Measuring pituitary tumor volume: a comparison of the simplified and non-simplified ellipsoid equation with the 3D planimetric volume assessment

PURPOSE

The ellipsoid equation came in an attempt to facilitate the estimation of tumor volume, by measuring the height, width, and anteroposterior length of the lesion. The estimated tumor volume can sometimes be different between methods, thus, it is of extreme interest to evaluate if the methods are significantly different, as well as to discuss the main limitations of each one.

METHODS

This is an observational, analytical, cross-sectional study. A systematic review of the literature was also performed in order to discuss the results observed in the present study.

RESULTS

A total of 82 patients (43 males and 39 females) ranging in age from 15 to 78 years (mean 47.95 ± 14.76) were included in the study. Seven patients were classified as Knosp grade 0 (8.5%), 36 Knosp grade 1 (44%), 14 Knosp grade 2 (17%), 20 Knosp grade 3 (24.4%), 5 Knosp grade 4 (6.1%). The tumor volume estimated by 3D planimetric assessment, non-simplified ellipsoid equation, and simplified ellipsoid formula averaged 10.68 cm³, 10.36 cm³, and 9.9 cm³ respectively.

CONCLUSION

A simplified form of the ellipsoid equation increases the divergence between the measurement obtained in planimetry, and should be discouraged, in view of the new automated methods of performing quick calculations using periodic digits. The non-simplified form underestimated the tumor volume by 2.9% on average but did so regularly. In clinical practice, measurement should be accompanied by an evaluation of tumor morphology.

Sudden Death In Adults Caused By Intracranial Pathology: A Systematic Review

OBJECTIVE

The study aimed to review the literature and was designed with the objective of elucidating the intracranial pathologies that cause sudden deaths in adults.

METHODS

The systematic review was carried out in concordance with the PRISMA checklist.

RESULTS

Epilepsy and intracranial hemorrhage have been found to be the two main causes of sudden and unexplained deaths in adults due to intracranial pathologies. Intracranial neoplasms are not among the two main causes of SD, as they are usually discovered before fatality, so their rate of SD is not so extensive. It is noticed that the highest incidence of this type of death is also related to the abusive use of alcohol and other drugs, such as cocaine, heroin and nicotine. There is a possibility that the actual incidence of SD in adults due to intracranial pathologies is even greater, since there is a lack of reliability in autopsies and the fact that most SD in adults are not witnessed.

CONCLUSION

The most recurrent etiologies of SD in adults are epilepsy, intracranial hemorrhage, meningitis or purulent abscess and tumors. Thus, it represents real challenge for neurosurgeons, since their understanding, accurate diagnosis and adequate treatment of these pathologies, in addition to healthy lifestyle habits by people can reduce the possibility of SD.