Hypopituitarism secondary to sphenoidal sinus carcinoma

Lebovits, Marc; Ross, J. Cosbie

doi:10.1016/s0196-0709(80)80093-7

Cited by 4 publications

(6 citation statements)

References 16 publications

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“…The incidence of hypopituitarism about four per 100,000 per year and the rate of mortality associated with hypopituitarism is high [ 12 ]. Secondary hypopituitarism rarely occurs in patients with sphenoid sinus disease [ 12 , 13 ]. Lebovits et al reported a patient with sphenoidal sinus carcinoma causing symptomatic panhypopituitarism and they also reported that secondary hypopituitarism occurred in 1% of sphenoid sinus malignancies [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

A long-term survival case with proton beam therapy for advanced sphenoid sinus cancer with hypopituitarism

et al. 2021

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Sphenoid sinus malignancies are rare diseases. Secondary hypopituitarism associated with sphenoid sinus malignancy is not well known. A 41-year-old male complained of right ptosis. Neurological findings revealed right oculomotor, trochlear and glossopharyngeal nerve palsy. Imaging diagnosis suggested a tumor that had spread bilaterally from the sphenoid sinus to the ethmoid sinus, nasopharynx and posterior pharyngeal space. Biopsy revealed squamous cell carcinoma (SCC). Based on these findings, a clinical diagnosis of SCC of the sphenoid sinus was made. Removal of the tumor without damaging nearby organs would have been difficult because the tumor extended to the bilateral optic nerves, optic chiasma and internal carotid artery, and surgeons, therefore, recommended proton beam therapy (PBT). Before PBT, the hypopituitarism occurred in the patient and we administered hydrocortisone and levothyroxine. During treating for hypopituitarism, we performed PBT with nedaplatin and 5-fluorouracil. The daily PBT fractions were 2.2 relative biological effectiveness (RBE) for the tumor received total dose of 81.4 Gy RBE. The acute side effect of grade 2 dermatitis according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Occurred after PBT. The patient needs to take hydrocortisone and levothyroxine, but he remains in complete remission 8 years after treatment without surgery or chemotherapy. Visual function is gradually declining, but there is no evidence of severe radiation-induced optic neuropathy.

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Section: Discussionmentioning

confidence: 99%

A long-term survival case with proton beam therapy for advanced sphenoid sinus cancer with hypopituitarism

et al. 2021

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“…3,9 Patients generally present in their fourth and fifth decades with a female preponderance as seen in this case. 1,6,7 Lesions in the spenoid sinus typically result from direct extension of malignant tumours from the surrounding structures such as the ethmoid sinus, rhinopharynx, clivus, or by growth of invasive pituitary macroadenomas from the sella turcica. Patients with a lesion in the sphenoid sinus often manifests with mild or non specific symptoms until the tumour expands beyond the walls of the sinus.…”

Section: Case Reportmentioning

confidence: 99%

“…Several literatures described ocular problems as initial symptom of primary sphenoid sinus tumour, occuring up to 75 percent of the patients with majority of them having diplopia. 1,4 This normally result from unilateral abducens nerve involvement owing its long course within the cavernous sinus which is in close proximity to site of tumour. Partial visual loss and ptosis can be explained by tumour extension to cranial nerves II and III.…”

Section: Case Reportmentioning

confidence: 99%

“…Patients with primary sphenoid sinus tumours may also present with non specific headache which described as ipsilateral, retro-orbital, or of the vertex similar to our case who complained of left sided headache. 1,4 This is probably due to the size reduction of the subcribriform sphenoethmoidal chamber. The other possibility is due to the involvement of the sphenopalatine nerve or ganglion, or of the middle fossa or cavernous dura.…”

Section: Case Reportmentioning

confidence: 99%

“…1,2,4,6 Isolated sphenoid sinus adenoid cystic carcinoma has been always difficult to diagnose because of its location and subtle symptoms. Adenoid cystic carcinoma is an insidious growing, locally invasive tumor of epithelial origin that represents only 1 percent of all head and neck malignancies.…”

Section: Introductionmentioning

confidence: 99%

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Unusual primary sphenoid adenoid cystic carcinoma: the importance of combined CT and MR evaluation

Soffian

Rohana

Lazim

et al. 2016

Bangladesh J Med Sci

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Objective: To report a diagnostic challenge of primary sphenoid adenoid cystic carcinoma. Case summary: A 60-year-old premorbid healthy lady presented with progressive deterioration of visual acuity of the left eye associated with diplopia, left epiphora and left ear blockage for two weeks duration. Examination revealed a 'non perception of light' (NPL) of the left eye with left abducent nerve palsy. The nasoendoscopic findings were unremarkable. Initial computed tomography of the brain and paranasal sinus showed a large clivus tumor with intracranial extension while subsequent magnetic resonance detected the epicenter of the tumour appeared to be in the sphenoid sinus with extension to the surrounding structures. A transeptal transsphenoidal biopsy was done reported as mixed pattern adenoid cystic adenocarcinoma. Discussion: Primary sphenoid adenoid cystic carcinoma is an extremely rare slow growing malignancy with non-specific clinical symptoms. The neuro-ophthalmology symptoms are the main presentation. Combined computed tomography and magnetic resonance images are essential in establishing differential diagnosis and to delineate the extent of this disease. Combined modality of surgery and postoperative radiation for adenoid cystic carcinoma has proven better results. Conclusions: Primary sphenoid adenoid cystic carcinoma poses a diagnostic challenge clinically. Combined radiological characteristic from computed tomography and magnetic resonance images are essential to aid the diagnosis.

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The complications of sphenoid sinusitis

Dale¹,

Mackenzie²

1983

J. Laryngol. Otol.

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Hypopituitarism secondary to sphenoidal sinus carcinoma

Cited by 4 publications

References 16 publications

A long-term survival case with proton beam therapy for advanced sphenoid sinus cancer with hypopituitarism

A long-term survival case with proton beam therapy for advanced sphenoid sinus cancer with hypopituitarism

Unusual primary sphenoid adenoid cystic carcinoma: the importance of combined CT and MR evaluation

The complications of sphenoid sinusitis

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