RESULTS: Among the 71 patients (mean age, 52.7 years; range, 12-79
years), 62 were females and 9 were males. The most typical symptoms recorded were proptosis in 61 patients (85.9%), visual impairment in 41 patients Danusertib in vivo (57.7%), and oculomotor paresis in 9 patients (12.7%). Complete removal was achieved in 59 patients (83%). At 6 months of follow-up, magnetic resonance imaging scans revealed residual tumor in 12 patients (9 in the cavernous sinus and 3 around the superior orbital fissure). Mean follow-up was 76.8 months (range, 12-168 months). Tumor recurrence was recorded in 3 of 59 patients (5%) with total macroscopic removal. Among the patients with subtotal resection, tumor progression was observed in 3 of 12 patients (25%; 2 patients with grade III and 1 patient with grade IV resection). Mean time to recurrence was 43.3 months (range, 32-53 months).
CONCLUSION: Surgical management of patients with sphenoid wing meningiomas cannot be uniform; it must be tailored on a case-by-case basis. Successful resection requires extensive intra- and extradural Surgery. Mocetinostat supplier We recommend optic canal decompression in all patients to ameliorate and/or preserve visual function.”
“OBJECTIVE: We aim to report a case of Kaposi sarcoma (KS) with Cushing’s syndrome caused by endogenic glucocorticoid-induced immunosuppression.
CLINICAL PRESENTATION: A 43-year-old
woman presented with delirium, hirsutism, fatigue, and hypertension. At the time of presentation, physical findings showed a Cushingoid appearance, with moon-like facies, hirsutism, and hyperpigmentation. Laboratory findings showed the following: adrenocorticotropic hormone, 86.7 pg/mL (normal range, 0-46 pg/mL); baseline cortisol level, 50 mu g/dL (normal range, 6.2-19 mu g/dL); potassium, 2.2 mEq/L (normal range, 3.5-5 mEq/L); and midnight cortisol level, 33 pg/dL. Serum Lumacaftor nmr cortisol levels failed to suppress after low and high doses of dexamethasone; these findings confirmed
the diagnosis of ectopic adrenocorticotropic hormone production. Magnetic resonance imaging revealed a 12 X 15-mm, round, hypothalamic mass lesion in the center of the median eminence.
INTERVENTION: Endoscopic biopsy from the floor of the third ventricle was performed, and pathological examination of the lesion showed a diffuse adrenocorticotropic hormone-secreting adenoma. The patient developed diffuse skin lesions that were proven to be a KS by skin biopsy while she was prepared for transcranial surgery. After surgical removal of the adenoma, she became hypocortisolemic and required cortisol replacement. Within 1 month after surgery, all KS lesions disappeared spontaneously.
CONCLUSION: Excessive cortisol may induce immunosuppression. KS is one of the most common malignant tumors of patients with immunosuppression.