Navegando por Palavras-chave "adenoma"
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- ItemAcesso aberto (Open Access)Adenomas hipofisários produtores de ACTH: Aspectos neurocirúrgicos(Academia Brasileira de Neurologia - ABNEURO, 2002-03-01) Tella Jr, Oswaldo Inácio [UNIFESP]; Herculano, Marco Antonio; Delcelo, Rosana [UNIFESP]; Aguiar, Paulo Henrique; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina de Jundiaí Disciplina de Neurocirurgia; Universidade de São Paulo (USP)We report our experience with 19 cases of ACTH secreting pituitary adenomas. They were microadenomas in 50% of the cases, coming with the typical picture of the Cushing syndrome. The ACTH adenoma associated with other types of hormones tend to show visual alterations. The treatment is often surgical using the transsphenoidal approach. The results were satisfactory in most of the cases. For those in which surgical cure was not reached, radiotherapy was indicated.
- ItemAcesso aberto (Open Access)Adenomas produtores de TSH: Relato de caso(Academia Brasileira de Neurologia - ABNEURO, 2002-03-01) Tella Jr, Oswaldo Inácio [UNIFESP]; Herculano, Marco Antonio; Delcelo, Rosana [UNIFESP]; Prandini, Mirto Nelso [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina de Jundiaí Disciplina de NeurocirurgiaWe describe a rare case of thyroid-stimulating hormone-secreting pituitary adenoma in a patient with a clinical picture of hyperthyroidism, that developed bitemporal hemianopsia after four years of a known thyroid dysfunction. CT scan showed a pituitary tumor considered grade 2 and stage C according to Hardy-Vezina and Wilson. Treatment was surgical, initially by a transsphenoidal approach, in which only a biopsy was possible. The patient was then submitted to an orbital-pterional craniotomy with sub-total resection of the tumor. Complementary treatment was indicated with radiotherapy.
- ItemAcesso aberto (Open Access)Cirurgia endoscópica transnasal da região selar: estudo dos primeiros 100 casos(Academia Brasileira de Neurologia - ABNEURO, 2003-09-01) Gondim, Jackson [UNIFESP]; Schops, Michele [UNIFESP]; Tella Jr, Oswaldo I. [UNIFESP]; Hospital Geral de Fortaleza; Universidade Federal de São Paulo (UNIFESP)An endoscopic endonasal transsphenoidal approach to the sella was performed in 100 consecutive patients, with a follow up from 3 to 55 months: 57 females and 43 males, age ranging from 14 and 70 years. 76 cases pituitary adenomas: 22 were acromegaly (7 microadenomas and 15 macroadenomas); 21 null cell adenomas (3 microadenomas and 18 macroadenomas); 19 Cushing disease (11 microadenomas and 8 macroadenomas), 10 prolactinomas (6 microadenomas and 4 macroadenomas), and 4 LH adenomas (4 macroadenomas). In this serie, remission was achieved in 44.8% for macroadenomas, 60% for acromegaly, 27.7% for null cell adenoma, 50% for Cushing disease, 50% for prolactinomas and 50% for LH adenomas, and 81.4% for microadenomas 85% for acromegaly, 100% for null cell adenoma, 81.8% for Cushing disease, 66% for prolactinoma. We had also four craniopharyngiomas, four sphenoidal mucocele, three sphenoidal aspergillus, one Rathke cyst, one hypophysitis, one cavernous aneurysm, one encefalocele, one intrasellar meningioma, one intrasellar tuberculoma and a sphenoid fibrous dysplasia. In this series we also had six fistulas of the anterior base that were completely cured. We had a mortality of 2, one null cell giant adenoma in a 57 years old man and another patient, 38 years old, with a giant craniopharyngioma. The morbidity was: two cured meningitis, three cured fistulas, and two permanent diabetes insipidus. Endoscopic endonasal transsphenoidal surgery in this series resulted with comparable surgical outcomes to conventional microscopic transsphenoidal surgery. The advantages of this technique have been represented by an easier access to the lesion, better visualisation and increased illumination of the surgical sites, microdissection of the tumor with maximum preservation of the pituitary function, and reduction of hospitalization times and coasts. The main limits have been the reduction of field depth, constant need of manual control of the endoscope, and required experience of the endoscope technique.
- ItemAcesso aberto (Open Access)Contribuição do índice de intensidade de sinal na sequência t1 desvio químico associado à espectroscopia por ressonância magnética no diagnóstico dos adenomas adrenais(Universidade Federal de São Paulo (UNIFESP), 2016-12-15) Dalavia, Claudio Carvalho [UNIFESP]; Ajzen, Sergio Aron [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE. To investigate the advantages of using modified signal intensity measurements on chemical shift imaging alone or correlate with proton spectroscopy in the differential diagnosis of adrenal adenomas. SUBJECTS AND METHODS. 97 patients (69 adenomas, 8 carcinomas, 14 pheochromocytomas, 4 metastasis, 1 myelolipoma and 1 granulomatous lesion) underwent chemical shift imaging and spectroscopy. Signal intensity index was calculated as [(signal intensity on in-phase image ? signal intensity on out-of-phase image) / (signal intensity on in-phase image)] × 100%. The averages of three minimum, mean, and maximum signal intensity values measured on three consecutive images, in the smaller lesions if not possible we use one or two images, with the region of interest covering one-half to two-thirds of the mass. All indexes were compared with spectroscopy metabolite ratios (lactate/creatine, glutamine-glutamate/creatine, choline/creatine, choline/lipid, 4.0?4.3 ppm/creatine, and lipid/creatine) for each type of adrenal mass. RESULTS. All signal intensity measurements and spectroscopy metabolite ratios were significant to the differentiation between adenomas and no adenomas, except Lip/Cr and Cho/Lip. Was not possible to apply the spectroscopy in 37,75% of the cases. CONCLUSION. The signal intensity index and spectroscopy metabolite ratios increased the accuracy of the differential diagnosis of adrenal adenomas.