The 'incidentaloma' of the pituitary gland: is neurosurgery required?

Article Abstract:

Eighteen patients are described who had a mass of the pituitary gland that was discovered by chance upon computed tomography (CT) scanning or magnetic resonance imaging (MRI), sophisticated diagnostic imaging techniques. Each patient had no symptoms related to the tumor when it was found, and the mass was discovered incidentally, while the patient was being examined for another disorder. The mass was therefore termed an 'incidentaloma'. Upon investigation, the origin of the tumors in these patients was found to vary. Five patients had signs of partial hypopituitarism (reduced secretion of pituitary hormones), two patients had bitemporal hemianopia (blindness in half of the visual field in both eyes), and one patient had excess secretion of growth hormone. The size of the masses was between 5 and 25 millimeters, with an average size of 13 millimeters. Four of the patients had surgical treatment, and 14 patients received conservative treatment for the tumor. Those who were not treated surgically underwent frequent CT scans and MRIs to monitor their condition. At an average follow-up time of 22 months, none of the patients had a significant increase in tumor size. It is recommended that patients with masses of the pituitary gland be carefully followed for anterior pituitary hormone abnormalities. Also, differential diagnosis must eliminate a variety of other disorders, some of which may mimic the characteristics shown on the CT scan, and other causes should be fully explored prior to final diagnosis. Patients with rapid tumor growth, excessive anterior pituitary hormone, hypopituitarism, or optic displacement should be considered for surgery. However, the cases presented illustrate that no adverse effects ensued from lack of aggressive treatment for the mass, demonstrating that neurological intervention is not always necessary. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Causes of, Surgery, Tumors, Adenoma, Pituitary gland, Pituitary gland tumors, Pituitary tumors, Hypopituitarism

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Dehydroepiandrosterone replacement in women with adrenal insufficiency

Article Abstract:

Dehydroepiandrosterone appears to be beneficial in women with adrenal insufficiency. Dehydroepiandrosterone is a natural hormone produced by the adrenal glands, but blood levels decrease as people age. People with adrenal insufficiency would have low levels even in their youth. Researchers randomly assigned 24 women with adrenal insufficiency to take 50 milligrams of dehydroepiandrosterone or a placebo every day for four months. The women ranged in age from 23 to 59. Dehydroepiandrosterone improved overall well-being, normalized many physiological values such as blood cholesterol, and improved sexual function in the women who took it.

Addison's disease, Dehydroepiandrosterone

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Adjuvant mitotane treatment for adrenocortical carcinoma

Article Abstract:

The efficacy of adjuvant mitotane for treatment of adrenocortical carcinoma is evaluated. Adjuvant mitotane may prolong recurrence-free survival in patients with radically resected adrenocortical carcinoma.

HEALTH SERVICES, All Other Miscellaneous Ambulatory Health Care Services, Disease Testing Programs, Evaluation, Drugs, Drug therapy, Cancer, Drug evaluation, Mitotane, Carcinoma, Clinical report

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