Spontaneous regression of Pituitary Adenomas: Illustrative case and systematic review

INTRODUCTION@#Spontaneous regression of pituitary adenomas is a rare occurrence that is thought to be due to pituitary apoplexy. We would like to review the demograhic data, imaging findings, and neurologic, endocrinologic, and radiologic outcomes of patients who exhibited this unusual phenomenon.@*METHODS@#We present a case of non-functioning pituitary adenoma (NFPA) in a 66-year-old man that underwent spontaneous regression. We also performed a systematic literature review on cases of pituitary adenomas that exhibited spontaneous regression, in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.@*RESULTS@#There have been only 27 reported cases of spontaneous regression observed in all pituitary adenomas, 16 of which are NFPAs. Headache was the most common symptom while decreased visual acuity and oculomotor nerve palsy were the most common sign. Pituitary hemorrhage was seen in two-thirds of cases, while findings suggestive of pituitary infarct, such as enhancement of the sphenoid sinus mucosa. were seen in one-third. Complete radiographic remission was observed in 62% of cases, with an 11% recurrence rate seen at least two years after the initial imaging. Neurologic recovery was reported in 88% and endocrinologic recovery from hypopituitarism was 40%.@*CONCLUSION@#Most patients exhibited neurologic and endocrinologic improvement concomitant with the regression of the pituitary adenoma. However, these tumors may recur; thus, regular and long- term neuro-ophthalmologic and radiologic follow-up is advised.

The comparison of the different adjustment factors for admission to the University of the Philippines College of Medicine

Background@#Among the different criteria, the General Weighted Average Grade (PMGWAG) holds the biggest bearing on admission for the UP College of Medicine. However, GWAs are not comparable across different courses, different batches, different UP units and different schools. An Adjustment Factor is necessary to make PMGWAGs comparable and to level the playing field. @*Objectives@#This study covering a 24-year period aimed to compare various proposed Admission Adjusted Factors of %PMGWAG (Pre-Med GWAG) in terms of Pearson's Correlation, Linear Regression Models and Mean Differences with %MGWAG (Medical GWAG), Class Rank and Board Rating as Outcome variables. @*Methodology@#Various proposed Adjustment Factors were applied to %PMGWAG of medical students from Class 1990 to Class 2014 and Pearson's Correlation, Linear Regression Models and Mean Differences with %MGWAG, Class Rank and Board Rating were derived and analyzed. @*Results@#Adjustment Factor A3 as applied to %PMGWAG correlates best with Board Rating and Class Rank while Adjustment Factor A6 with %MGWAG. On Linear Regression, A3 likewise bested other Adjustment Factors in predicting %MGWAG and %Board Rating while A6 on predicting Class Ranking. Among the various adjustments, A3 exerted the most impact on the outcome variables, based on mean differences. @*Conclusion@#The A3 Adjustment Factor is the preferred and most ideal among the various proposed adjustment factors. Its application on %PMGWAG, correlated best with, most predictive of and most influential to %MGWAG, Board Rating and Class Rating.