Growth hormone-releasing pituitary microadenoma overshaded by a macroadenoma: a case of double pituitary adenomas and review of the literature.

OBJECTIVES: Double pituitary adenoma is a rare entity that can pose a significant challenge. The incidence of double or multiple pituitary adenomas is ∼1% in autopsy cases and 0.4-1.3% in surgical series. Its definition varies, including 'double adenomas' in the literature in contrast to 'multiple adenomas', which is more specific and suitable. While some authors require separating topographically unique tumours, others have used a looser definition of separate immunohistochemistry. CASE PRESENTATION: We presented the case of a 26-year-old patient with recurrent carpal tunnel syndrome symptoms, with double pituitary adenomas secreting growth hormone (GH) and thyroid-stimulating hormone (TSH). To date, 89 patients have been reported in the literature with symptomatic carpal tunnel syndrome, but only five had GH-TSH secretion. CONCLUSIONS: Double adenoma resection is of great importance for ensuring successful biochemical treatment. To ensure a successful operation, a careful preoperative 3T MRI examination is of great importance.

Desmoplastic fibroma of the jaw bones: A series of twenty-two cases.

Desmoplastic fibroma (DF) is an intraosseous counterpart of desmoid-type soft tissue fibromatosis. It is most frequently seen in the jawbones. The clinical and radiological features of the present cases were nonspecific. The accumulation of beta-catenin in the nuclei of neoplastic cells which is a diagnostic feature of desmoid-type soft tissue fibromatosis could not be detectED in the present DF series. The aim of this study is to report a series of 22 cases of DF involving either mandible or maxilla. A retrospective evaluation of desmoplastic fibroma and beta-catenin, smooth muscle actin, nestin, cyclin D1 immunostaining's patterns. Most of the DF cases expressed only cytoplasmic beta-catenin immunostainings. We suggest that nuclear beta-catenin staining may not be used as a corroborating the diagnosis of DF. Immunohistochemical staining difference of jaw bone desmoplastic fibromas from other soft tissue and bone lesions may be related to the origination of jaw bone from The neural crest. Strong nestin and cyclin D1 positivity in our series supported this. A combined clinical, radiological, and histopathological analysis of the DF cases is essential in the diagnosis and management.

Effects of melatonin on uterine hypertrophy/hyperplasia: A preliminary experimental rat study.

Endometrial hyperplasia is a process of endometrial proliferation that results in a thickening of the endometrial tissue. Melatonin might be able to change the pathophysiological process and prognosis into a positive way that might prevent and heal endometrial hyperplasia, which is the first stage of endometrial cancer. For this perspective, we tried to investigate the effect of melatonin on uterine hypertrophy/hyperplasia in an experimental rat model. Forty Wistar-Albino rats were undergone bilateral oophorectomy and randomized into four groups. To create a model of uterine hypertrophy/hyperplasia in all groups, except the control group [C] (n = 10), 4 mg/kg/day estradiol hemihydrate were given for 14 days. The uterine hypertrophy/hyperplasia was evaluated histopathologically in the left uterine horns, then the groups were treated for 14 days as follows; melatonin (10 mg/kg/day/po) [M] (n = 10), melatonin + estradiol hemihydrate (10 mg/kg/day/po and 4 mg/kg/day/po) [M + E] (n = 10), and dark environment [D] (n = 10). Finally, the effects of the melatonin were examined histopathologically in the right uterine horns. An uterine hypertrophy/hyperplasia model was established in all groups compared to the control group (p < 0.05). In the [M] and [M + E] groups, epithelial cell height and luminal epithelial cell height significantly decreased (41µm vs 12µm, p = 0.005; 14µm vs 10µm, p = 0.005, respectively for [M] group) and (32µm vs 14µm, p = 0.012; 17µm vs 10µm, p = 0.017, respectively for [M + E] group). The [D] group exhibited a significant decrease in epithelial cell height (33µm vs 20µm, p = 0.017). With or without estrogen exposure, melatonin-treated and physiologically melatonin-released rats experienced a significant uterine hypertrophy/hyperplasia recovery. Melatonin may have protective effects on endometrial hyperplasia.

Coexistence of sclerosing polycystic adenosis and dysgenetic polycystic disease of parotid, Report of a case.

Sclerosing polycystic adenosis (SPA) is a rare benign salivary gland lesion. Dysgenetic polycystic disease (DPD), which is a histologically similar lesion, may cause a lattice-like gross appearance with bilateral enlargement of the entire salivary glands. In this report, we present a case of SPA in the right parotid and coexistent DPD involving the both parotid.

Parenchymal changes of salivary glands adjacent to a variety of salivary gland disorders.

A fully developed tumor is the first manifestation of a typical salivary gland neoplasm. Identification of precursor lesions and the accompanying clinical findings may improve our understanding of these tumors. The frequency of possible precursor lesions of salivary gland tumors have not been systematically investigated to date. In this study, slides of 661 cases from three pathology laboratories in Ankara, Turkey were reviewed to search for possible precursor lesions. Salivary gland parenchymal changes adjacent to a variety of salivary gland disorders such as metaplastic changes, ductal epithelial hyperplasia, adenomatoid ductal hyperplasia, adenomatoid oxyphilic hyperplasia, adenomatoid hyperplasia of the minor salivary glands, myoepithelial sialadenitis and dysplasia were screened histologically as potentially precursor lesions. Nuclear protein Ki-67 and cellular tumor antigen p53 were also analyzed immunohistochemically in selected cases. Approximately 16% of the cases in this series contained various types of pathologic hyperplasia. Only a minority of these lesions were originally reported, so most of the findings in this study were not part of the original histology reports. The majority of these parenchymal changes were seen in parotids. Adenomatoid ductal hyperplasia was the most frequent possible precursor lesion, and it was found most frequently around pleomorphic adenomas. Although the biological significance of most of the lesions described in this report still remains to be understood completely, efforts to define and detect possible preneoplastic lesions should be intensified. We believe that detection and eradication of the precursors is the best way of decreasing the overall morbidity caused by salivary gland tumors.

A series of 240 odontogenic keratocysts: Should we continue to use the terminology of 'keratocystic odontogenic tumour' for the solid variant of odontogenic keratocyst?

Most of the odontogenic keratocysts show an indolent behaviour like non-neoplastic lesions. For this reason, the odontogenic keratocyst was reclassified within the odontogenic cysts category in the WHO 2017 classification. Some odontogenic keratocysts may contain satellite cysts or solid squamoid islands within their wall. Recently, a solid form of odontogenic keratocyst has also been described which is composed entirely of multiple epithelial islands and small cysts in a collagenous stroma. The true nature of this variant is unclear yet. In this article, we present a series of 204 odontogenic keratocyst cases. Clinical and histologic findings of the cases in this series were described. These were also categorised according to the presence of satellite lesions. Additionally, the features of two cases of the solid form of odontogenic keratocysts were compared with those of the previous reports and other histologically similar odontogenic lesions. Current evidence suggests that this variant may be neoplastic and it differs from other odontogenic keratocysts, at least histologically. We believe diagnosing a solid lesion as a cyst is counterintuitive and the term "keratocystic odontogenic tumour" better describes this particular variant.