ABSTRACT
At least 50% of surgically resected non-functioning pituitary adenomas (NFPA) recur. Either early or late adjuvant radiotherapy is highly efficacious in controlling recurrent NFPA but associates potentially burdensome complications like hypopituitarism, vascular complications or secondary neoplasm. Reoperation is indicated in bulky tumor rests compressing the optic pathway. To date, no standardized medical therapy is available for recurrent NFPA although cabergoline and temozolomide show promising results. Guidelines on the management of recurrent NFPAs are now available. The new 2017 WHO pituitary tumor classification, based on immunohistochemistry and transcription factor assessment, identifies a group of aggressive NFPA variants that may benefit from earlier adjuvant therapy. Nevertheless, NFPA patients exhibit a reduced overall life expectancy largely due to hypopituitarism and treatment-related morbidity. The management of recurrent NFPA benefits from a multidisciplinary teamwork of surgeons, endocrinologists, radiation oncologists, ophthalmologists, pathologists and neuro-radiologists in order to provide individualized therapy and anticipate deterioration
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Subject(s)
Humans , Pituitary Neoplasms/pathology , Neoplasm Recurrence, Local/pathology , Pituitary Neoplasms/classification , Pituitary Neoplasms/therapy , Transcription Factors/genetics , Practice Guidelines as TopicABSTRACT
At least 50% of surgically resected non-functioning pituitary adenomas (NFPA) recur. Either early or late adjuvant radiotherapy is highly efficacious in controlling recurrent NFPA but associates potentially burdensome complications like hypopituitarism, vascular complications or secondary neoplasm. Reoperation is indicated in bulky tumor rests compressing the optic pathway. To date, no standardized medical therapy is available for recurrent NFPA although cabergoline and temozolomide show promising results. Guidelines on the management of recurrent NFPAs are now available. The new 2017 WHO pituitary tumor classification, based on immunohistochemistry and transcription factor assessment, identifies a group of aggressive NFPA variants that may benefit from earlier adjuvant therapy. Nevertheless, NFPA patients exhibit a reduced overall life expectancy largely due to hypopituitarism and treatment-related morbidity. The management of recurrent NFPA benefits from a multidisciplinary teamwork of surgeons, endocrinologists, radiation oncologists, ophthalmologists, pathologists and neuro-radiologists in order to provide individualized therapy and anticipate deterioration.
Subject(s)
Adenoma/classification , Adenoma/therapy , Pituitary Neoplasms/classification , Pituitary Neoplasms/therapy , HumansABSTRACT
In this review we try to update the knowledge about the tumors of epididymis, describing problems in diagnosis and treatment. We present a case of a 39 years old patient who consults by left testicular mass, before the sonogarphy suspect of tumor was made magnetic resonance imaging , wich aimed towards tumorlike injury. Excision of the injury via inguinal was made and the pathologic diagnosis was of adenomatoid tumor. Owing to the few series that appear in literature, and being the commentaries of these tumors about isolated cases, we expose the characteristics of this illustrated case to value the characteristics in diagnosis and treatment to compare them with other cases.
Subject(s)
Adenomatoid Tumor/diagnosis , Epididymis , Genital Neoplasms, Male/diagnosis , Scrotum , Adult , Humans , MaleABSTRACT
Con esta revisión pretendemos actualizar los conocimientos acerca de los tumores de epidídimo, describiendo problemas en el diagnostico y tratamiento. Presentamos el caso de un paciente de 39 años que consulta por masa testicular izquierda, ante la duda ecográfica de tumor se realizó resonancia nuclear magnética que apuntaba hacia lesión tumoral. Se realizó exéresis de la lesión vía inguinal y el diagnóstico anatomopatológico fue de tumor adenomatoide. Dada las escasas series que aparecen en la literatura, y siendo los comentarios de estos tumores acerca de casos aislados, creemos oportuno exponer las características de este caso ilustrado iconográficamente para valorar las características diagnosticas y actitud terapéutica para poder compararlas con otros casos
In this review we try to update the knowledge about the tumors of epididymis, describing problems in diagnosis and treatment. We present a case of a 39 years old patient who consults by left testicular mass, before the sonogarphy suspect of tumor was made magnetic resonance imaging , wich aimed towards tumorlike injury. Excision of the injury via inguinal was made and the pathologic diagnosis was of adenomatoid tumor. Owing to the few series that appear in literature, and being the commentaries of these tumors about isolated cases, we expose the characteristics of this illustrated case to value the characteristics in diagnosis and treatment to compare them with other cases
