Pituitary macroadenoma associated with pulmonary and cutaneous sarcoidosis--a clinical case.
Autor(a) principal: | |
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Data de Publicação: | 2005 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1028 |
Resumo: | Sarcoidosis is a granulomatous disease of unknown etiology that can affect all organs and systems, including the central nervous system in approximately 5% of patients. Although the hypothalamo-hypophyseal system may be one of the areas affected by neurosarcoidosis, pseudotumoral lesions are very rare. This paper reports the case of a 42-year-old male Caucasian patient followed by the Pneumology and Dermatology services for pulmonary and cutaneous sarcoidosis. Corticotherapy was initiated five months from diagnosis and the patient showed clear clinical and imagiological signs of improvement. In the following two months, the patient experienced visual disturbances and a slight decrease in libido, but denied having other symptoms associated with hypothalamo-hypophyseal hypofunction. Laboratorial evaluation (basal determinations and stimulation tests) revealed panhypopituitarism. The EC-NMR showed a bulky intrasellar lesion extending into the suprasellar and right parasellar regions, with evidence of optic chiasm compression, erosion of the floor of the sella and cavernous sinus invasion. Campimetry showed a bitemporal hemianopsia. For the purposes of chiasmatic decompression and histological study of the lesion the patient underwent a right frontal craniotomy, with a subtotal resection of the hypophyseal lesion. The histological diagnosis revealed a pituitary adenoma with no immunohistochemical expression. The patient began radiotherapy six months after surgery. Although today's diagnostic tools allow for a high degree of accuracy, hypophyseal lesions still present problems to the endocrinologist as their identification is essential for determining the appropriate treatment. At times the final diagnosis is only achieved after a histological identification of the lesion (biopsy/surgery). It should be noted that the described cases of association between sarcoidosis and hypophyseal adenoma are very rare, making the differential diagnosis with neurosarcoidosis difficult--a condition which has a preferential medical approach and a different prognosis. |
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Pituitary macroadenoma associated with pulmonary and cutaneous sarcoidosis--a clinical case.Macroadenoma da hipófise Associado a Sarcoidose Pulmonar e Cutânea.Sarcoidosis is a granulomatous disease of unknown etiology that can affect all organs and systems, including the central nervous system in approximately 5% of patients. Although the hypothalamo-hypophyseal system may be one of the areas affected by neurosarcoidosis, pseudotumoral lesions are very rare. This paper reports the case of a 42-year-old male Caucasian patient followed by the Pneumology and Dermatology services for pulmonary and cutaneous sarcoidosis. Corticotherapy was initiated five months from diagnosis and the patient showed clear clinical and imagiological signs of improvement. In the following two months, the patient experienced visual disturbances and a slight decrease in libido, but denied having other symptoms associated with hypothalamo-hypophyseal hypofunction. Laboratorial evaluation (basal determinations and stimulation tests) revealed panhypopituitarism. The EC-NMR showed a bulky intrasellar lesion extending into the suprasellar and right parasellar regions, with evidence of optic chiasm compression, erosion of the floor of the sella and cavernous sinus invasion. Campimetry showed a bitemporal hemianopsia. For the purposes of chiasmatic decompression and histological study of the lesion the patient underwent a right frontal craniotomy, with a subtotal resection of the hypophyseal lesion. The histological diagnosis revealed a pituitary adenoma with no immunohistochemical expression. The patient began radiotherapy six months after surgery. Although today's diagnostic tools allow for a high degree of accuracy, hypophyseal lesions still present problems to the endocrinologist as their identification is essential for determining the appropriate treatment. At times the final diagnosis is only achieved after a histological identification of the lesion (biopsy/surgery). It should be noted that the described cases of association between sarcoidosis and hypophyseal adenoma are very rare, making the differential diagnosis with neurosarcoidosis difficult--a condition which has a preferential medical approach and a different prognosis.Sarcoidosis is a granulomatous disease of unknown etiology that can affect all organs and systems, including the central nervous system in approximately 5% of patients. Although the hypothalamo-hypophyseal system may be one of the areas affected by neurosarcoidosis, pseudotumoral lesions are very rare. This paper reports the case of a 42-year-old male Caucasian patient followed by the Pneumology and Dermatology services for pulmonary and cutaneous sarcoidosis. Corticotherapy was initiated five months from diagnosis and the patient showed clear clinical and imagiological signs of improvement. In the following two months, the patient experienced visual disturbances and a slight decrease in libido, but denied having other symptoms associated with hypothalamo-hypophyseal hypofunction. Laboratorial evaluation (basal determinations and stimulation tests) revealed panhypopituitarism. The EC-NMR showed a bulky intrasellar lesion extending into the suprasellar and right parasellar regions, with evidence of optic chiasm compression, erosion of the floor of the sella and cavernous sinus invasion. Campimetry showed a bitemporal hemianopsia. For the purposes of chiasmatic decompression and histological study of the lesion the patient underwent a right frontal craniotomy, with a subtotal resection of the hypophyseal lesion. The histological diagnosis revealed a pituitary adenoma with no immunohistochemical expression. The patient began radiotherapy six months after surgery. Although today's diagnostic tools allow for a high degree of accuracy, hypophyseal lesions still present problems to the endocrinologist as their identification is essential for determining the appropriate treatment. At times the final diagnosis is only achieved after a histological identification of the lesion (biopsy/surgery). It should be noted that the described cases of association between sarcoidosis and hypophyseal adenoma are very rare, making the differential diagnosis with neurosarcoidosis difficult--a condition which has a preferential medical approach and a different prognosis.Ordem dos Médicos2005-08-31info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1028oai:ojs.www.actamedicaportuguesa.com:article/1028Acta Médica Portuguesa; Vol. 18 No. 4 (2005): July-August; 309-13Acta Médica Portuguesa; Vol. 18 N.º 4 (2005): Julho-Agosto; 309-131646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1028https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1028/696Vilar, HelenaNobre, E LacerdaJorge, ZulmiraFilipe, J SousaCastro, J Jácome deinfo:eu-repo/semantics/openAccess2022-12-20T10:57:21Zoai:ojs.www.actamedicaportuguesa.com:article/1028Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:16:55.264405Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Pituitary macroadenoma associated with pulmonary and cutaneous sarcoidosis--a clinical case. Macroadenoma da hipófise Associado a Sarcoidose Pulmonar e Cutânea. |
title |
Pituitary macroadenoma associated with pulmonary and cutaneous sarcoidosis--a clinical case. |
spellingShingle |
Pituitary macroadenoma associated with pulmonary and cutaneous sarcoidosis--a clinical case. Vilar, Helena |
title_short |
Pituitary macroadenoma associated with pulmonary and cutaneous sarcoidosis--a clinical case. |
title_full |
Pituitary macroadenoma associated with pulmonary and cutaneous sarcoidosis--a clinical case. |
title_fullStr |
Pituitary macroadenoma associated with pulmonary and cutaneous sarcoidosis--a clinical case. |
title_full_unstemmed |
Pituitary macroadenoma associated with pulmonary and cutaneous sarcoidosis--a clinical case. |
title_sort |
Pituitary macroadenoma associated with pulmonary and cutaneous sarcoidosis--a clinical case. |
author |
Vilar, Helena |
author_facet |
Vilar, Helena Nobre, E Lacerda Jorge, Zulmira Filipe, J Sousa Castro, J Jácome de |
author_role |
author |
author2 |
Nobre, E Lacerda Jorge, Zulmira Filipe, J Sousa Castro, J Jácome de |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Vilar, Helena Nobre, E Lacerda Jorge, Zulmira Filipe, J Sousa Castro, J Jácome de |
description |
Sarcoidosis is a granulomatous disease of unknown etiology that can affect all organs and systems, including the central nervous system in approximately 5% of patients. Although the hypothalamo-hypophyseal system may be one of the areas affected by neurosarcoidosis, pseudotumoral lesions are very rare. This paper reports the case of a 42-year-old male Caucasian patient followed by the Pneumology and Dermatology services for pulmonary and cutaneous sarcoidosis. Corticotherapy was initiated five months from diagnosis and the patient showed clear clinical and imagiological signs of improvement. In the following two months, the patient experienced visual disturbances and a slight decrease in libido, but denied having other symptoms associated with hypothalamo-hypophyseal hypofunction. Laboratorial evaluation (basal determinations and stimulation tests) revealed panhypopituitarism. The EC-NMR showed a bulky intrasellar lesion extending into the suprasellar and right parasellar regions, with evidence of optic chiasm compression, erosion of the floor of the sella and cavernous sinus invasion. Campimetry showed a bitemporal hemianopsia. For the purposes of chiasmatic decompression and histological study of the lesion the patient underwent a right frontal craniotomy, with a subtotal resection of the hypophyseal lesion. The histological diagnosis revealed a pituitary adenoma with no immunohistochemical expression. The patient began radiotherapy six months after surgery. Although today's diagnostic tools allow for a high degree of accuracy, hypophyseal lesions still present problems to the endocrinologist as their identification is essential for determining the appropriate treatment. At times the final diagnosis is only achieved after a histological identification of the lesion (biopsy/surgery). It should be noted that the described cases of association between sarcoidosis and hypophyseal adenoma are very rare, making the differential diagnosis with neurosarcoidosis difficult--a condition which has a preferential medical approach and a different prognosis. |
publishDate |
2005 |
dc.date.none.fl_str_mv |
2005-08-31 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1028 oai:ojs.www.actamedicaportuguesa.com:article/1028 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1028 |
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oai:ojs.www.actamedicaportuguesa.com:article/1028 |
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por |
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por |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1028 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1028/696 |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 18 No. 4 (2005): July-August; 309-13 Acta Médica Portuguesa; Vol. 18 N.º 4 (2005): Julho-Agosto; 309-13 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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