Endoscopic transnasal transsphenoidal transtuberculum sellae extradural approach to suprasellar pituitary lesions: A case report

September 20, 2015     Tapan Nagpal, MS


Pituitary adenomas are benign tumors that arise within the anterior lobe (the adenohypophysis) of the pituitary gland in the sella turcica. As they grow, they can extend through the pituitary stalk and into the suprasellar compartment. The surgical management of these adenomas via a conventional intradural approach is fraught with a high risk of causing a large cerebrospinal fluid leak. We report a case of pituitary adenoma in a 60-year-old woman whose surgery was performed via a minimally invasive endoscopic transnasal transsphenoidal transtuberculum sellae extradural approach.

A rare case of pleomorphic adenoma of the nasal septum

June 4, 2015     Tejinder Singh Anand, MS, PhD; Gautam Bir Singh, MS; Sunil Garg, MS; Garima Yadav, MBBS; Anita Nangia, MD

Pleomorphic adenomas of the nasal cavity differ from those found elsewhere in that they have more myoepithelial cells and little or no stromal component.

Parathyroid localization using 4D-computed tomography

April 27, 2015     Darrin V. Bann, PhD; Thomas Zacharia, MD; David Goldenberg, MD, FACS; Neerav Goyal, MD, MPH

To decrease the risk of iatrogenic cancers associated with 4D-CT, several groups have used one- or two-phase imaging protocols to identify parathyroid adenomas.

A transoral surgical approach to a parapharyngeal-space pleomorphic adenoma

October 17, 2014     Christopher Schutt, MD; Joehassin Cordero, MD, FACS


It is relatively difficult to gain surgical access to pleomorphic adenomas of the parapharyngeal space. Since the lateral border is the mandible, gaining access to them can put several important neurovascular structures at risk. A number of surgical approaches have been developed to overcome this difficulty, and each has its advantages and disadvantages. We report the case of a 59-year-old woman with a parapharyngeal-space pleomorphic adenoma that was accessed via a transoral approach. Transoral approaches are controversial and rarely used. However, we feel that for a selected group of tumors, this approach provides clear benefits by decreasing cosmetic and functional disability while providing good surgical access to the tumor.

Transoral approach to a deep-lobe parotid tumor

October 17, 2014     Lyndon Gonzalez, BS; Alex Fernandez, MS; Belinda Mantle, MD

Because of their location in this potential space, parapharyngeal tumors tend to be asymptomatic and remain undetected for a long time.

Parathyroid adenoma

July 13, 2014     Lester D.R. Thompson, MD

Most of these lesions are identified in glands within their usual anatomic location instead of in an ectopic or supernumerary site.

Massive pleomorphic adenoma of the parotid gland: Surgical considerations

May 7, 2014     Alex Fernandez, MS; Ryan F. Osborne, MD, FACS; Jason S. Hamilton, MD, FACS

Preservation of the facial nerve and its branches requires special consideration when dealing with a large parotid mass. The traditional approach of anterograde dissection of the facial nerve proves ineffective in patients with large lesions that effectively obstruct the field of view and origin of the nerve trunk

Parathyroid adenoma in a woman with secondary hyperparathyroidism

May 7, 2014     Darrin V. Bann, PhD; Neerav Goyal, MD, MPH; David Goldenberg, MD, FACS

For surgical treatment of secondary hyperparathyroidism, a common approach is the removal of three and one-half glands (subtotal parathyroidectomy), leaving the remaining half gland in place with an intact vascular pedicle. Alternatively, a total parathyroidectomy may be performed, and one-half of one gland may be minced and reimplanted into shallow pockets created in the sternocleidomastoid or brachioradialis muscles.

A rare cause of submandibular swelling in a 12-year-old child: Pleomorphic adenoma

January 21, 2014     Puneet S. Braich, MD, MPH; Shohan Shetty, MD; Archana Lingampally, MBBS; Michael S. Ajemian, MD, FACS; Mahesh H. Bhaya, MBBS, FACS


Pleomorphic adenoma is rare in pediatric populations, where viral and congenital problems are the usual culprits responsible for submandibular masses. We report the case of a 12-year-old child who presented with a painless right submandibular mass that had developed over the course of 4 months. The patient denied fever, erythema, and edema. The mass was diagnosed as a branchial cleft cyst before complete excision was performed. The pattern and etiology of a pleomorphic adenoma in children differs from those in adults. In children, it requires prompt and correct diagnosis to keep morbidity and mortality at a minimum.

Massive calcification in a pleomorphic adenoma: Report of an unusual presentation

January 24, 2013     Luiz O.M. Coelho, MD; Sergio E. Ono, MD; Arnolfo de Carvalho Neto, PhD; Christiane S. Kawasaki, MD; Luciano V. Sabóia, MD; Maria F. Soares, MD


We report a case of histology-proven pleomorphic adenoma of the parapharyngeal space in a 20-year-old man. This case was unusual in that a massive amount of dystrophic calcification was scattered throughout the tumor. The patient underwent successful surgical resection, and he exhibited no signs of recurrence during follow-up. Literature about such an unusual presentation is scarce.

Huge middle ear adenoma with delayed facial nerve paralysis

June 4, 2012     Seung Ho Lee, MD; Hoseok Choi, MD, PhD; Young Chae Chu, MD; Young Hyo Kim, MD; Kyu-Sung Kim, MD, PhD


Middle ear adenoma is a rare disease that arises from the mucosa of the middle ear. Only a few cases of associated facial nerve paralysis have been reported. Facial nerve involvement is most likely related to nerve compression rather than tumor invasion of the nerve. We describe a case of a huge middle ear adenoma in a 63-year-old man. He presented with a 1-month history of right-sided otalgia, otorrhea, and facial palsy; he also had a 10-year history of right-sided hearing loss. A tympanomastoidectomy was performed. Intraoperatively, the tumor was found to fill the middle ear cavity as well as the entire diameter of the external auditory canal. The tumor had eroded the wall of the facial canal at the second genu, and it was tightly adherent to the epineurium. Focal inflammation around the tumor was observed at the exposed facial nerve. The tumor was removed and the facial nerve was decompressed. Immediately after surgery, the patient’s aural symptoms resolved. The final pathology evaluation established the diagnosis of a middle ear adenoma. At the 3-year follow-up, the ear cavity was completely healed and facial nerve function was improved.

Hyalinizing trabecular adenoma of the thyroid gland

September 20, 2011     Lester D.R. Thompson, MD
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