Pituitary apoplexy: endocrine, surgical and oncological emergency. Incidence, clinical course and treatment with reference to 799 cases of pituitary adenomas.

Authors analyzed retrospectively the incidence of pituitary apoplexy in a series of 799 pituitary adenomas with respect to the long term follow-up of the patients. Focal vascular abnormalities in histological specimens of tumours, regarded as morphological suggestion of past apoplexy (haemorrhage, ischaemic infarction or necrosis), were established in 113 out of 783 surgical cases (14.4%).

[Teratoma of the posterior cranial fossa].

Two cases of posterior cranial fossa teratomas are reported. The rarity of these lesions is stressed. In the material of surgically treated cases of brain tumours from a period of 12 years in only two patients teratomas of this location were found.

[Many-year survival after surgical treatment of glioblastoma multiforme. Report of 2 cases].

Two female patients are described with survival over 13 years after operation for glioblastoma multiforme. The first patient was 42-year-old at the time of partial removal of the tumour situated in deep parts of the temporal lobe. After the operation she was not given any radiotherapy.

[Postoperative radiotherapy of glial tumors of the central nervous system].

The authors analysed the survival time of 372 patients subjected to radiotherapy after operations for central nervous system tumours of glial origin. Subtentorial gliomas with a better prognosis than supratentorial gliomas accounted for 82% of cases in this group of 67 children, and cerebellar medulloblastoma most sensitive to radiation accounted for 85%. In the group of 305 adults supratentorial tumours were found in 90.

[Erdheim's tumors in adults--diagnosis, treatment and therapeutic results].

The authors present a group of 27 adult patients aged over 25 years treated in the Department of Neurosurgery, Medical Academy in Warsaw in the years 1960-1985 for Erdheim's tumours. In most cases the first signs were visual disturbances and signs of raised intracranial pressure, and in only 48% of cases endocrine disturbances were additionally found. The basic diagnostic method in these cases was computerized tomography which indicates precisely the location of the lesion, its consistency and width of ventricles.

Cytostatics for acromegaly. Marked improvement in a patient with an invasive pituitary tumour.

A 21-year-old woman suffering from acromegaly was treated with transsphenoidal subtotal hypophysectomy (microscopy: acidophilic adenoma), followed by x-ray and bromocriptine therapy. Seven years later she was re-operated because of a partial bitemporal loss of vision, intracranial hypertension, and regrowth of the pituitary tumour seen on CT-scan. A large part of the invasive suprasellar tumour was then removed by transcranial approach.

[Neuropathologic analysis of 8 undiagnosed cases of cerebral cysticercosis].

The presented material comprised 17 cases observed in four Warsaw hospitals in a period of 20 years. Nine patients with the pseudotumour syndrome were diagnosed correctly and referred to neurosurgical services. The remaining eight cases died in neurological hospital departments with the following clinical diagnoses: cerebral stroke 3, subarachnoid haemorrhage 1, comatose state preceded by dementia 1, chronic meningoencephalitis 1, status epilepticus 2 cases postmortem investigations demonstrated cerebral cysticercosis in all cases.

[Effect of the method of treatment on mean survival time of patients with glial brain tumors].

In the years 1976-1981 54 patients were treated for malignant glial tumours confirmed by histological examination. The purpose of the reported analysis was a comparison of the mean survival time and the mean time of survival without evidence of recurrence in 3 groups of patients. In group I of 13 patients not treated surgically but receiving only conservative management the mean survival time was 7.

Results of neurosurgical treatment by a transsphenoidal approach in 10 patients with Nelson's syndrome.

Ten patients with Nelson's syndrome, nine women and one man, aged 22 to 61 years, were treated neurosurgically by a transsphenoidal approach. In four patients, microadenomas were found, ranging in diameter from 4 to 10 mm. Microscopically, mixed adenoma was diagnosed in six cases, basophilic adenoma in three patients, and chromophobe adenoma in one patient.

[A case of tumor of the pineal body treated with gamma rays of Co-60].

A 21-year-old patients was admitted to hospital with symptoms suggesting a tumour in the area of the epiphysis. Computer tomography confirmed the initial diagnosis. Since signs were present of increased intracranial pressure a Pudenz valve was implanted and in the second stage of treatment radiotherapy with radioactive cobalt was applied.

[Late recurrent subarachnoid hemorrhage after strengthening the aneurysm wall with aneuroplastic].

Two patients are presented in whom repeated subarachnoideal haemorrhages developed 4 and 13 years after operations for intracranial aneurysms including strengthening of aneurysm wall with aneuroplastic. The patients were reoperated on by microsurgery. In both cases it was possible to clip the aneurysm after removing aneuroplastic.

[Internal carotid artery aneurysm in the sella turcica area simulating pituitary tumor].

A giant aneurysm of the internal artery is described which was situated in the sella and simulated hormonally inactive hypophyseal adenoma. Axial computer tomography demonstrated a hypophyseal tumour. During operation from intranasal approach through sphenoid sinus massive haemorrhage developed but was controlled with fibrin sponge.

Nelson's syndrome: incidence and prognosis.

Fifty patients bilaterally adrenalectomized for Cushing's disease were followed for 1 to 22 (mean, 12) years. In 14 of them (28%) Nelson's syndrome appeared within 1.5 to 12 (mean, 4.

[Surgical treatment of acromegaly by the trans-sphenoidal approach. II. Hormonal results].

Growth hormone determinations were done in the serum of 45 patients with acromegaly. In 3 cases the basal GH levels was normal, in the remaining ones it was raised. Of the functional tests those with insulin, glucose and L-Dopa were done.

[Treatment of acromegaly by the surgical approach through the sphenoid bone. I. Clinical results].

Forty-five cases of pituitary adenomas with clinical characteristics of acromegaly treated surgically from an approach through the nose and sphenoid sinus are presented. After the operation the somatic features of acromegaly decreased in 66% of cases, headaches regressed in 88%, visual field defects disappeared in 20% of cases. Selective removal of pituitary microadenoma caused return of regular menstrual cycles in 12 women and in 3 of them successful pregnancy and labour resulted.

[Embryonal hemangioma and adenoma of the pituitary gland in a patient. Case report].

The authors describe a 54-year-old woman treated surgically 28 years earlier for embryonal haemangioma of the cerebellum and admitted with signs of hypophyseal tumour. Radiological examinations confirmed this suspicion and the patient was treated surgically from the approach through the nose and sphenoidal bone. The previous disease and intraoperative observation suggested the possibility of embryonal angioma in the sella but histological examination demonstrated that the tumour was a chromophobe adenoma.