Pituitary gland

2018 ◽  
pp. 60-121
Author(s):  
Helen E. Turner ◽  
Richard Eastell ◽  
Ashley Grossman
Keyword(s):  
Growth Hormone ◽  
Clinical Practice ◽  
Genetic Testing ◽  
Pituitary Gland ◽  
Pituitary Adenomas ◽  
Adrenocorticotropic Hormone ◽  
Sella Turcica ◽  
Thyroid Stimulating Hormone ◽  
Imaging Methods ◽  
The Brain

This chapter describes the pituitary gland, associated disorders, and clinical practice. The pituitary gland or hypophysis is a bean shaped, bilaterally symmetrical reddish-brown organ, located in the sella turcica at the base of the brain under the hypothalamus. The chapter discusses genetic testing for pituitary adenomas, as well as imaging methods, indications for treatment and management. It presents disorders such as prolactinoma, acromegaly, Cushing’s disease, pituitary tumours, pituitary carcinoma, and parasellar pituitary conditions, describing their causes, common symptoms, and clinical treatments. It also describes the general, anatomical pathway for pituitary-related disorders from growth hormone (commonly abbreviated as GH), to gonadotrophins, to adrenocorticotropic hormone (commonly abbreviated as ACTH), and finally to thyroid-stimulating hormone (commonly abbreviated as TSH).

FAMILIAL PITUITARY DWARFISM ASSOCIATED WITH AN ABNORMAL SELLA TURCICA

PEDIATRICS ◽  
1969 ◽  
Vol 43 (5) ◽  
pp. 858-865
Author(s):  
Pierre E. Ferrier ◽  
E. Franklin Stone
Keyword(s):  
Growth Hormone ◽  
Adrenocorticotropic Hormone ◽  
Sella Turcica ◽  
Growth Failure ◽  
Thyroid Stimulating Hormone ◽  
Sphenoid Bone ◽  
Pituitary Dwarfism ◽  
Abnormal Morphology ◽  
Normal Stature ◽  
Severe Growth

Two non-twin sisters issued from healthy non-consanguineous parents of normal stature demonstrated severe growth failure, hypoglycemia, and evidence of deficiency of growth hormone, thyroid stimulating hormone (TSH), and adrenocorticotropic hormone (ACTH); in addition, they both had a very small sella turcica located in a sphenoid bone of abnormal morphology. This form of familial pituitary dwarfism is different from the genetic forms previously described.

Diseases of the Pituitary Gland

2018 ◽  
pp. 373-394
Author(s):  
Vânia Nosé ◽  
Sandro Santagata ◽  
Edward R. Laws
Keyword(s):  
Cell Differentiation ◽  
Infectious Diseases ◽  
Pituitary Gland ◽  
Pituitary Adenomas ◽  
Sella Turcica ◽  
Vascular Lesions ◽  
Malignant Neoplasms ◽  
Systemic Diseases ◽  
Pathological Findings ◽  
Hormone Production

Diseases of the pituitary gland are common, and the most frequently encountered lesions within the sella turcica and pituitary are described and illustrated in details in this chapter. The lesions present within this chapter include cysts and malformations, vascular lesions, inflammatory disorders, infectious diseases, systemic diseases, and both benign and malignant neoplasms. The most common neoplasms of the pituitary are the pituitary adenomas, and these are described in detail including the numerous subtypes depending on the cell differentiation and hormone production. The chapter contains numerous tables and figures illustrating the pathological findings.

Transnasal Endoscopic Approach to the Sella Turcica

1998 ◽  
Vol 12 (4) ◽  
pp. 283-288 ◽  
Author(s):  
Michelle R. Aust ◽  
Thomas V. McCaffrey ◽  
John Atkinson
Keyword(s):  
Pituitary Gland ◽  
Pituitary Adenomas ◽  
Sphenoid Sinus ◽  
Sella Turcica ◽  
Cerebrospinal Fluid Leak ◽  
Pituitary Surgery ◽  
Endoscopic Approach ◽  
Transseptal Approach ◽  
Transnasal Endoscopic Approach ◽  
Posterior Septum

The transseptal/transsphenoidal approach to the pituitary gland has been the most commonly used approach for resection of pituitary adenomas for the last 50 years. This procedure has a low morbidity and provides direct midline access to the sella and pituitary gland. Recent advancements in endoscopic surgery, however, suggest that a lower morbidity approach to the sella would be possible via transnasal endoscopic route. Prior reports have confirmed effectiveness of this approach to the pituitary gland and we report here an early series of endoscopic transnasal pituitary surgery from our institution. We report seven cases of transnasal endoscopic pituitary surgery. Our technique consists of endoscopic exposure of the sphenoid ostium unilaterally, excision of the posterior septum anterior to the rostrum of the sphenoid sinus with resection of the sphenoid rostrum for bilateral exposure of the sphenoid sinus. A specially designed nasal speculum is positioned to displace the posterior septum and lateralize the middle turbinates, permitting direct midline exposure of the sphenoid sinus and sella. We have progressively modified the technique over the seven cases that we present and will discuss our specific instrumentation, indications, and technique for this procedure. We have encountered one cerebrospinal fluid leak in this series. Patient satisfaction has been high and hospitalization is less than with the conventional transseptal approach, averaging 1 day. Our impression is that the transnasal endoscopic approach to pituitary adenomas is a safe technique with reduced morbidity permitting shortened hospital stay.

scholarly journals Sellar Masses: An Epidemiological Study

2015 ◽  
Vol 43 (2) ◽  
pp. 291-297 ◽  
Author(s):  
Khaled Al-Dahmani ◽  
Syed Mohammad ◽  
Fatima Imran ◽  
Chris Theriault ◽  
Steve Doucette ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenomas ◽  
Adrenocorticotropic Hormone ◽  
Vision Loss ◽  
Population Based ◽  
Population Based Study ◽  
History Of ◽  
Relative Prevalence ◽  
Secondary Hypogonadism ◽  
Growth Hormone Secreting Adenomas

AbstractBackground: Sellar masses (SM) are mostly benign growths of pituitary or nonpituitary origin that are increasingly encountered in clinical practice. To date, no comprehensive population-based study has reported the epidemiology of SM from North America. Aim: To determine the epidemiology of SM in the province of Nova Scotia, Canada. Methods: Data from all pituitary-related referrals within the province were prospectively collected in interlinked computerized registries starting in November 2005. We conducted a retrospective analysis on all patients with SM seen within the province between November 2005 and December 2013. Results: A total of 1107 patients were identified, of which 1005 were alive and residing within the province. The mean age at presentation was 44.6±18 years, with an overall female preponderance (62%) and a population prevalence rate of 0.1%. Of patients with SM, 837 (83%) had pituitary adenomas and 168 (17%) had nonpituitary lesions. The relative prevalence and standardized incidence ratio, respectively, of various SM were: nonfunctioning adenomas (38.4%; 2.34), prolactinomas (34.3%; 2.22), Rathke’s cyst (6.5%; 0.5), growth hormone–secreting adenomas (6.5%; 0.3), craniopharyngiomas (4.5%; 0.2), adrenocorticotropic hormone–secreting adenomas (3.8%; 0.2), meningiomas (1.9%), and others (3.9%; 0.21). At presentation, 526 (52.3%) had masses ≥1 cm, 318 (31.6%) at <1 cm, and 11 (1.1%) had functioning pituitary adenomas without discernible tumor, whereas tumor size data were unavailable in 150 (14.9%) patients. The specific pathologies and their most common presenting features were: nonfunctioning adenoma (incidental, headaches, and vision loss), prolactinomas (galactorrhea, menstrual irregularity, and headache), growth hormone–secreting adenomas (enlarging extremities and sweating), adrenocorticotropic hormone-secreting adenoma (easy bruising, muscle wasting, and weight gain) and nonpituitary lesions (incidental, headaches, and vision problems). Secondary hormonal deficiencies were common, ranging from 19.6% to 65.7%; secondary hypogonadism, hypothyroidism, and growth hormone deficiencies constituted the majority of these abnormalities. Conclusions: This is the largest North American study to date to assess the epidemiology of SM in a large stable population. Given their significant prevalence in the general population, more studies are needed to evaluate the natural history of these masses and to help allocate appropriate resources for their management.

The influence of the pituitary gland on the functions and development of the organism

1927 ◽  
Vol 23 (2) ◽  
pp. 239-243
Author(s):  
A. A. Sukhov
Keyword(s):  
Pituitary Gland ◽  
Dura Mater ◽  
Animal Species ◽  
Third Ventricle ◽  
Sella Turcica ◽  
Posterior Lobe ◽  
Posterior Pituitary ◽  
The Third ◽  
The Brain ◽  
Posterior Pituitary Lobe

The pituitary gland or gl. pituitaria is an organ lying at the base of the brain in a cavity formed by the sella turcica at the front, back, and bottom, and by the sinus venosus cavernosus dex. et sin. This entire cavity is lined by the dura mater, which covers it from above in the form of diaphragma sellae turcicae. Through its opening passes the infundibulum, which connects the pituitary gland in its posterior lobe with the brain. The cavity infundibuli, which is a recess of the bottom of the third ventricle, in some animal species (e.g., in dogs) passes as recessus infundibuli into the cavity of the posterior pituitary lobe (in humans this lobe has no cavity).

Pituitary tumours

2019 ◽  
pp. 299-320
Author(s):  
Kanna Gnanalingham ◽  
Zsolt Zador ◽  
Tara Kearney ◽  
Federico Roncaroli ◽  
H. Rao Gattamaneni
Keyword(s):  
Pituitary Gland ◽  
Anterior Pituitary ◽  
Horizontal Plane ◽  
Third Ventricle ◽  
Sella Turcica ◽  
Thyroid Stimulating Hormone ◽  
Posterior Lobe ◽  
Recommended Treatment ◽  
Stimulating Hormone

The pituitary gland occupies the sella turcica, approximately 5 cm posterior to the tip of the nose in the midline of the skull base. It is closely related to the hypothalamus and third ventricle superiorly, chiasm and lamina terminalis anterosuperiorly, sphenoid sinus anteroinferiorly, cavernous sinus and cavernous segment of the carotid artery laterally, the posterior clinoids and clivus posteriorly. There are two distinct components to the pituitary gland, the anterior and posterior lobe, which are derived from the ectoderm and neuroectoderm, respectively. The anterior pituitary constitutes 80% of the gland mass and in the horizontal plane it is distributed into two lateral wings. The hormones produced by the anterior pituitary are adrenocorticotropic hormone, prolactin, growth hormone, thyroid-stimulating hormone, follicle-stimulating hormone, and luteinizing hormone. This chapter looks in detail at the role of the pituitary gland, what happens when it becomes tumorous, and the recommended treatment avenues.

[3H]Spiperone Binding to Human Anterior Pituitaries and Pituitary Adenomas Secreting Prolactin, Growth Hormone, and Adrenocorticotropic Hormone*

1980 ◽  
Vol 50 (2) ◽  
pp. 387-391 ◽  
Author(s):  
MICHAEL J. CRONIN ◽  
CECILIA Y. CHEUNG ◽  
CHARLES B. WILSON ◽  
ROBERT B. JAFFE ◽  
RICHARD I. WEINER
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenomas ◽  
Adrenocorticotropic Hormone

IL-18 expression in clinical human pituitary adenoma

2021 ◽  
pp. 1-6
Author(s):  
Qi Shao ◽  
Ning Liu ◽  
Guo-Fu Li ◽  
Qian-Cheng Meng ◽  
Jia-Hao Yao ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Mrna Expression ◽  
Pituitary Adenomas ◽  
Adrenocorticotropic Hormone ◽  
Pituitary Tumors ◽  
Thyroid Stimulating Hormone ◽  
Mrna Levels ◽  
Human Pituitary ◽  
Human Pituitary Adenoma ◽  
Real Time Quantitative Pcr

BACKGROUND: IL-18 is known as an interferon-inducing factor that belongs to the IL-1 family, and is synthesized as an inactive precursor protein. OBJECTIVE: The present study aims to investigate the expression of IL-18, IL-18R, R and IL-18 binding protein (BP) mRNA in various types of human pituitary tumors, such as adrenocorticotropic hormone (ACTH), growth hormone (GH), prolactin (PRL), thyroid stimulating hormone (TSH)-producing adenomas and non-function adenomas. METHODS: Pituitary adenoma tissues were obtained during the surgery of 41 patients: nine patients had ACTH-producing pituitary adenomas, nine patients had GH-producing pituitary adenomas, five patients had TSH-producing pituitary adenomas, seven patients had PRL-producing pituitary adenomas, and 11 patients had non-functioning adenomas. The mRNA expression levels of IL-18, IL-18BP, IL-18R and IL-18R were quantified using real-time quantitative PCR. RESULTS: The mRNA expression of IL-18 was significantly higher in ACTH-, GH- and PRL-producing adenomas, when compared to non-function tumors. Similarly, a significantly higher mRNA expression of IL-18BP and IL-18R was observed in ACTH-, GH- and PRL-producing adenomas, when compared with non-functional adenomas. In contrast, no upregulation of IL-18R mRNA was observed in any of the pituitary adenomas. CONCLUSIONS: The mRNA levels of IL-18, IL-18BP and IL-18R are significantly elevated in clinical pituitary tumors, such as ACTH-, GH- and PRL-producing adenomas, when compared to non-functional adenomas. These present results suggest the possibility that IL-18 may be involved in the pathogenesis of pituitary adenoma.

Gamma Knife Radiosurgery for Pituitary Adenoma: Early Results

Neurosurgery ◽  
2003 ◽  
Vol 53 (1) ◽  
pp. 51-61 ◽  
Author(s):  
Zbigniew Petrovich ◽  
Cheng Yu ◽  
Steven L. Giannotta ◽  
Chi-Shing Zee ◽  
Michael L.J. Apuzzo
Keyword(s):  
Growth Hormone ◽  
Radiation Dose ◽  
Gamma Knife ◽  
Pituitary Adenomas ◽  
Cranial Nerve ◽  
Adrenocorticotropic Hormone ◽  
Tumor Volume ◽  
Gamma Knife Radiosurgery ◽  
Late Toxicity

Abstract OBJECTIVE In recent years, gamma knife radiosurgery (GKRS) has emerged as an important treatment modality in the management of pituitary adenomas. Treatment results after performing GKRS and the complications of this procedure are reviewed. METHODS Between 1994 and 2002, a total of 78 patients with pituitary adenomas underwent a total of 84 GKRS procedures in our medical center. This patient group comprised 46 men (59%) and 32 women (41%). All patients were treated for recurrent or residual disease after surgery or radiotherapy, with 83% presenting with extensive tumor involvement. The cavernous sinus was involved in 75 patients (96%), and 22 patients (28%) had hormone-secreting adenomas. This latter subset of patients included 12 prolactinomas (15%), 6 growth-hormone secreting tumors (8%), and 4 adrenocorticotropic hormone-secreting tumors (5%). The median tumor volume was 2.3 cm3, and the median radiation dose was 15 Gy defined to the 50% isodose line. The mean and median follow-up periods were 41 and 36 months, respectively. RESULTS GKRS was tolerated well in these patients; acute toxicity was uncommon and of no clinical significance. Late toxicity was noted in three patients (4%) and consisted of VIth cranial nerve palsy. In two patients, there was spontaneous resolution of this palsy, and in one patient, it persisted for the entire 3-year duration of follow-up. Of the 15 patients who presented with cranial nerve dysfunction, 8 (53%) experienced complete recovery and 3 (20%) showed major improvement within 12 months of therapy. Tumor volume reduction was slow, with 30% of patients showing decreased tumor volume more than 3 years after undergoing GKRS. None of the 56 patients with nonfunctioning tumors showed progression in the treated volume, and 4 (18%) of the 22 hormone-secreting tumors relapsed (P = 0.008). Of the four patients with adrenocorticotropic hormone-secreting adenomas, therapy failed in two of them. All six patients with growth hormone-producing tumors responded well to therapy. Of the 12 patients with prolactinomas 10 (83%) had normalization of hormone level and 2 patients experienced increasing prolactin level. Two patients with prolactinomas had three normal pregnancies after undergoing GKRS. CONCLUSION GKRS is a safe and effective therapy in selected patients with pituitary adenomas. None of the patients in our study experienced injury to the optic apparatus. A radiation dose higher than 15 Gy is probably needed to improve control of hormone-secreting adenomas. Longer follow-up is required for a more complete assessment of late toxicity and treatment efficacy.

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