The application of transsphenoidal microsurgery in the management of pituitary microadenoma, long regarded as effective surgical treatment, has had a relatively low mortality and morbidity rate. However early failure and late recurrence has been reported in no small numbers. It has been proposed that stereotactic radiosurgery is an alternative treatment modality. Recent advances in neuroimaging permits precise targeting in radiosurgery of microadenomas. Additionally, a prompt hormonal reduction after the treatment is important for the patients with hormonally active microadenomas. The authors performed Gamma Knife radiosurgery in 27 patients with pituitary adenomas and observed the hormonal changes after radiosurgery in 19 patients with functioning microadenomas (5 with Cushing's disease, 7 with acromegaly, and 7 with prolactinoma). The maximum dose administered ranged from 25 to 75 Gy. The margin of the tumor was encompassed within the 50 to 90% isodose volume. The endocrinological status was assessed pre- and post-operatively. We measured the serum growth hormone and prolactin level, as well as the 24-hour urinary free-cortisol level. Normalization of the hormonal level was achieved in 6 cases, the majority of them within 10 months. The other 6 cases showed marked reduction of hormonal levels (less than 50% of preoperative levels) with a strong possibility of hormonal remission at further follow-up. The remaining 6 were failures. The cure for one case is still pending. It took approximately 1 approximately 3 months after the radiosurgery before the reduction of hormonal secretion began to show up with some improvement of symptoms. When the GKS was successful, hormonal secretion seemed to return to normal within 10 months. Although further follow-up is necessary to evaluate the long-term tumor control rate and hormonal effect, these initial results indicate a potential therapeutic role of radiosurgery in controlling hormone hypersecretion in pituitary microadenomas. Gamma knife radiosurgery is very promising in managing pituitary microadenoma with complementary of the transsphenoidal surgery.
Adenoma/metabolism/*surgery ; Adolescent ; Adult ; Female ; Human ; Male ; Middle Age ; Pituitary Neoplasms/metabolism/*surgery ; *Radiosurgery

Adenoma, Pleomorphic ; metabolism ; pathology ; surgery ; Aged ; Carcinoma ; metabolism ; pathology ; surgery ; Cell Transformation, Neoplastic ; Humans ; Lung Neoplasms ; metabolism ; pathology ; surgery ; Male ; Mucin-1 ; metabolism ; S100 Proteins ; metabolism ; Vimentin ; metabolism

Adenoma, Oxyphilic ; metabolism ; pathology ; surgery ; Cadherins ; metabolism ; Carcinoma, Renal Cell ; metabolism ; pathology ; surgery ; Catheter Ablation ; Diagnosis, Differential ; Humans ; Keratins ; metabolism ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Parvalbumins ; metabolism ; S100 Proteins ; metabolism

Acanthoma ; metabolism ; pathology ; surgery ; Adenoma ; metabolism ; pathology ; Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Keratin-14 ; metabolism ; Keratin-5 ; metabolism ; Keratin-6 ; metabolism ; Keratosis ; metabolism ; pathology ; surgery ; Male ; Poroma ; classification ; metabolism ; pathology ; surgery ; Sweat Gland Neoplasms ; classification ; metabolism ; pathology ; surgery

No abstract available.
Adenoma, Liver Cell/metabolism/*pathology/surgery ; Adult ; Glutamate-Ammonia Ligase/metabolism ; Humans ; Immunohistochemistry ; Liver Neoplasms/metabolism/*pathology/surgery ; Male ; Tomography, X-Ray Computed ; beta Catenin/*metabolism

Adenoma ; metabolism ; pathology ; surgery ; Humans ; Keratin-7 ; metabolism ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Kidney Transplantation ; Living Donors ; Male ; Mucin-1 ; metabolism ; Young Adult

Adenoma, Villous ; metabolism ; pathology ; surgery ; Aged ; Diagnosis, Differential ; Female ; Humans ; Keratin-20 ; metabolism ; Keratin-7 ; metabolism ; Mullerian Ducts ; pathology ; Papilloma ; pathology ; Vaginal Neoplasms ; metabolism ; pathology ; surgery

OBJECTIVETo investigate the clinicopathological and immunohistochemical features, diagnosis and differential diagnosis of nipple adenoma of the breast.

METHODSMorphological observation and immunohistochemistry were applied to 18 cases of nipple adenoma with a review of the related literatures.

RESULTSThe neoplasms were localized at nipples or under the areola of breast, adherent to the epidermis, mainly composed of dilated ducts in a tubular appearance associated with fibrotic matrix. The glandular epithelium showed various type of proliferation, forming thick layers or complex structures such as papillae, micropapillae, tufts, fronds, arcades or bridges accompanying with solid or cribriform cell nests. The tumor cells were crowding, lack of an uniform morphology and polarity with intact myoepithelial cells around the ducts. By immunostaining, the glandular epithelium was diffusely positive for 34betaE12, patchily positive for CK5/6, and negative for p53 and c-erbB-2. The myoepithelium, positive for p63, smooth muscle actin and Calponin, was well preserved and outlining the ducts.

CONCLUSIONSNipple adenoma is an infrequent type of benign breast neoplasm, presenting as sclerosing papilloma, papillomatosis or florid sclerosing adenosis. It is easily confused with atypical ductal hyperplasia/low grade ductal carcinoma in situ, invasive ductal carcinoma or low grade adenosquamous carcinoma. A correct diagnosis is based on the peculiar location and morphology of the tumor, and immunohistochemistry is helpful in some cases.

Adenoma ; metabolism ; pathology ; surgery ; Adult ; Breast Neoplasms ; metabolism ; pathology ; surgery ; Carcinoma in Situ ; metabolism ; pathology ; Carcinoma, Adenosquamous ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Keratin-5 ; metabolism ; Keratins ; metabolism ; Middle Aged ; Nipples ; metabolism ; pathology ; surgery

Functioning adrenocortical oncocytomas are extremely rare and most reported patients are 40-60 yr of age. To our knowledge, only 2 cases of functioning adrenocortical oncocytomas have been reported in childhood. We report a case of functioning adrenocortical oncocytoma in a 14-yr-old female child presenting with virilization. She presented with deepening of the voice and excessive hair growth, and elevation of plasma testosterone and dehydroepiandrosterone sulfate. She had an adrenalectomy. The completely resected tumor composed predominantly of oncocytes without atypical mitosis and necrosis. A discussion of this case and a review of the literature on this entity are presented.
Adenoma, Oxyphilic/*complications/metabolism/pathology/surgery ; Adolescent ; Adrenal Cortex Neoplasms/*complications/metabolism/pathology/surgery ; Adrenalectomy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Virilism/*etiology/pathology/surgery

Actins ; metabolism ; Adenoma, Pleomorphic ; congenital ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Fibrosarcoma ; metabolism ; pathology ; Humans ; Infant ; Male ; Nasopharyngeal Neoplasms ; congenital ; metabolism ; pathology ; surgery ; Rhabdomyosarcoma ; metabolism ; pathology ; Salivary Gland Neoplasms ; congenital ; metabolism ; pathology ; surgery ; Vimentin ; metabolism