• Title/Summary/Keyword: Pituitary tumor

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The Effect of Bromocriptine Treatment for Invasive Prolactinoma (침습성 프로락틴 분비 뇌하수체 선종에서 Bromocriptine의 치료효과)

  • Yang, Moon-Sool;Kim, Sun-Ho;Lim, Seung-Gil;Lee, Seung-Koo
    • Journal of Korean Neurosurgical Society
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    • v.37 no.4
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    • pp.275-281
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    • 2005
  • Objective: The prolactinoma is the most common pituitary tumor and sometimes shows severe invasiveness to the adjacent cavernous sinus, especially in the male patient. The dopamine agonist can be used as an alternative treatment modality to surgery. But, the transsphenoidal or transcranial approach for tumor removal has been more preferred treatment option of neurosurgeons in invasive prolactinoma. Especially rapid decompression of mass effect and resolution of the neurologic deficit is demanded. The prospective study is done in order to identify the therapeutic efficacy of bromocriptine as an initial treatment option for the invasive prolactionomas. Methods: Twenty patients with invasive prolactinoma were studied. Preoperative neurological and endocrinological evaluations were done, and size and invasiveness of the tumor was estimated on MRI. Bromocriptine was administrated by increasing dose planning reaching maximum dose at 1 month of treatment, with close neurological and endocrinological monitoring. At 3months after treatment, MRI was taken and decision was made whether to continue bromocriptine or to have surgical intervention. Results: Thirteen patients showed excellent result with only bromocriptine treatment. These patients showed not only marked reduction of tumor volume and prolactin level, but also, improving clinical symptoms and other hormonal deficits. 13patients who had visual field defect and decreased visual acuity had all improved visual symptoms. But, the remaining 4patients required surgical treatment due to insufficient reduction of tumor size inspite of normalized prolactin level within 3months. Remaining 2patients had $20{\sim}30%$ of tumor size reduction, but prolactin level was not normalized. One patient required radiation therapy. Conclusion: Bromociptine can be used as initial treatment for the invasive prolactinomas with careful monitoring of the neurological and endocrinological status. It should be carefully followed up for tumor size reduction within 3 months after initiation of treatment.

CT of Late Complication of Central Nervous System after Radiation Therapy of Brain Tumors (뇌종양의 방사선치료후 발생한 만성변화의 CT소견)

  • Hong, Seong-Eon;Cho, Chong-Hee;Ahn, Chi-Yul
    • Radiation Oncology Journal
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    • v.2 no.2
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    • pp.287-297
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    • 1984
  • The normal intracranial structures are relatively resistant to therapeutic radiation, but may react adversely in a variety of ways, and the damage to nerve tissue may be slow in making its appearance, and once damage has occured the patient recovers slowly and incompletly. Therefore, it is important to consider the possibility of either recurrent tumor or late adverse effect in any patient who has had radiotherapy. The determination o( rnorphological/pathological correlation is very important to the therapeutic radiologist who uses CT scans to define a treatment volume, as well as to the clinician who wishes to explain the patient's clinical state in terms of regress, progression, persistence, or recurrence of tumor or radiation-induced edema or necrosis, The authors are obtained as following results ; 1. The field size(whole CNS, large, intermediate, small field) was variable according to the location and extension of tumor and histopathologic diagnosis, and the tatal tumor dose was 4,000 to 6,000 rads except one of recurred case of 9,100 rads. The duration of follow up CT scan was from 3 months to 5 year 10 months. 2, The histopathologic diagnosis of 9cases were glioblastoma multiforme(3 cases), pineal tumor (3), oligodendroglioma (1), cystic astrocytoma (1), pituitary adenoma (1) and their adverse effects after radiation therapy were brain atrophy (4 cases) , radiation necrosis(2), tumor recurrence with or without calcification (2), radiation·induced infarction (1). 3. The recurrent symptoms after radiation therapy of brain tumor were not always the results of regrowth of neoplasm, but may represent late change of irradiated brain. 4. It must be need that we always consider the accurate treatment planning and proper treatment method to reduce undesirable late adverse effects in treatment of brain tumors.

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Recurrent thymic carcinoid tumor in familial isolated primary hyperparathyroidism

  • Song, Jeong Eun;Shon, Mu Hyun;Kim, Ga Young;Lee, Da Young;Lee, Jung Hun;Kim, Jong Ho;Shon, Ho Sang;Lee, Ji Hyun;Jeon, Eon Ju;Jung, Eui Dal
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.131-134
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    • 2014
  • Familial isolated primary hyperparathyroidism(FIPH) is associated with multiple endocrine neoplasia type 1 (MEN1) syndrome, primary hyperparathyroidism accompanied by jaw-tumor syndrome, and familial hypocalciuric hypercalcemia. FIPH may be an early stage of MEN1 or an allelic variant of MEN1. Thymic carcinoid tumor is a rare tumor in MEN1 syndrome. Here, the authors report the case of a 40-year-old man diagnosed with recurrent thymic carcinoid tumor and FIPH. Both the patient and his elder sister had been previously diagnosed to have FIPH with a novel frameshift mutation in the MEN1 gene. Initially, the patient underwent thymectomy because of an incidental finding of a mediastinal mass in his chest X-ray, and had remained asymptomatic over the following 4 years. Pancreas computed tomography conducted to evaluate MEN1 syndrome revealed anterior and middle mediastinal masses, and resultantly, massive mass excision was performed. Histological findings disclosed atypical carcinoids with infiltrative margins. In view of the thymic carcinoid tumor relapse that occurred in this patient, the authors recommend that regular pancreas and pituitary imaging studies be conducted for FIPH associated with a MEN1 gene mutation.

A Deep Learning Method for Brain Tumor Classification Based on Image Gradient

  • Long, Hoang;Lee, Suk-Hwan;Kwon, Seong-Geun;Kwon, Ki-Ryong
    • Journal of Korea Multimedia Society
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    • v.25 no.8
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    • pp.1233-1241
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    • 2022
  • Tumors of the brain are the deadliest, with a life expectancy of only a few years for those with the most advanced forms. Diagnosing a brain tumor is critical to developing a treatment plan to help patients with the disease live longer. A misdiagnosis of brain tumors will lead to incorrect medical treatment, decreasing a patient's chance of survival. Radiologists classify brain tumors via biopsy, which takes a long time. As a result, the doctor will need an automatic classification system to identify brain tumors. Image classification is one application of the deep learning method in computer vision. One of the deep learning's most powerful algorithms is the convolutional neural network (CNN). This paper will introduce a novel deep learning structure and image gradient to classify brain tumors. Meningioma, glioma, and pituitary tumors are the three most popular forms of brain cancer represented in the Figshare dataset, which contains 3,064 T1-weighted brain images from 233 patients. According to the numerical results, our method is more accurate than other approaches.

Gamma Knife Radiosurgery for Craniopharyngioma (두개인두종에 대한 감마나이프 방사선수술)

  • Chang, Jong Hee;Chang, Jin Woo;Park, Yong Gou;Chung, Sang Sup
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.561-566
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    • 2001
  • Objective : The purpose of this study are to evaluate the effectiveness of Gamma Knife radiosurgery(GKS) as a treatment of craniopharyngioma and to investigate the proper dose planning technique in GKS for craniopharyngioma. Method : Between May 1992 and March 1999, seven Gamma Knife radiosurgical procedures were done for residual tumor mass of 6 patients with craniopharyngioma after microsurgical resection. Conventional radiation therapy was not performed. In this study, their clinical, radiological and radiosurgical data were analyzed and the radiation dosage to the optic pathway, hypothalamus, pituitary stalk, and cavernous sinus were calculated and correlation with clinical outcome was evaluated. The mean follow-up period was 33.5 months(12.3-55.2 months). Result : The mean tumor volume was 4.4cc(0.4-18.0cc) and the maximum radiation dose ranged from 14 to 32 Gy(mean 20.9Gy). The radiation was given with isodose curve, 50-90% and the marginal dose varied within 8-22.4Gy(mean 12.7Gy). The mean number of isocenter was 4.3(1-12). The tumor was well controlled in all cases. In 5 of 7 cases, the size of tumor decreased to 10-50% of pre-GKS volume and remaining two showed no volume change. The mean dose to optic pathway was 5.7Gy(5.1-11.2Gy) and there were no complications. Conclusion : GKS seems to be effective for control of craniopharyngioma as an adjuvant treatment after microsurgical resection and even suboptimal dose for tumor margin is considered to be enough for tumor control. It is safe with careful dose planning to protect surrounding important structures, especially optic pathway. We believe conventional radiation therapy should be avoided because it has limitation for dose planning of additional treatments such as radiosurgery or intracystic instillation of radioisotope in case of recurrence.

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Endoscopy Assisted Transsphenoidal Surgery for Pituitary Tumors (내시경적 경접형동 접근술에 의한 뇌하수체 종양의 수술)

  • Ahn, Young Sang;Chun, Young Il;Ahn, Jae Sung;Jeon, Sang Ryong;Kim, Jeong Hoon;Ra, Young Shin;Roh, Sung Woo;Kim, Chang Jin;Kwon, Yang;Rhim, Seung Chul;Lee, Jung Kyo;Kwun, Byung Duk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.586-591
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    • 2001
  • Objective : Transseptal or sublabial transsphenoidal surgery has been standard teatment for pituitary tumors for decades. However, as an alternative to this surgery endonasal endoscopic technique has been reported with encouraging results. We have started endoscopy-assisted transsphednoidal surgery from May 1998. In this paper we analyzed the methods, outcome, advantage and disadvantage of this surgical approach for the purpose of planning optimal treatment of pituitary tumors. Methods : This study consisits of 13 cases of pituitary tumors who were treated by endoscopy-assisted transsphenoidal surgery using one nostril from May 1998 to July 1999. Mean follow up period was 12.9 months. Results : There was no septal or sublabial incision and little surgical damage to nasal structure. With this technique, rapid surgical approach and short hospital day were possible, being 3-6 days in patients without CSF leakage. Using various angled endoscope, good surgical view was obtained. Initially it was difficult to use various instruments in narrow nasal cavity, but became feasible after several procedures. Among 13 cases, total removal was possible in 11 cases. One of two cases in whom tumor was incompletely removed underwent gamma-knife radiosurgery and second underwent reoperation through subfrontal approach. There were 6 cases of hormone secreting tumors and hormonal remission was achived in all of these cases. Postoperative complications were CSF leakage(6 cases), diabetes insipidus(2 cases) and panhypopituitarysm(1 case). Lumbar drainage was done in all cases of CSF leakage. Conclusion : The advantage of endoscopy-assisted transsphenoidal surgery are rapid surgical approach, low postoperative morbidity, short hospital day and good surgical view. The disadvantage of this appoach are difficulty in manupulating various instruments in narrow nostril and difficulty in distance perception but these problems can be overcome by practice and using stereoscopic endoscope.

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Systemic Review: The Study on Bee Venom Related to Cancer in PubMed (암관련 봉독 연구에 대한 고찰-PubMed를 이용한 Medline 검색)

  • Yun, Hyoun-Seok;Lee, Jae-Dong;Lee, Yun-Ho
    • Journal of Acupuncture Research
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    • v.17 no.4
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    • pp.69-78
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    • 2000
  • Objective : To research the trends of the study related to bee venom and cancer, and to establish the hereafter direction of the study on bee venom herbal acupuncture. Method : We searched in PubMed, with bee venom and cancer(in English, with abstract) Results : 1. We searched 28 Journals, 36 Papers. the frequency of Journals and Papers was as follows: Biochem Biophys Res Commun(4 Papers), FEBS Lett(3), Life Sci, Proc Natl Acad Sci USA, J Immunol(each 2), other 23 Journals(each 1). 2. The pattern of the study was as follows: Review article(3 Journals, 3 Papers), Epidemiologic study(1, 1), Experimental study(24, 32) In vivo 1, 1), In vitto(24, 31) 3. The involved components of bee venom were as follows: Melittin(20), Apamin(8), Phospholipase A2(3), Melittin & Phospholipase A2(3), Melittin& Tertiapin(1). 4. The involved cancer was as follows: leukemia(9), tumor(5), neuroblastoma(4), pituitary tumor and pheochromocytoma(each 3), lymphoma, astrocytoma, glioma and lung cancer(small cell carcinoma)(eacn 2), bladder carcinoma, pancreatic cancer, breast carcinoma, ovarian carcinoma and spuamous cell carcinoma(each 1) Conclusion : We concluded that the most frequent pattern of the study was in vitro experimental study with peptide components of bee venom and the most frequeni invovled cancer was leukemia.

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Biosynthesis of Ergot Alkaloids (맥각 알칼로이드의 생합성)

  • Kim, Byong-Kak
    • Korean Journal of Pharmacognosy
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    • v.4 no.1
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    • pp.1-7
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    • 1973
  • Recent findings that agroclavine strongly inhibits: lactation and that ergocornine and ergonovine induce regression or inhibition of pituitary tumor growth in rats revealed new pharmacological activities in addition to the well-known activities of ergot alkaloids. Clavicipitic acid, isochanoclavine (I) and chanoclavine (II) are newly isolated alkaloids. It was already established that tryptophan, mevalonic acid and methionine are biosynthetic precursors of ergoline, a basic structure of the alkaloids, which is formed via $4-({\gamma},{\gamma}-dimethylallyl)-tryptophan$, mediated by dimethylallylpyrophosphate: tryptophan dimethylallyl transferase. Chanoclavine-I appears to be an intermediate to agroclavine which is converted to elymoclavine. Agroclavine and elymoclavine were also found to be hydroxylated by peroxidase to setoclavine and penniclavine, respectively. Elymoclavine is converted to ergotamine and lysergic acid ${\alpha}-hydroxyethylamide$, respectively. Pyruvate and alanine were found to be incorporated into the two-carbon unit of the ${\alpha}-hydroxyethyl$ moiety of the latter. Lysergylalanine is converted to ergometrine, but not to lysergic acid ${\alpha}-hydroxyethylamide$.

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Intra-Suprasellar Schwannoma Originating from the Diaphragma Sellae

  • Park, Hyun-Woong;Jung, Shin;Jung, Tae-Young;Moon, Kyung-Sub
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.375-377
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    • 2009
  • A 49-year-old woman presented with headache, vomiting and visual disturbance. Neurological examination revealed bitemporal hemianopsia with poor visual acuity. Magnetic resonance imaging showed a bulky intra-suprasellar mass, which was isointense with brain parenchyma on T1-weighted images, and slightly hyperintense on T2-weighted images. After gadolinium administration, the mass was homogeneously enhanced. The mass was partially removed by the endonasal transsphenoidal approach and then the remnant mass was totally removed by the transcranial approach five months later. We found a yellowish mass which was attached to the diaphragm sellae in operation field. Histopathological examination of the tumor revealed the characteristic features of a schwannoma. We report an unusual case of an intra-suprasellar schwannoma resembling a non-functioning pituitary macroadenoma both clinically and radiologically.

Adrenal incidentaloma: a case of asymptomatic pheochromocytoma

  • Park, Sang Yoong;Rim, Jong Cheol;Cho, Hyun Chul;Lee, Yoon Chan;Kim, Jung A;Choi, So Ron
    • Kosin Medical Journal
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    • v.33 no.2
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    • pp.215-222
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    • 2018
  • An incidentaloma is a tumor found incidentally without clinical symptoms or suspicion; the lesion may be adrenal, pituitary, or thyroidal. We report the case of an asymptomatic individual with preoperatively undiagnosed pheochromocytoma (size: 4.86 cm) that was revealed using elective nonadrenal surgical procedures. The patient demonstrated peri- and post-operative hypertensive crisis and tachycardia. Three days after the dramatic onset of symptoms, the patient expired due to pulmonary edema, multiple organ failure, and terminal sepsis, despite administration of extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation. A left medial kidney mass obtained at autopsy confirmed pheochromocytoma.