Medicine
/
Pituitary

Pituitary

PituitaryTumours

 

Pathology:                    Monoclonal tumours with tumour activity depending on cell type

                                          Corticotrophs-Cushing’s Disease

Comatotrophs-Increased Growth hormone secretion

Thyrotrophs-Increased TSH Secretion

Gonadotrophs-Increased FSH/LH secretion.

 

Aetiology:                     Mutations in oncogenes: Gsα (~40% of GH-secreting tumours) and

Ras (aggressive tumours)

                                          Multiple Endocrine Neoplasia: Type 1

 

Symptoms:                   Headache(typically worse on waking), fatigue, myalgia, double vision, nasal congestion

 

Signs:                              Bi-temporalhemianopia, CSF rhinorrhoea, signs of raised ICP, cranial nerve palsy of nervesIII, IV and VI within the cavernous sinus.

.

Investigations:         Bloods: Pituitaryprofile. Likely to need Dynamic EndocrineTesting.

                                        Special tests: Humphrey’s fieldtest

                                        Imaging: MRI pituitary

 

Treatment:                  Medical: Hormone replacement as required and radiotherapy issurgery not

possible

Surgical: Trans-sphenoidalsurgery

 

Complications:          Apoplexy (bleed into pre-existingtumour), hypopituitarism

 

Prognosis:                    Good where tumour fully resectedand no hormone pathology.

 

 

 

 

 

 

 

Join Shiken For FREE

Gumbo Study Buddy

Explore More Subject Explanations

Try Shiken Premium
for Free

14-day free trial. Cancel anytime.
Get Started
The first 14 days are on us
96% of learners report x2 faster learning
Free hands-on onboarding & support
Cancel Anytime