURES:The rate of PPAR γ positive cells in different types of adenoma was based on hormonal levels and invasiveness of pituitary tumor cells.RESULTS:All tumor biopsies were determined to express PPAR γ.T1le rate of PPAR γ-positive cells ranged between 8%-65% in the pituitary adenomas.According to hormonal type,PPAR γ expression did not vary between the groups.In addition.there was no significant difference in PPAR γ expression between the non-invasive and invasive pituitary adenomas.CONCLUSIONS:Human pituitary adenomas express PPAR γ,and this

  8. Composite Epstein-Barr Virus-Associated B-Cell Lymphoproliferative Disorder and Tubular Adenoma in a Rectal Polyp.

    Lo, Amy A; Gao, Juehua; Rao, M Sambasivia; Yang, Guang-Yu

    2016-02-01

    Composite tumors are formed when there is intermingling between two components of separate tumors seen histologically. Cases demonstrating composite tubular adenoma with other types of tumors in the colon are rare. Composite tubular adenomas with nonlymphoid tumors including carcinoids, microcarcinoids, and small cell undifferentiated carcinoma have been reported in the literature. The occurrence of composite lymphoma and tubular adenoma within the colorectal tract is extremely rare. Only three cases have been reported and include one case of mantle cell lymphoma and two cases of diffuse large B-cell lymphoma arising in composite tubular adenomas. We present the first case of composite Epstein-Barr virus-associated B-cell lymphoproliferative disorder and tubular adenoma in a rectal polyp with a benign endoscopic appearance.

  9. Usefulness of {sup 99m}Tc-methoxy-isobutyl-isonitrile scintigraphy for preoperative localization of adenoma in primary hyperparathyroidism

    Yamaguchi, Seiji; Kobayashi, Yoshiyuki; Tsujikawa, Kozo [Ikeda Municipal Hospital, Osaka (Japan)] (and others)

    2001-09-01

    We evaluated the usefulness of {sup 99m}Tc-methoxy-isobutyl-isonitrile (MIBI) dual phase scintigraphy for detecting hyperfunctioning parathyroid adenoma. We retrospectively reviewed 18 hyperparathyroid patients who received MIBI prior to neck exploration and compared the radiological findings of MIBI with ultrasonography (US) and magnetic resonance imaging (MRI). Fifteen patients were studied with MRI, and 17 patients were examined with US. All patients were found to have a solitary parathyroid adenoma histopathologically. MIBI correctly revealed the location of 17 adenomas among 18 confirmed tumors. In our series, there was one false-positive case that was found to have thyroid adenoma. The diagnostic sensitivity of MIBI MRI and US and 94.4%, 80% and 52.5%, respectively. The positive predictive value (PPV) was 94.4% for MIBI, 81.8% for MRI and 92.3% for US. We conclude that MIBI is useful and accurate for the preoperative localization of adenoma in primary hyperparathyroidism. (author)

  10. [Prognostic implications of folliculo-stellate cells in pituitary adenomas: relationship with tumoral behavior].

    Tortosa, F; Pires, M; Ortiz, S

    2016-10-01

    Introduccion. A pesar del progreso en la comprension de su patogenia, no se ha encontrado ningun marcador predictivo independiente del comportamiento agresivo de los adenomas hipofisarios que facilite el tratamiento y seguimiento de pacientes afectados. Objetivo. Analizar la expresion de celulas foliculo-estrelladas, mediante inmunomarcacion con proteina S-100, en una serie de pacientes con adenomas hipofisarios seguidos durante al menos siete años. Pacientes y metodos. Estudio retrospectivo de 51 pacientes diagnosticados de adenoma hipofisario entre 2006 y 2008, segun los criterios vigentes de la Organizacion Mundial de la Salud. Se evaluo inmunohistoquimicamente la expresion de S-100 en celulas foliculo-estrelladas, y se correlaciono con parametros clinicorradiologicos e histopatologicos del tumor y la progresion/recurrencia postoperatoria. Resultados. De 51 tumores, 40 se clasificaron como adenomas hipofisarios tipicos y 11 como atipicos. La mayoria de los tipicos mostro celulas foliculo-estrelladas positivas para S-100 (media: 3,93%); los atipicos tenian pocas o ninguna celula S-100 positivas (media: 0,83%). No hubo diferencias significativas en la expresion de S-100 con respecto a la edad o sexo del paciente, tamaño, invasividad o recidiva tumoral posquirurgica. Conclusiones. En el grupo de estudio, a excepcion de los adenomas no funcionantes inmunopositivos para prolactina, con la media mas baja y mas alta de todos los subtipos en ambos grupos (tipicos, 0,25%, frente a atipicos, 9,24%; p = 0,0028), el factor predictivo de agresividad tumoral para los adenomas hipofisarios no esta representado por un bajo valor de S-100 en las celulas foliculo-estrelladas, lo que no permite seleccionar a pacientes para un tratamiento postoperatorio intensivo.

  11. WT1 expression in salivary gland pleomorphic adenomas: a reliable marker of the neoplastic myoepithelium.

    Langman, Gerald; Andrews, Claire L; Weissferdt, Annikka

    2011-02-01

    Pleomorphic adenoma is a benign salivary gland neoplasm with a diverse morphology. This is considered to be a function of the neoplastic myoepithelium, which shows histological and immunophenotypical variability. Wilms' tumor 1 gene (WT1) protein, involved in bidirectional mesenchymal-epithelial transition, has been detected by reverse transcription PCR in salivary gland tumors showing myoepithelial-epithelial differentiation. The aim of this study was to investigate the immunoreactivity of WT1 in pleomorphic adenomas and to compare the pattern of staining with p63 and calponin, two reliable markers of myoepithelial cells. A total of 31 cases of pleomorphic adenoma were selected. The myoepithelium was classified as myoepithelial-like (juxtatubular and spindled), modified myoepithelium (myxoid, chondroid and plasmacytoid) and transformed myoepithelium (solid epithelioid, squamous and basaloid cribriform). Immunohistochemistry for WT1, p63 and calponin was assessed in each myoepithelial component, as well as in nonneoplastic myoepithelial cells and inner tubular epithelial cells. There was no immunostaining of tubular epithelial cells by any of the markers. In contrast to p63 and calponin, WT1 did not react with normal myoepithelial cells. Cytoplasmic WT1 staining was present in all pleomorphic adenomas, and in 29 cases (94%), >50% of neoplastic myoepithelial cells were highlighted. p63 and calponin stained the myoepithelium in 30 tumors. In comparison, 50% of cells were positive in 21 (68%) and 9 (29%) cases of p63 and calponin, respectively. Staining with WT1 showed less variability across the spectrum of myoepithelial differentiation with the difference most marked in the transformed myoepithelium. WT1 is a sensitive marker of the neoplastic myoepithelial cell in pleomorphic adenomas. The role of this protein in influencing the mesenchymal-epithelial state of cells suggests that WT1 and the myoepithelial cell have an important role in the histogenesis of

  12. Gene-specific DNA methylation of DNMT3B and MTHFR and colorectal adenoma risk.

    Ho, Vikki; Ashbury, Janet E; Taylor, Sherryl; Vanner, Stephen; King, Will D

    2015-12-01

    DNA methyltransferase 3B (DNMT3B) and methylenetetrahydrofolate reductase (MTHFR) are genes which encode enzymes critical to one-carbon metabolism. Polymorphisms in these genes have been implicated in colorectal cancer etiology; however, epigenetic modifications such as gene-specific DNA methylation also affect gene expression. DNA methylation of DNMT3B and MTHFR was quantified in blood leukocytes using Sequenom EpiTYPER® among 272 participants undergoing a screening colonoscopy. DNA methylation was quantified in 66 and 28CpG sites of DNMT3B and MTHFR respectively, and conceptualized using two approaches. First, measures representing average methylation across all CpG sites were created. Second, unsupervised principal component (PC) analysis was used to identify summary variables representing methylation around the transcription start site and in the gene-coding area for both DNMT3B and MTHFR. Logistic regression was used to compare methylation levels between participants diagnosed with colorectal adenoma(s) versus those with a normal colonoscopy via the estimation of odds ratios (ORs) and 95% confidence intervals (95% CIs) for the risk of colorectal adenomas. No association was observed between average DNA methylation of either DNMT3B or MTHFR and colorectal adenoma risk. For DNMT3B, increasing DNA methylation of CpG sites in the gene-coding area was associated with a higher risk of colorectal adenomas (OR=1.34; 95% CI: 1.01-1.79 per SD). This research provides preliminary evidence that methylation of DNMT3B may have functional significance with respect to colorectal adenomas, precursors to the vast majority of colorectal cancers.

  13. Somatomammotrophic cells in GH-secreting and PRL-secreting human pituitary adenomas.

    Bassetti, M; Brina, M; Spada, A; Giannattasio, G

    1989-11-01

    A morphological study has been carried out on 20 GH-secreting adenomas removed from acromegalic normoprolactinemic patients, on 29 PRL-secreting adenomas removed from hyperprolactinemic patients without signs of acromegaly and on one normal human anterior pituitary gland collected at autopsy. The protein A-gold immunoelectron microscopic technique has been utilized in order to verify the presence of mixed cells producing both GH and PRL (somatomammotrophs) in these pituitary tissues. In the normal pituitary a considerable number of somatomammotrophs (15-20%) was found, thus supporting the idea that these cells are normal components of the human anterior pituitary gland. In 10 GH-secreting adenomas and in 10 PRL-secreting adenomas somatomammotrophs were present in a variable number (from 4 to 20% of the whole cell population in GH adenomas and from 1 to 47% in PRL tumors). It can be concluded therefore that these cells, largely present in all GH/PRL-secreting adenomas, can also be found in GH-secreting and PRL-secreting tumors without clinical evidence of a mixed secretion. Adenomatous somatomammotrophs displayed ultrastructural features of adenomatous somatotrophs and mammotrophs (prominent Golgi complexes, abundant rough endoplasmic reticulum, irregular nuclei). The size and the number of granules were variable. In some cells GH and PRL were stored in distinct secretory granules, in others in mixed granules or both in mixed and distinct granules, thus suggesting that in adenomatous somatomammotrophs the efficiency of the mechanisms of sorting of the two hormones varies from one cell to another.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Inflammatory hepatocellular adenomas developed in the setting of chronic liver disease and cirrhosis.

    Calderaro, Julien; Nault, Jean C; Balabaud, Charles; Couchy, Gabrielle; Saint-Paul, Marie-Christine; Azoulay, Daniel; Mehdaoui, Dalila; Luciani, Alain; Zafrani, Elie S; Bioulac-Sage, Paulette; Zucman-Rossi, Jessica

    2016-01-01

    Hepatocellular adenoma is considered to occur exclusively in non-fibrotic livers. It is a heterogeneous entity and a molecular classification is now widely accepted. The most frequent hepatocellular adenoma subtype, namely inflammatory adenoma, harbor somatic activating mutations of genes involved in the interleukin-6 pathway that lead to high C-reactive protein and serum amyloid A expression. The aim of our study was to investigate a series of benign hepatocellular neoplasms developed on cirrhotic livers and characterized by an unequivocal histological diagnosis. We performed a clinical, pathological, and molecular study of 10 benign hepatocellular neoplasms developed in three patients with cirrhosis. Markers allowing hepatocellular adenoma classification were assessed by quantitative real-time PCR and immunohistochemistry. Samples were sequenced for CTNNB1, HNF1A, IL6ST, GNAS, STAT3, and TERT (promoter) mutations. A control series of 32 classical macronodules developed in cirrhosis related to various etiologies was screened by immunohistochemistry and gene sequencing. The three patients had cirrhosis related to metabolic syndrome and/or alcohol intake; two had a single tumor, while the third developed more than 30 lesions. Microscopic examination showed well-differentiated neoplasms sharing features with inflammatory adenoma including inflammatory infiltrates, sinusoidal dilatation, and dystrophic vessels. Sequencing revealed classical hotspot somatic mutations (IL6ST, n=8; STAT3, n=1; and GNAS, n=1) known to be responsible for IL-6/JAK/STAT pathway activation. Two classical high-grade macronodules demonstrated high serum amyloid A and/or C-reactive protein expression, without gene mutations. Altogether, our findings support the existence of rare inflammatory adenoma developed in cirrhosis.

  15. Gallbladder villous adenoma in a patient with acromegaly: A case report

    Miodrag Krstic; Tamara Alempijevic; Bojan Stimec; Marjan Micev; Miroslav Milicevic; Dragan Micic; Goran Jankovic

    2007-01-01

    Villous adenomas are benign epithelial lesions with malignant potential that can occur in any part of the gastrointestinal tract. We present a case of a middle age woman with acromegaly who was investigated for nonspecific gastrointestinal complaints. Ultrasonography and subsequent endosonography diagnosed a large (4.5 cm), hyperechoic, sessile polyp with numerous pedicles. An open cholecystectomy was performed and revealed a villous adenoma with several foci of carcinoma in situ. Detailed investigations showed no other tumors of the gastrointestinal tract. After five years of follow-up, the patient reports no complaints, and the results of laboratory testing and imaging studies are within the normal range.

  16. Primary hyperparathyroidism due to an intrathyroidal parathyroid adenoma associated with chronic lymphocytic thyroiditis.

    Cating-Cabral, Monica Therese; Cabungcal, Arsenio Claro; Villafuerte, Cesar Vincent; Añel-Quimpo, Joselynna

    2012-06-08

    This is a case of a 44-year-old woman with an anterior neck mass and hypothyroidism who presented with an incidental finding of an elevated serum calcium level and was found to have primary hyperparathyroidism and osteoporosis. During surgical exploration no parathyroid adenoma was found, although a nodule was palpated within the right thyroid lobe. Examination of the excised right thyroid lobe revealed an intrathyroidal parathyroid adenoma and chronic lymphocytic thyroiditis. After surgery, she did not develop severe hypocalcaemia and this was attributed to preoperative treatment with pamidronate. In the months following surgery, parathyroid hormone remained undetectable.

  17. Dietary protein and fat intake in relation to risk of colorectal adenoma in Korean

    Yang, Sun Young; Kim, Young Sun; Lee, Jung Eun; Seol, Jueun; Song, Ji Hyun; Chung, Goh Eun; Yim, Jeong Yoon; Lim, Sun Hee; Kim, Joo Sung

    2016-01-01

    Abstract Consumption of red meat and alcohol are known risk factors for colorectal cancer, but associations for dietary fat remain unclear. We investigated the associations of dietary fat, protein, and energy intake with prevalence of colorectal adenoma. We performed a prospective cross-sectional study on asymptomatic persons who underwent a screening colonoscopy at a single center during a routine health check-up from May to December 2011. Dietary data were obtained via a validated Food Frequency Questionnaire (FFQ), assisted by a registered dietician. We also obtained information on alcohol consumption and smoking status, and measured metabolic syndrome markers including abdominal circumference, blood pressure, fasting glucose, serum triglyceride and high-density lipoprotein cholesterol. We calculated odds ratio (OR) and 95% confidence interval (CI) to evaluate the associations using the polytomous logistic regression models. As a secondary analysis, we also conducted a matched analysis, matched by age and sex (557 cases and 557 non-cases). The study sample included 557 cases (406 males and 151 females) with histopathologically confirmed colorectal adenoma, and 1157 controls (650 males and 507 females). The proportion of advanced adenoma was 28.1% of men and 18.5% of female, respectively. Although vegetable protein intake was inversely associated with the prevalence of colorectal adenoma, further adjustment for potential confounding factors attenuated the association, resulting in no significant associations. There were no significant associations between dietary fat intake and colorectal adenoma in energy-adjusted models. For vegetable protein in women, the OR for the comparison of those in the highest tertile with those in the lowest tertile was 0.47 (95% CI 0.25–0.91, P for trend = 0.07) after adjustment for total energy intake. However, after controlling for metabolic syndrome markers, body mass index, smoking status, alcohol consumption, and family history

  18. Dietary protein and fat intake in relation to risk of colorectal adenoma in Korean.

    Yang, Sun Young; Kim, Young Sun; Lee, Jung Eun; Seol, Jueun; Song, Ji Hyun; Chung, Goh Eun; Yim, Jeong Yoon; Lim, Sun Hee; Kim, Joo Sung

    2016-12-01

    Consumption of red meat and alcohol are known risk factors for colorectal cancer, but associations for dietary fat remain unclear. We investigated the associations of dietary fat, protein, and energy intake with prevalence of colorectal adenoma.We performed a prospective cross-sectional study on asymptomatic persons who underwent a screening colonoscopy at a single center during a routine health check-up from May to December 2011. Dietary data were obtained via a validated Food Frequency Questionnaire (FFQ), assisted by a registered dietician. We also obtained information on alcohol consumption and smoking status, and measured metabolic syndrome markers including abdominal circumference, blood pressure, fasting glucose, serum triglyceride and high-density lipoprotein cholesterol. We calculated odds ratio (OR) and 95% confidence interval (CI) to evaluate the associations using the polytomous logistic regression models. As a secondary analysis, we also conducted a matched analysis, matched by age and sex (557 cases and 557 non-cases).The study sample included 557 cases (406 males and 151 females) with histopathologically confirmed colorectal adenoma, and 1157 controls (650 males and 507 females). The proportion of advanced adenoma was 28.1% of men and 18.5% of female, respectively. Although vegetable protein intake was inversely associated with the prevalence of colorectal adenoma, further adjustment for potential confounding factors attenuated the association, resulting in no significant associations. There were no significant associations between dietary fat intake and colorectal adenoma in energy-adjusted models. For vegetable protein in women, the OR for the comparison of those in the highest tertile with those in the lowest tertile was 0.47 (95% CI 0.25-0.91, P for trend = 0.07) after adjustment for total energy intake. However, after controlling for metabolic syndrome markers, body mass index, smoking status, alcohol consumption, and family history of

  19. Coexistence of small cell neuroendocrine carcinoma and villous adenoma in the ampulla of Vater

    Ji-Hong Sun; Ming Chao; Shi-Zheng Zhang; Guang-Qiang Zhang; Bin Li; Jian-Jun Wu

    2008-01-01

    Small cell neuroendocrine carcinoma of the ampulla of Vater is extremely rare and different from the common ampullary adenocarcinoma. The ampullary adenoma is also a rare neoplasm and has the potential to develop an adenocarcinoma. Their coexistence has been rarely reported in the literature. We herein describe an unusual case of a small cell neuroendocrine carcinoma associated with a villous adenoma in the ampulla of Vater with emphasis on computed tomography (CT)and histopathological findings. We also discuss their clinical, histopathological and radiological features as well as possible histogenesis.

  20. A rare occurrence of basal cell adenoma of palate: A case report with comprehensive immunohistochemical analysis

    Surinder Pal Singh Sodhi

    2015-01-01

    Full Text Available Basal cell adenoma (BCA of the salivary glands is an uncommon type of monomorphic adenoma which constitutes 1% of all salivary gland tumors. It most commonly involves parotid gland, while it rarely occurs in minor salivary glands. Upper lip, buccal mucosa, and lower lip are the common intraoral sites; whereas, palate being the rarest one. Due to prognostic implications, differential diagnosis with basal cell adenocarcinoma, basaloid squamous cell carcinoma, and adenoid cystic carcinoma (AdCC is mandatory. Considering the rarity of this lesion and histologic paradox regarding its diagnosis, we report a case of BCA of palate with emphasis on need of comprehensive immunohistochemical (IHC analysis.

  1. Malignant hypertension and hypertensive encephalopathy in primary aldosteronism caused by adrenal adenoma

    Bortolotto Luiz Aparecido

    2003-01-01

    Full Text Available Two cases are reported as follows: 1 1 female patient with accelerated-malignant hypertension secondary to an aldosterone-producing adrenal adenoma; and 2 1 female patient with adrenal adenoma, severe hypertension, and hypertensive encephalopathy. This association is a rare clinical finding, and malignant hypertension may modify the hormonal characteristic of primary aldosteronism, making its diagnosis more difficult. The diagnosis of primary aldosteronism should be considered in patients with malignant hypertension or hypertensive encephalopathy if persistent hypokalemia occurs. Identification of primary aldosteronism is of paramount importance for the patient's evolution, because the surgical treatment makes the prognosis more favorable.

  2. Tumoral angiogenesis in both adrenal adenomas and nonadenomas: a promising computed tomography biomarker for diagnosis

    Wang X

    2016-03-01

    Full Text Available Xifu Wang,1 Kangan Li,1 Haoran Sun,2 Jinglong Zhao,1 Zhuoli Zhang,3 Linfeng Zheng,1 Weiguo Li,3 Renju Bai,2 Guixiang Zhang11Department of Radiology, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, 2Department of Radiology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 3Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USAAbstract: To explore the correlation between the typical findings of dynamic contrast-enhanced computed tomography (DCE-CT and tumoral angiogenesis (microvessel density [MVD] and vascular endothelial growth factor [VEGF] in adenomas and nonadenomas such that the enhancement mechanism of DCE-CT in adrenal masses can be explained more precisely. Forty-two patients with 46 adrenal masses confirmed by surgery and pathology were included in the study; these masses included 23 adenomas, 18 nonadenomas, and 5 hyperplastic nodules. The findings of DCE-CT and angiogenesis in adrenal masses were studied. The features of DCE-CT in adenomas and nonadenomas were evaluated to determine whether the characteristics of DCE-CT in adrenal masses were closely correlated with tumoral angiogenesis. Adrenal adenomas were significantly different from nonadenomas in the time density curve and the mean percentage of enhancement washout at the 7-minute delay time in DCE-CT. The mean MVD and VEGF expression exhibited significant differences between the rapid washout group (types A and C and the slow washout group (types B, D, and E and between the relative washout (Washr ≥34% and the absolute washout (Washa ≥43% on the 7-minute enhanced CT scans (P=0.000. Adenomas were suggested when adrenal masses presented as types A and C, and/or the Washr ≥34%, and/or the Washa ≥43%, and the opposite was suggested for nonadenomas. These results showed a close correlation between the characteristics of DCE-CT and both MVD and VEGF expression in adrenal masses

  3. Osseous metaplasia and mature bone formation with extramedullary hematopoiesis in follicular adenoma of thyroid gland

    Harsh Mohan

    2009-07-01

    Full Text Available Follicular adenomas of the thyroid may be subjected to degenerative changes like hemorrhagic and cystic changes, fibrosis, and calcification. Mature bone formation is a rare phenomenon, but extramedullary hematopoiesis (EMH has also been rarely reported in thyroid gland. The combination of mature bone formation and EMH is rarer and has been reported, in a single case report, in a multinodular goitre. We describe a case of follicular adenoma with histologically proven osseous metaplasia and mature bone formation with EMH in a middle- aged woman, which, to our knowledge, is the first case in English language literature.

  4. Pleomorphic adenoma of the parotid gland with cystic degeneration: A rare case report

    Preeti Dhir

    2014-01-01

    Full Text Available Pleomorphic adenoma, also called benign mixed tumor, is the most common tumor of the salivary glands. Usually they are found as solitary, unilateral, firm and mobile, painless, slow growing masses. Only 10% of them occur in the minor salivary glands and 90% of them occur in the parotid gland. The incidence of parotid tumor is about 2.4 in 100000/year of all neoplasia of head and neck region, the right side being commonly involved and seen more often in males. Management involves surgical resection by superficial or total parotidectomy. This case report illustrates clinical features, imaging characteristics and histopathological features in a case of pleomorphic adenoma.

  5. A Trial of Calcium and Vitamin D for the Prevention of Colorectal Adenomas

    Baron, John A.; Barry, Elizabeth L.; Mott, Leila A.; Rees, Judy R.; Sandler, Robert S.; Snover, Dale C.; Bostick, Roberd M.; Ivanova, Anastasia; Cole, Bernard F.; Ahnen, Dennis J.; Beck, Gerald J.; Bresalier, Robert S.; Burke, Carol A.; Church, Timothy R.; Cruz-Correa, Marcia; Figueiredo, Jane C.; Goodman, Michael; Kim, Adam S.; Robertson, Douglas J.; Rothstein, Richard; Shaukat, Aasma; Seabrook, March E.; Summers, Robert W.

    2015-01-01

    BACKGROUND Epidemiologic and preclinical data suggest that higher intake and serum levels of vitamin D and higher intake of calcium reduce the risk of colorectal neoplasia. To further study the chemopreventive potential of these nutrients, we conducted a randomized, double-blind, placebo-controlled trial of supplementation with vitamin D, calcium, or both for the prevention of colorectal adenomas. METHODS We recruited patients with recently diagnosed adenomas and no known colorectal polyps remaining after complete colonoscopy. We randomly assigned 2259 participants to receive daily vitamin D3 (1000 IU), calcium as carbonate (1200 mg), both, or neither in a partial 2×2 factorial design. Women could elect to receive calcium plus random assignment to vitamin D or placebo. Follow-up colonoscopy was anticipated to be performed 3 or 5 years after the baseline examinations, according to the endoscopist’s recommendation. The primary end point was adenomas diagnosed in the interval from randomization through the anticipated surveillance colonoscopy. RESULTS Participants who were randomly assigned to receive vitamin D had a mean net increase in serum 25-hydroxyvitamin D levels of 7.83 ng per milliliter, relative to participants given placebo. Overall, 43% of participants had one or more adenomas diagnosed during follow-up. The adjusted risk ratios for recurrent adenomas were 0.99 (95% confidence interval [CI], 0.89 to 1.09) with vitamin D versus no vitamin D, 0.95 (95% CI, 0.85 to 1.06) with calcium versus no calcium, and 0.93 (95% CI, 0.80 to 1.08) with both agents versus neither agent. The findings for advanced adenomas were similar. There were few serious adverse events. CONCLUSIONS Daily supplementation with vitamin D3 (1000 IU), calcium (1200 mg), or both after removal of colorectal adenomas did not significantly reduce the risk of recurrent colorectal adenomas over a period of 3 to 5 years. (Funded by the National Cancer Institute; ClinicalTrials.gov number, NCT

  6. A unique case of isolated sebaceous adenoma of the bulbar conjunctiva

    Hatice Deniz Ilhan

    Full Text Available ABSTRACT Our patient was a 34 year-old male who presented with a painless conjunctival mass that had developed 3 months before his first visit. On performing slit-lamp biomicroscopy, a lobulated pink-yellowish solid mobile mass was observed on the nasal bulbar conjunctival surface of his left eye. The tumor was excised, and histopathologic examination of the tumor revealed a sebaceous adenoma. Systemic examination was normal. No recurrence was observed during the 24-month follow-up period. Sebaceous adenoma of the bulbar conjunctiva is an extremely rare benign tumor, which may be observed to be isolated in the absence of malignancy.

  7. Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma

    Bae, Suh Eun; Lee, Jeong Hoon; Park, Young Soo; Ahn, Ji Yong; Kim, Do Hoon; Choi, Kee Don; Song, Ho June; Lee, Gin Hyug; Jang, Se Jin; Jung, Hwoon-Yong

    2017-01-01

    Background In patients with adenoma, assessing premalignant changes in the surrounding mucosa is important for surveillance. This study evaluated atrophic and metaplastic progression in the background mucosa of adenoma or early gastric cancer (EGC) cases. Methods Among 146 consecutive patients who underwent endoscopic resection for intestinal-type gastric neoplasia, the adenoma group included 56 patients with low-grade dysplasia and the ECG group included 90 patients with high-grade dysplasia or invasive carcinoma. For histology, 3 paired biopsies were obtained from the antrum, corpus lesser curvature (CLC), and corpus greater curvature (CGC). Serological atrophy was determined based on pepsinogen A (PGA), progastricsin (PGC), gastrin-17, and total ghrelin levels. Topographic progression of atrophy and/or metaplasia was staged using the operative link on gastritis assessment (OLGA) and operative link on gastric intestinal metaplasia assessment (OLGIM) systems. Results Rates of moderate-to-marked histological atrophy/metaplasia in patients with adenoma were 52.7%/78.2% at the antrum (vs. 58.8%/76.4% in EGC group), 63.5%/75.0% at the CLC (vs. 60.2%/69.7% in EGC group), and 10.9%/17.9% at the CGC (vs. 5.6%/7.8% in EGC group). Serological atrophy indicated by PGA and PGC occurred in 23.2% and 15.6% of cases in the adenoma and ECG groups, respectively (p = 0.25). Mean serum gastrin-17 concentrations of the adenoma group and EGC group were 10.4 and 9.0 pmol/L, respectively (p = 0.54). Mean serum total ghrelin levels were 216.6 and 209.5 pg/mL, respectively (p = 0.71). Additionally, between group rates of stage III–IV OLGA and OLGIM were similar (25.9% vs. 25.0%, p = 0.90; 41.8% vs. 44.9%, p = 0.71, respectively). Conclusions Atrophic and metaplastic progression is extensive and severe in gastric adenoma patients. A surveillance strategy for metachronous tumors should be applied similarly for patients with adenoma or EGC. PMID:28072871

  8. Vulva Fibroadenoma Associated with Lactating Adenoma in a 26-Year-Old Nigerian Female

    C. C. Anunobi

    2013-01-01

    Full Text Available Background. Vulva lactating adenoma is rare and may be misdiagnosed as adenocarcinoma in frozen section and aspiration cytology if breast tissue is not anticipated. Objective. To raise the awareness of lactating vulva ectopic breast lesion among clinicians and pathologists. Case Report. We present a case of vulva fibroadenoma associated with lactating adenoma in a 26-year-old Nigerian female. Conclusion. The rarity of vulva ectopic breast tissue can present a diagnostic challenge for both the clinician and the anatomical pathologist. Once excisional biopsy is done and the lesion confirmed histologically, the anxious patient can be reassured.

  9. Small intestine adenocarcinoma in conjunction with multiple adenomas causing acute colic in a horse.

    Moran, Juan A Muñoz; Lemberger, Karin; Cadoré, Jean-Luc; Lepage, Olivier M

    2008-01-01

    An 11-year-old Andalusian stallion developed marked signs of colic associated with an acute small intestine obstruction. Exploratory laparotomy revealed a distal jejunum full-thickness wall induration and multiple small adherent intraluminal masses. Fifteen centimeters of jejunum, including the induration, and several intraluminal masses were resected. Histologic examination revealed an adenocarcinoma and multiple polypoid adenomas. The horse was discharged, and no complications were reported 12 months postoperatively. Colic was considered secondary to partial jejunal lumen obstruction by the adenocarcinoma. Adenocarcinoma recurrence or transformation from remaining adenomas into an adenocarcinoma is still a major risk.

  10. [Efficacy and safety of use of likoprofit in patients with chronic prostatitis and prostatic adenoma].

    Spivak, L G

    2013-01-01

    The article summarizes the results of the clinical trials on application of likoprofit in patients with a chronic prostatitis and prostate adenoma, which were conducted by the Russian urologists for the last 8 years. Application of likoprofit in patients after TURP contributes to significantly earlier and effective restoration of microcirculation, which decreases the risk of development of postoperative complications and accelerates rehabilitation of patients. Studies in which likoprofit was applied in patients with a chronic prostatitis and prostate adenoma, proved that likoprofit also has antiedematous effect, improves the urination act, improves ejaculate parameters, positively impacts on sexual function, and has a high safety profile.

  11. Immunoexpression of the COX-2, p53, and caspase-3 proteins in colorectal adenoma and non-neoplastic mucosa

    Nogueira, Renan Brito; Pires, Andréa Rodrigues Cordovil; Soares, Thélia Maria Santos; Rodrigues, Simone Rabello de Souza; Campos, Mariane Antonieta Menino; Toloi, Giovanna Canato; Waisberg, Jaques

    2013-01-01

    ABSTRACT Objective: To analyze the immunoexpression of the COX-2, p53, and caspase-3 proteins in colorectal adenomas and non-neoplastic mucosa. Methods: 72 individuals were subjected to colonoscopy, which provided 50 samples of adenomas and 45 samples of non-neoplastic colorectal mucosa. The tissue samples were obtained via the tissue microarray technique and subjected to immunohistochemical analysis using primary anti-p53, anti-COX-2, and anti-caspase-3 antibodies. The positivity and intensity of the immunoreaction were classified. The analyzed variables were as follows: site of the adenomas in the colon, degree of dysplasia, size, and score of positivity and intensity of immunoexpression of the p-53, caspase-3, and COX-2 proteins. Results: The immunoexpression of mutated protein p53 was positive in 30 (60%) adenoma samples and negative in 20 (40%) adenoma samples. The immunoexpression of mutated protein p53 was negative in 39 (86.6%) samples and positive in 6 (13.3%) samples of the non-neoplastic colorectal mucosa (p<0.0001). Significant differences were seen between both the largest size (p=0.006) and the highest degree of dysplasia (p<0.0001) of the adenomas and the intensity of immunoexpression of mutated protein p53. The positivity and intensity of immunoexpression of COX-2 (p=0.14) and caspase-3 (p=0.23) showed no significant differences between the adenomas and the non-neoplastic colorectal mucosa. Conclusion: Mutated protein p53 was hyperexpressed in the adenomas compared with the non-neoplastic mucosa. Greater size and greater degree of dysplasia in the adenomas were associated with higher expression of mutated protein p53. The immunoexpression of COX-2 and caspase-3 in the adenomas did not exhibit a correlation with the anatomical-pathological features of the tumors and did not differ from the corresponding expression levels in the non-neoplastic mucosa. PMID:24488384

  12. Occurrence of gigantic biogenic magnetite during the Paleocene-Eocene Thermal Maximum

    Schumann, D.; Raub, T. D.; Kopp, R. E.; Guerquin-Kern, J. L.; Wu, T. D.; Rouiller, I.; Smirnov, A. V.; Sears, S. K.; Lücken, U.; Tikoo, S. M.; Hesse, R.; Kirschvink, J. L.; Vali, H.

    2009-04-01

    et al. 2008] to other PETM locations of the Atlantic margin and to a possible modern analog environment. High surface productivity with low-organic carbon density sediments and meter-scale sedimentary suboxic zones are provided by tropical shelves fed by energetic river systems, such as the Amazon. We inverstigated several magnetic extracts of samples taken from the meter-scale suboxic zones of the Amazone delta system. Sluijs A, Brinkhuis H, Schouten S, Bohaty SM, John CM, Zachos JC, Reichart GJ, Damste JSS, Crouch EM, Dickens GR. 2007. Environmental precursors to rapid light carbon injection at the Palaeocene/Eocene boundary. Nature 450:1218-1221. Kopp RE, Raub TD, Schumann D, Vali H, Smirnov AV, Kirschvink JL 2007. Magnetofossil spike during the Paleocene-Eocene thermal maximum: Ferromagnetic resonance, rock magnetic, and electron microscopy evidence from Ancora, New Jersey, United States. Paleoceanography, doi:10.1029/2007pa001473. Lipper PC, Zachos JC 2007. A biogenic origin for anomalous fine-grained magnetic material at the Paleocone-Eocene booundary at Wilson Lake, New Jesery. Paleoceanography, doi:10.1029/2007pa001471. Schumann D, Raub TD, Kopp RE, Guerquin-Kern JL, Wu TD, Rouiller I, Smirnov AV, Sears K, Lücken U, Tikoo SM, Hesse R, Kirschvink JL, Vali H 2008. Gigantism in unique biogenic magnetite at the Paleocene-Eocene Thermal Maximum. PNAS, 105:17648-17653.

  13. Tratamento operatório das bolhas pulmonares gigantes Surgical treatment of giant emphysematous lung bullae

    Marcio Botter

    2007-06-01

    Full Text Available OBJETIVOS: A escassez de publicações nacionais a respeito desta doença no Brasil nos motivou a realizar o presente trabalho, cujos objetivos são descrever a evolução histórica e analisar os resultados do tratamento operatório das bolhas enfisematosas gigantes na Santa Casa de São Paulo. MÉTODOS: Avaliamos retrospectivamente, entre janeiro de 1979 a junho de 2005, os prontuários de 83 doentes submetidos a uma entre quatro modalidades operatórias: bulectomia por toracotomia, bulectomia por cirurgia torácica videoassistida (CTVA, drenagem de bolha por CTVA e drenagem de bolha com anestesia local, totalizando 92 operações. Os parâmetros analisados foram tempo de internação, complicações pós-operatórias, mortalidade perioperatória e tardia, além de parâmetros clínicos e funcionais pré e pós-operatórios. RESULTADOS: A morbidade foi de 40,2% e mortalidade pós-operatória precoce, de 4,3%. As complicações pós-operatórias tiveram relação com os antecedentes mórbidos dos doentes. Fatores como enfisema pulmonar difuso, múltiplas bolhas e idade não influenciaram nas complicações precoces. Houve melhora da sintomatologia e dos resultados funcionais em 94,5% dos doentes. Não houve recidiva das bolhas operadas. A mortalidade cinco anos após a operação foi de 18,3% e decorreu, principalmente, da progressão clínica do enfisema pulmonar difuso. CONCLUSÃO: Diversas modalidades operatórias foram realizadas para tratar bolhas pulmonares enfisematosas, desde a bulectomia por toracotomia, na fase inicial até a drenagem de bolha com anestesia local e talcagem, o método que preferencialmente realizamos nos dias atuais. Independente do método utilizado, entretanto, não obstante a morbidade relativamente elevada, os resultados pós-operatórios são bastante favoráveis, com baixa mortalidade e incontestável melhora clínico-funcional dos doentes operados.OBJECTIVE: Lack of Brazilian publications regarding this disease

  14. Análise da expressão gênica no tumor ósseo de células gigantes

    Babeto, Erica [UNESP

    2011-01-01

    O tumor ósseo de células gigantes (TCG) é um tumor benigno, que causa destruição osteolítica, com comportamento biológico incerto e com características particulares como um elevado número de células gigantes multinucleadas e comportamento agressivo. A recorrência local do TCG é freqüentemente observada em 20 a 50% dos casos. Mais agravante que a recorrência, é o fato de que após a recidiva, o paciente muitas vezes também apresenta metástases em outros órgãos, principalmente no pulmão. Dessa f...

  15. BIM-23A760 influences key functional endpoints in pituitary adenomas and normal pituitaries: molecular mechanisms underlying the differential response in adenomas.

    Ibáñez-Costa, Alejandro; López-Sánchez, Laura M; Gahete, Manuel D; Rivero-Cortés, Esther; Vázquez-Borrego, Mari C; Gálvez, María A; de la Riva, Andrés; Venegas-Moreno, Eva; Jiménez-Reina, Luis; Moreno-Carazo, Alberto; Tinahones, Francisco J; Maraver-Selfa, Silvia; Japón, Miguel A; García-Arnés, Juan A; Soto-Moreno, Alfonso; Webb, Susan M; Kineman, Rhonda D; Culler, Michael D; Castaño, Justo P; Luque, Raúl M

    2017-02-09

    Chimeric somatostatin/dopamine compounds such as BIM-23A760, an sst2/sst5/D2 receptors-agonist, have emerged as promising new approaches to treat pituitary adenomas. However, information on direct in vitro effects of BIM-23A760 in normal and tumoral pituitaries remains incomplete. The objective of this study was to analyze BIM-23A760 effects on functional parameters (Ca(2+) signaling, hormone expression/secretion, cell viability and apoptosis) in pituitary adenomas (n = 74), and to compare with the responses of normal primate and human pituitaries (n = 3-5). Primate and human normal pituitaries exhibited similar sst2/sst5/D2 expression patterns, wherein BIM-23A760 inhibited the expression/secretion of several pituitary hormones (specially GH/PRL), which was accompanied by increased sst2/sst5/D2 expression in primates and decreased Ca(2+) concentration in human cells. In tumoral pituitaries, BIM-23A760 also inhibited Ca(2+) concentration, hormone secretion/expression and proliferation. However, BIM-23A760 elicited stimulatory effects in a subset of GHomas, ACTHomas and NFPAs in terms of Ca(2+) signaling and/or hormone secretion, which was associated with the relative somatostatin/dopamine-receptors levels, especially sst5 and sst5TMD4. The chimeric sst2/sst5/D2 compound BIM-23A760 affects multiple, clinically relevant parameters on pituitary adenomas and may represent a valuable therapeutic tool. The relative ssts/D2 expression profile, particularly sst5 and/or sst5TMD4 levels, might represent useful molecular markers to predict the ultimate response of pituitary adenomas to BIM-23A760.

  16. BIM-23A760 influences key functional endpoints in pituitary adenomas and normal pituitaries: molecular mechanisms underlying the differential response in adenomas

    Ibáñez-Costa, Alejandro; López-Sánchez, Laura M.; Gahete, Manuel D.; Rivero-Cortés, Esther; Vázquez-Borrego, Mari C.; Gálvez, María A.; de la Riva, Andrés; Venegas-Moreno, Eva; Jiménez-Reina, Luis; Moreno-Carazo, Alberto; Tinahones, Francisco J.; Maraver-Selfa, Silvia; Japón, Miguel A.; García-Arnés, Juan A.; Soto-Moreno, Alfonso; Webb, Susan M.; Kineman, Rhonda D.; Culler, Michael D.; Castaño, Justo P.; Luque, Raúl M.

    2017-01-01

    Chimeric somatostatin/dopamine compounds such as BIM-23A760, an sst2/sst5/D2 receptors-agonist, have emerged as promising new approaches to treat pituitary adenomas. However, information on direct in vitro effects of BIM-23A760 in normal and tumoral pituitaries remains incomplete. The objective of this study was to analyze BIM-23A760 effects on functional parameters (Ca2+ signaling, hormone expression/secretion, cell viability and apoptosis) in pituitary adenomas (n = 74), and to compare with the responses of normal primate and human pituitaries (n = 3–5). Primate and human normal pituitaries exhibited similar sst2/sst5/D2 expression patterns, wherein BIM-23A760 inhibited the expression/secretion of several pituitary hormones (specially GH/PRL), which was accompanied by increased sst2/sst5/D2 expression in primates and decreased Ca2+ concentration in human cells. In tumoral pituitaries, BIM-23A760 also inhibited Ca2+ concentration, hormone secretion/expression and proliferation. However, BIM-23A760 elicited stimulatory effects in a subset of GHomas, ACTHomas and NFPAs in terms of Ca2+ signaling and/or hormone secretion, which was associated with the relative somatostatin/dopamine-receptors levels, especially sst5 and sst5TMD4. The chimeric sst2/sst5/D2 compound BIM-23A760 affects multiple, clinically relevant parameters on pituitary adenomas and may represent a valuable therapeutic tool. The relative ssts/D2 expression profile, particularly sst5 and/or sst5TMD4 levels, might represent useful molecular markers to predict the ultimate response of pituitary adenomas to BIM-23A760. PMID:28181484

  17. What Lies Beneath: Sub-Articular Long Bone Shape Scaling in Eutherian Mammals and Saurischian Dinosaurs Suggests Different Locomotor Adaptations for Gigantism

    2013-01-01

    Eutherian mammals and saurischian dinosaurs both evolved lineages of huge terrestrial herbivores. Although significantly more saurischian dinosaurs were giants than eutherians, the long bones of both taxa scale similarly and suggest that locomotion was dynamically similar. However, articular cartilage is thin in eutherian mammals but thick in saurischian dinosaurs, differences that could have contributed to, or limited, how frequently gigantism evolved. Therefore, we tested the hypothesis tha...

  18. Ultrafast Gigantic Photo-Response in Charge-Ordered Organic Salt (EDO-TTF)2PF6 on 10-fs time scales

    Itatani, J.; Rini, M.; Cavalleri, A.; Onda, K.; Ishikawa, T.; Ogihara, S.; Koshihara, S.; Shao, X. F.; Nakano, Y.; Yamochi, H.; Saito, G.; Schoenlein, R. W.

    The initial dynamics of photo-induced phase transition in charge-ordered organic salt (EDO-TTF)2PF6 was investigated using 10-fs near-infrared laser pulses. We observed sub-20-fs gigantic photo-responses (|∆R/R|>100%) due to intra-molecular vibration and a clear signature of a structural bottleneck (~50 fs) for the first time.

  19. Outcomes of Proton Therapy for Patients With Functional Pituitary Adenomas

    Wattson, Daniel A.; Tanguturi, Shyam K. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Spiegel, Daphna Y. [Tufts University School of Medicine, Boston, Massachusetts (United States); Niemierko, Andrzej [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Biller, Beverly M.K.; Nachtigall, Lisa B. [Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts (United States); Bussière, Marc R. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Swearingen, Brooke; Chapman, Paul H. [Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts (United States); Loeffler, Jay S. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Shih, Helen A., E-mail: hshih@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2014-11-01

    Purpose/Objective(s): This study evaluated the efficacy and toxicity of proton therapy for functional pituitary adenomas (FPAs). Methods and Materials: We analyzed 165 patients with FPAs who were treated at a single institution with proton therapy between 1992 and 2012 and had at least 6 months of follow-up. All but 3 patients underwent prior resection, and 14 received prior photon irradiation. Proton stereotactic radiosurgery was used for 92% of patients, with a median dose of 20 Gy(RBE). The remainder received fractionated stereotactic proton therapy. Time to biochemical complete response (CR, defined as ≥3 months of normal laboratory values with no medical treatment), local control, and adverse effects are reported. Results: With a median follow-up time of 4.3 years (range, 0.5-20.6 years) for 144 evaluable patients, the actuarial 3-year CR rate and the median time to CR were 54% and 32 months among 74 patients with Cushing disease (CD), 63% and 27 months among 8 patients with Nelson syndrome (NS), 26% and 62 months among 50 patients with acromegaly, and 22% and 60 months among 9 patients with prolactinomas, respectively. One of 3 patients with thyroid stimulating hormone—secreting tumors achieved CR. Actuarial time to CR was significantly shorter for corticotroph FPAs (CD/NS) compared with other subtypes (P=.001). At a median imaging follow-up time of 43 months, tumor control was 98% among 140 patients. The actuarial 3-year and 5-year rates of development of new hypopituitarism were 45% and 62%, and the median time to deficiency was 40 months. Larger radiosurgery target volume as a continuous variable was a significant predictor of hypopituitarism (adjusted hazard ratio 1.3, P=.004). Four patients had new-onset postradiosurgery seizures suspected to be related to generously defined target volumes. There were no radiation-induced tumors. Conclusions: Proton irradiation is an effective treatment for FPAs, and hypopituitarism remains the primary

  20. Coexisting diseases modifying each other’s presentation - lack of growth failure in Turner syndrome due to the associated pituitary gigantism

    Dragović Tamara

    2016-01-01

    Full Text Available Introduction. Turner syndrome presents with one of the most frequent chromosomal aberrations in female, typically presented with growth retardation, ovarian insufficiency, facial dysmorphism, and numerous other somatic stigmata. Gigantism is an extremely rare condition resulting from an excessive growth hormone (GH secretion that occurs during childhood before the fusion of epiphyseal growth plates. The major clinical feature of gigantism is growth acceleration, although these patients also suffer from hypogonadism and soft tissue hypertrophy. Case report. We presented a girl with mosaic Turner syndrome, delayed puberty and normal linear growth for the sex and age, due to the simultaneous GH hypersecretion by pituitary tumor. In the presented case all the typical phenotypic stigmata related to Turner syndrome were missing. Due to excessive pituitary GH secretion during the period while the epiphyseal growth plates of the long bones are still open, characteristic stagnation in longitudinal growth has not been demonstrated. The patient presented with delayed puberty and primary amenorrhea along with a sudden appearance of clinical signs of hypersomatotropinism, which were the reasons for seeking medical help at the age of 16. Conclusion. Physical examination of children presenting with delayed puberty but without growth arrest must include an overall hormonal and genetic testing even in the cases when typical clinical presentations of genetic disorder are absent. To the best of our knowledge, this is the first reported case of simultaneous presence of Turner syndrome and gigantism in the literature.