Mario G. Siqueira

Subclinical pituitary microadenomas

To analyze the incidence as well as the natural history of asymptomatic pituitary microadenomas, 450 pituitary glands obtained during routine autopsies were studied. The series consisted of patients of both sexes, without any evidence of pituitary dysfunction, in a broad age range. Thirty-nine tumors were found in 36 pituitary glands, with a peak incidence in the seventh decade of life and an evident predominance in male patients. The medical records and available x-ray films of the skull of these patients with subclinical microadenomas were reviewed for clinical evidence of endocrinopathy and to detect minor radiologic abnormalities of the sella turcica. No significant differences were found in comparing the histologic aspect of these tumors with symptomatic cases. The possibility of these tumors as a preclinical stage of pituitary adenoma or a separate entity is discussed.

Diagnosis and Management of Peripheral Nerve Schwannomas

Peripheral neural sheath tumors are rare. The most common type is the schwannoma, also known as neurilemoma, neurinoma, and perineural fibroblastoma. Schwannomas usually are solitary lesions, are not associated with von Recklinghausen disease (neurofibromatosis type 1), and, as a rule, do not become malignant. These tumors usually are seen in adults and have no gender predilection. This article reviews the clinical diagnosis, diagnostic studies, pathologic aspects, differential diagnosis, operative technique, and surgical results of peripheral nerve schwannomas of the extremities.