Pituitary
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Pituitary tuberculomas are extremely rare lesions, with only few cases described in the literature, usually mistaken as pituitary tumors. Its heterogeneous clinical and imaging profile preclude preoperative diagnosis which ultimately relies on the histopathological examination. We describe a 46 years old woman who presented with an episode of confusion and hypopituitarism with no evidence of systemic tuberculosis. ⋯ A caseous material was found at the center of the lesion involved by a thick wall. Due to the wall adherence to the optic chiasm and the inflammatory aspects of the lesion, subtotal removal was achieved and the patient followed on anti-tuberculous and hormonal replacement therapy. Sellar tuberculomas should be considered in the differential diagnosis of sellar tumors in order to offer appropriate treatment.
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Comparative Study
Gender-related differences in growth hormone-releasing pituitary adenomas. A clinicopathological study.
Pituitary adenomas are the third most common primary intracranial neoplasm, after astrocytomas and meningiomas, and about 30% of them secrete growth hormone (GH). Other subtypes of pituitary tumors are characterized by well-known gender-related differences, not only in clinical presentation and other biological characteristics but also in surgical outcome. For GH-releasing pituitary adenomas, however, detailed data on gender differences of postsurgical treatment are not available. ⋯ The clinical course and tumor biology of GH-releasing pituitary adenomas appear to differ in women and men. Men demonstrated a shorter preoperative duration of symptoms, larger and more invasive tumors, and a worse clinical outcome. These findings suggest that therapy for GH-releasing adenomas should be more aggressive in men than in women. The gender-related differences in GH-releasing pituitary adenomas appear to have a basis in different biologic behavior, which warrants further investigation.