CyberKnife for the management of Cushing's disease: our institutional experience and review of literature.

Introduction: Surgery is the primary treatment for Cushing's disease(CD). In cases with no biochemical remission after surgical resection or when recurrence occurs after a period of remission stereotactic radiosurgery (SRS) is used as alternative/adjuvant treatment. The aim of this study is to demonstrate the effectiveness of SRS and FSRS(Fractionated stereotactic radiosurgery) for the treatment of CD in a long term follow up.

Decrease of Proliferative Potential and Vascular Density of Giant Prolactinoma in Patients Treated with Cabergoline.

Introduction: Currently, cabergoline therapy is the main treatment for prolactinomas. The use of the drug in most cases leads to regression of the tumor, normalization of prolactin (PRL) levels, and restoration of gonadotropic function. The mechanism of its action in tumor cells "" tracked in dynamics in the same human tumor is of considerable interest.

Modern Methods of Stereotactic Radiosurgery and Radiotherapy for the Treatment of Cushing Disease.

Cushing's disease is caused by a pituitary tumor causing increased production of adrenocorticotropic hormone, which leads to chronic hypersecretion of cortisol through adrenal cortices. Endoscopic trans-sphenoidal adenomectomy is the first choice of treatment with greatest efficiency for the treatment of the disease. However, in the absence of remission or recurrence of hypercortisolism after neurosurgical resection (adenomectomy), as well as in cases when surgical intervention cannot be carried due to medical contraindications to surgical intervention, radiation treatment is used as an alternative or adjoining therapy.

Restoration of fertility in a woman with giant prolactinoma in response to cabergoline treatment.

Summary: A 32-year-old woman presented with primary amenorrhoea, prolactin (PRL) level of 154 150 mIU/L and was diagnosed with a giant pituitary adenoma measuring maximum 6.2 cm. Cabergoline (CAB) treatment at a dose of 0.

[Reproductive disorders and preservation of fertility in males with benign and malignant brain tumors].

Brain tumors rank third in the incidence rate among cancer nosologies. However, improvement of neurosurgical treatment methods and the use of modern regimens of chemotherapy and radiotherapy have increased survival of patients with benign and malignant brain tumors. A significant proportion of patients with brain tumors are young people in the reproductive age who are interested in maintaining their fertility.

[Clinical and functional characteristics of giant pituitary adenomas in the population of patients in the Moscow region].

Unlabelled: Benign pituitary tumors are the most common sellar neoplasms. Lesions larger than 39 mm in the maximum dimension are called giant. They are rare, and, therefore, there are few data on the clinical and morphological features of giant pituitary tumors with different hormonal activity.

[Preoperative and postoperative endocrine disorders associated with pituitary stalk injuries caused by suprasellar growing tumors].

Unlabelled: The pituitary stalk (PS) is a relatively thin bundle connecting the hypophyseal stalk to the pituitary gland; it consists of both axons of the hypothalamic nuclei (terminating in the neurohypophysis) and the system of portal vessels. Compression of the PS by a space-occupying lesion or its transection (forced or intended) during surgery may lead to the development of endocrine disorders: hypopituitarism, diabetes insipidus, and hyperprolactinemia. The modern literature lacks studies evaluating the severity of endocrine disorders depending on the PS condition before and after surgery.

[Indications for surgical treatment of prolactin-secreting pituitary adenomas].

Prolactinomas account for about 40% of all pituitary adenomas. The main treatment for prolactinomas is undoubtedly therapy with dopamine agonists (DAs). However, prolonged conservative treatment (for many years or even throughout life) that is necessary for permanent control of the disease makes some patients refuse pharmacological treatment for various reasons.

[A rare case of diencephalic cachexia in an adult female with cranio-pharyngioma].

Diencephalic cachexia (DС) is progressive weight loss despite a normal caloric intake and a satisfactory state of health, which is caused by hypothalamic lesions. This is a rare (about 100 cases were reported) and potentially fatal disorder of unknown pathogenesis. At present, there is no effective pharmacological therapy for the disorder.

[The efficacy of desmopressin in the treatment of central diabetes insipidus after resection of chiasmo-sellar region tumors].

Unlabelled: Central diabetes insipidus (CDI) is a neuroendocrine disease, the pathogenesis of which is associated with abnormal secretion of the antidiuretic hormone. One of the specific causes of CDI is neurosurgical resection of chiasmatic-sellar region tumors.

Aim: to study the efficacy and safety of desmopressin in CDI patients after resection of chiasmatic-sellar region (CSR) tumors.

[Modern diagnosis and postoperative monitoring of acromegaly patients at a neurosurgical clinic].

Acromegaly is a severe disease associated with chronic overproduction of the growth hormone (GH) and insulin-like growth factor-1 (IGF-1), which is caused in most cases by pituitary adenoma. The main causes of mortality in acromegaly are cardiovascular diseases, respiratory diseases, and cancers. At present, the most effective treatment for acromegaly is surgical pituitary adenomectomy.

Clinical and morphological characteristics, diagnostic criteria, and outcomes of surgical treatment of TSH-secreting pituitary adenomas.

Unlabelled: Thyrotropinomas (TSH-secreting tumors) are a rare type of pituitary adenomas, which account for about 0.5-2.0% of all pituitary tumors.

Endoscopic transsphenoidal resection of pituitary adenomas invading the cavernous sinus.

Introduction: Pituitary adenomas are benign growths that invade the cavernous sinus (CS) in 10-15% of cases. There are different types of microsurgical and endoscopic approaches enabling resection of tumors from the CS cavity that is a relatively small and hard to reach anatomical structure comprising eloquent neurovascular structures.

Material And Methods: A study group included 97 patients with pituitary adenomas (PAs) invading the CS.

The rate of hyponatremia in neurosurgical patients (comparison between the data from the Burdenko Neurosurgical Instutite and the literature) and recommendations for the diagnosis and treatment.

Unlabelled: Hyponatremia is a relatively frequent and serious complication in patients with various neurosurgical pathologies.

Objective: This study is aimed at assessing the incidence of hyponatremia in neurosurgical patients depending on the pathology.

Material And Methods: This paper presents a retrospective analysis 39 479 cases of patients operated on at the Burdenko Neurosurgical Institute from 2008 to 2014.

[Thyrotropin-producing adenomas and thyrotropic hyperplasia (clinical case reports and the review of the literature)].

An increased blood level of the thyroid stimulating hormone (TSH) is usually associated with primary hypothyroidism (PHT) but can also be observed in such rare cases as TSH-secreting pituitary tumor. The article describes four clinical cases of elevated TSH blood levels: 1) TSH-secreting pituitary adenoma with hyperthyroidism; 2) TSH-secreting adenoma with hypothyroidism; 3) hormonally inactive pituitary adenoma combined with primary hypothyroidism; 4) reversible thyrotropic hyperplasia. These clinical situations substantiate the importance of considering different diagnoses in a patient with a pituitary gland tumor associated with an increased TSH blood level.

Endoscopic endonasal anterior extended transsphenoidal approach in craniopharyngioma surgery.

The paper describes results of treatment of 56 patients with suprasellar craniopharyngioma (stem, intra-extraventricular) who were operated in Burdenko Neurosurgical Institute using endoscopic endonasal anterior extended transsphenoidal approach. Assessed dynamics of major clinical syndromes (neuro-ophthalmological symptoms, neurological and hormonal status), radicality of surgery, incidence and nature of postoperative complications, postoperative mortality. A comparative analysis of the results obtained in previous studies of our Institute, as well as with those of foreign authors is performed.

Transsphenoidal surgery of craniopharyngioma: form palliative surgery to radical removal.

The paper presents basic principles of transsphenoidal craniopharyngioma surgery. Stages of methodology development. Steps of methodology development of such operations in the Institute are described--from palliative interventions to the high-tech modern radical surgery with the use of anterior extended approach.

[Hormonally inactivated pituitary adenoma: morphological, immunohistochemical and electron-microscopic characteristic].

Morphology of hormonally inactivated pituitary adenoma can be different types of tumors. Morphological immunohistochemical and electron-microscopic researches of 23 hormonally inactivated pituitary adenomas has been carried out. We shown that more frequent morphological substrate was gonadotropinoma or "zero-cells" adenoma.

[Endoscopic endonasal surgery of pituitary adenomas (experience of 1700 operations)].

The current paper analyses results of endoscopic endonasal surgical treatment of 1700 patients with pituitary adenomas in Burdenko Neurosurgical Institute during recent 7 years. We assessed the following parameters: dynamics of basic syndromes (neuroophthalmological, neurological and endocrinological symptoms), degree of resection, frequency and types of postoperative complications, postoperative mortality, recurrence rate etc. The obtained data were compared with results of microsurgical transnasal operations which were formerly performed in our department, as well as with results of leading endoscopic neurosurgeons of the world.

[Experience of skull base defect reconstruction using local pedicled grafts in endoscopic transsphenoidal surgery].

Since endoscopic technique was introduced in transsphenoidal surgery, the midline skull base from olfactory fossa to craniocervical junction has become available through transnasal corridor. One of the most challenging aspects in these types of surgery is watertight closure of skull base defect and prevention of postoperative CSF leaks. Various materials and sealants are applied in different clinics.

[Complications of treatment of prolactinoma by dopamine agonists].

Treatment of prolactin-secreting pituitary adenomas by dopamine agonists is highly effective and currently is used as basic treatment in most cases, however, literature sources practically do not contain data about possible complications of this therapy. We described a total of 11 cases of deterioration due to primary treatment of macroprolactinomas by cabergoline in the series of 176 patients. The first group included patients with enlargement of the tumor producing deterioration of the symptoms (onset of visual disorders and/or cephalgia).

[Development of secondary resistance to dopamine agonists in a patient with giant prolactinoma].

Currently conservative treatment is therapy of choice in most patients with prolactinoma. However in 10-20% of them resistance to dopamine agonists occurs. In the majority of such cases resistance is initial, and only a few patients after good primary response to dopamine agonists develop so called "secondary" resistance ("escape" from effect).

[Comparative analysis of surgical and medical treatment of macroprolactinoma of different localization].

The authors performed comparative analysis of results of primary surgical and medical treatment of 306 patients with macroprolactinoma. The series included 178 male and 128 female patients. The tumor was endosellar in 48 cases, endosuprasellar in 94, invaded skull base in 164.

[Rare observation of giant pituitary adenoma spreading into posterior cranial fossa].

A case observation of unusual course of pituitary adenoma is presented. In 47-year old male patient with endo-supra-laterosellar pituitary adenoma and active acromegaly 2 different tumors were discovered intraoperatively during surgery for recurrence of the primary tumor. The first tumor was pituitary adenoma with nuclear polymorphism and the second was meningotheliomatous meningioma with solitary mitoses.