This is a content made by the students of Pharmacy dept of Comilla University about the Endocrine system, In this you can easily find the glands in out body and their functions. and specific organs which secrete specific hormones for our body. figures are added to make it more convenient. thank you all.

1. Welcome to Our Presentation
1

2.  Endocrine System
2

3. Group -1
Group members Student id
1.Ishrat jahan jui 11915026
2.Sayed bin mamun 11915030
3.Gazi mehedi hasan rakib 11915034
4.Ramim mia 11915036
5. Reza at tanzil 11915037
3

4. Content
Introduction
Pituitary glands
Thyroid glands
Parathyroid glands
Adrenal cortex
Adrenal medulla
Islets of Langerhans
4

5.  Introduction
5

6.  Endocrine System
• The endocrine system is a chemical messenger system
comprising feedback loops of hormones released by
internal glands of an organism directly into the circulatory
system, regulating distant target organs.
• In humans, the major endocrine glands are the thyroid
gland and the adrenal glands.
• In vertebrates, the hypothalamus is the neural control
centre for all endocrine systems. The study of the endocrine
system and its disorders is known as endocrinology. 6

7. 7

8. Pituitary gland
8

9. The master gland :
• The pituitary gland is called the “master gland”
because its hormones regulate other important
endocrine glands—including the adrenal, thyroid, and
reproductive glands (e.g., ovaries and testes)—and in
some cases have direct regulatory effects in major
tissues, such as those of the musculoskeletal system.
9

10. 10

11.  Anatomy
Location
• Lies at the base of brain Sella turcica.
• Connected with the hypothalamus by the pituitary
stalk or hypophyseal stalk.
Division
• Anterior lobe ( adenohypophysis)
• Intermediate lobe ( not present or very small in
humans dispersed within anterior lobe)
• Posterior lobe ( neurohypophysis)
11

12.  Lobes of pituitary gland
• Anterior pituitary ( adenohypophysis)
Consists of three divisions
1. Pars distalis
2. Pars tuberalis
3. Pars intermedia
• Posterior pituitary
Consist of two parts
1.Infundibular stalks
2.Pars nervosa
12

13. 13

14. Pituitary hormone secretion
14

15.  Hormones secreted by anterior
pituitary
Hormone Target organ Principal effect
FSH - Follicle stimulating hormone Ovaries, testes  Female : Growth of ovarian follicles and
secretion of estrogen hormone.
 Male : Sperm production.
LH - Luteinizing hormone Ovaries, testes  Female : Ovulation , maintenance of corpus
luteum .
 Male : Testosterone secretion.
TSH - Thyroid stimulating hormone Thyroid gland Growth of thyroid, secretion of hormone
ACTH - Adrenocorticotropic hormone Adrenal cortex Secretion of glucocorticoids, growth of
adrenal cortex.
Prolactin Mammary glands, testes  Female : Milk synthesis.
 Male : Increased LH sensitivity and
testosterone secretion.
GH - Growth hormone Liver Somatostatin secretion and widespread
growth of tissues.
15

16.  Secretory hormones of posterior
pituitary
Hormones Target organ Principal effects
ADH - Antidiuretic hormone Kidneys Water retention
OT - Oxytocin Uterus, mammary glands Female : labor contractions, milk release.
Male : possibly involved in ejaculation, sperm
transport and sexual affection.
16

17.  Pituitary gland disorders
Causes of disorders of pituitary gland
• Hyperactivity
• Hypoactivity
Hyperpituitarism
• Hyperfunctioning of anterior pituitary gland -
Gigantism and acromegaly
• Hyperfunctioning of posterior pituitary gland -
Inappropriate release of ADH
17

18.  Hypopituitarism
• Hypofunctioning of anterior pituitary
Dwarfism.
• Hypofunctioning of posterior pituitary
Diabetes insipidus
18

19.  Gigantism
Characterized signs and symptoms :
• Excess Growth of body
• Average height is approximately 7-8 feet
• Headache due to tumor of pituitary
• Hyperglycemia, visual disturbance and pituitary diabetes
mellitus.
• Cure : Gigantism can be cured by hypopituitarism ( burning
cells of anterior pituitary)
19

20. 20

21.  Acromegaly
Characterized symptom & causes
• Enlargement, thickening and broadening of bones.
• Particularly extremities of the body.
• Hypersecretion of growth hormone, thyroid,
parathyroid hormone.
• Hypertension, headache and visual disturbance are
seen.
• Cure : as like as gigantism.
21

22.  Dwarfism
Deficiency of
growth hormone
in children before
growth is
completed
resulting retarded
growth.
• Short stature.
22

23. Thyroid gland
23

24. The thyroid gland is a butterfly-shaped gland located at the
base of the base of the neck and wrapped around the lateral
sides of the trachea.
The thyroid gland produces 3 major hormones:
• Calcitonin: Reduce the concentration of calcium ions in the
blood by aiding the absorption of calcium into the matrix of
bones.
• Triiodothyronine (T3)
• Thyroxine (T4)
The hormones T3 and T4 work together to regulate the body’s
metabolic rate. Increased levels of T3 and T4 lead to increased
cellular activity and energy usage in the body.
24

25. 25

26.  Thyroid Hormone Synthesis
There are six steps in the synthesis of thyroid hormone-
• Active transport of Iodide into the follicular cell via
Sodium-Iodide Symporter (NIS). This is actually secondary
active transport, and the sodium gradient driving it is
maintained by a Sodium-Potassium ATPase.
• Thyroglobulin (Tg), a large protein rich in Tyrosine, is
formed in follicular ribosomes and placed into secretory
vesicles.
• Exocytosis of Thyroglobulin into follicle lumen, where it is
stored as colloid. Thyroglobulin is the scaffold upon which
thyroid hormone is synthesised.
26

27. • Iodination of the Thyroglobulin. Iodide is made reactive by
the enzyme thyroid peroxidase. Iodide binds to the benzene
ring on Tyrosine residues of Thyroglobulin. First formed is
monoiodotyrosine (MIT) then diiodotyrosine (DIT).
• Coupling of MIT and DIT to give Triiodothyronine (T3)
hormone and coupling of DIT and DIT to give
Tetraiodothyronine (T4) hormone, also known as
Thyroxine.
• Endocytosis of iodinated thyroglobulin back into the
follicular cell. Thyroglobulin undergoes proteolysis in
lysosomes to cleave the iodinated tyrosine residues from the
larger protein. Free T3 or T4 is then released, and the
Thyroglobulin scaffold is recycled.
27

28.  Secretion of thyroid hormone-
• Thyroid hormones are released as part of a hypothalamic-
pituitary-thyroid axis. The Hypothalamus detects a low
plasma concentration of thyroid hormone and releases
Thyrotropin-Releasing Hormone (TRH) into the
hypophyseal portal system.
• TRH binds to receptors found on thyrotrophic cells of the
anterior pituitary gland, causing them to release Thyroid
Stimulating Hormone (TSH) into the systemic circulation.
TSH binds to TSH receptors on the basolateral membrane of
thyroid follicular cells and induces the synthesis and release
of thyroid hormone.
28

29.  Function
The thyroid gland is one of the main regulators of metabolism.
T3 and T4 typically act via nuclear receptors in target tissues
and initiate a variety of metabolic pathways. High levels of
them typically cause these processes to occur faster or more
frequently.
Metabolic processes increased by thyroid hormones include:
• Basal Metabolic Rate
• Gluconeogenesis
• Glycogenolysis
• Protein synthesis
• Lipogenesis
• Thermogenesis
29

30.  Thyroid Conditions-
• Goiter: A general term for thyroid swelling. Goiters can be
harmless, or can represent iodine deficiency or a condition
associated with thyroid inflammation called Hashimoto’s
thyroiditis.
• Thyroiditis: Inflammation of the thyroid, usually from a
viral infection or autoimmune condition. Thyroiditis can be
painful, or have no symptoms at all.
• Hyperthyroidism: Excessive thyroid hormone production.
Hyperthyroidism is most often caused by Graves disease or
an overactive thyroid nodule.
• Hypothyroidism: Low production of thyroid hormone.
Thyroid damage caused by autoimmune disease is the most
common cause of hypothyroidism . 30

31. • Graves disease: An autoimmune condition in which the
thyroid is overstimulated, causing hyperthyroidism.
• Thyroid cancer: An uncommon form of cancer, thyroid
cancer is usually curable. Surgery, radiation, and hormone
treatments may be used to treat thyroid cancer.
• Thyroid nodule: A small abnormal mass or lump in the
thyroid gland. Thyroid nodules are extremely common. Few
are cancerous. They may secrete excess hormones, causing
hyperthyroidism, or cause no problems.
• Thyroid storm: A rare form of hyperthyroidism in which
extremely high thyroid hormone levels cause severe illness
31

32.  Thyroid function tests-
• Thyroid function tests are a series of blood tests
used to measure how well your thyroid gland is
working. Available tests include the T3, T3RU, T4,
and TSH.
32

33.  T4 & TSH results-
• The T4 test and the TSH test are the two most common
thyroid function tests. They’re usually ordered together.
• The T4 test is known as the thyroxine test. A high level of
T4 indicates an overactive thyroid (hyperthyroidism).
Symptoms include anxiety, unplanned weight loss, tremors,
and diarrhea. Most of the T4 in your body is bound to
protein. A small portion of T4 is not and this is called free
T4. Free T4 is the form that is readily available for your
body to use. Sometimes a free T4 level is also checked
along with the T4 test.
• The TSH test measures the level of thyroid-stimulating
hormone in your blood. The TSH has a normal test range
between 0.4 and 4.0 milli-international units of hormone per
liter of blood (mIU/L). 33

34.  T3 result-
• The T3 test checks for levels of the hormone
triiodothyronine. It’s usually ordered if T4 tests and TSH
tests suggest hyperthyroidism. The T3 test may also be
ordered if you’re showing signs of an overactive thyroid
gland and your T4 and TSH aren’t elevated.
• The normal range for the T3 is 100–200 nanograms of
hormone per deciliter of blood (ng/dL). Abnormally high
levels most commonly indicate a condition called Grave’s
disease. This is an autoimmune disorder associated with
hyperthyroidism.
34

35.  Parathyroid Gland
35

36.  Structure
• 4 tiny parathyroid glands, in the neck, on the posterior
surface
of the thyroid gland. Have 2 superiorly & 2 inferiorly.
• Small in size, measuring about 6 mm long,
3 mm wide and 2 mm thick with dark brown color
36

37. 37

38.  Histology
• Made up of chief cells & oxyphil cells
Chief cells
• Secrete parathormone
Oxyphil cells
• Degenerated chief cells and their function is
unknown.
• May secrete parathormone during physiological
condition called parathyroid adenoma.
38

39.  Parathormone
• Secreted by the chief cells of the parathyroid glands.
• Essential for the maintenance of blood calcium
level within a very narrow critical level.
• Maintenance of blood calcium level is necessary
because calcium is an inorganic ion for many
physiological functions.
39

40. Chemistry
• Parathormone is protein in nature, having 84 amino acids.
• It’s Molecular weight in 9,500.
Half life & Plasma level
• Parathormone has a half-life of 10 minutes.
• Normal plasma level of PTH is about 1.5-5.5 mg/dL.
40

41.  Actions of PTH on Blood Calcium Level
• Primary action of the PTH is to maintain the blood calcium
level within the critical range of 9-11 mg/dL
• PTH control blood calcium level by
1. Reabsorption of Ca from Bones
2. Reabsorption of Ca from renal tubules (Kidney)
3. Absorption of Ca from Gastrointestinal tract
41

42. On bones
• PTH enhances the reabsorption of Ca from the bones by
acting on osteoblasts and osteoclasts of the bone.
• Increases the number and activity of osteoclasts (bone
destroying cells).
• Increases collagen synthesis.
• Increases alkaline phosphatase activity.
• Increases local growth factors: IGF and transforming
factors.
42

43. On Kidney
• PTH increases the reabsorption of Ca from the renal tubules
along with magnesium ions and hydrogen ions Increases
Ca reabsorption mainly from distal convoluted tubule
and proximal part of collecting duct.
• PTH also increases the formation of 1, 25-di-
hydroxycholecalciferol (activated form of vitamin D) from
25-hydroxycholecalciferol in kidneys.
• Decreased phosphate, sodium and bicarbonate reabsorption
from the proximal tubule.
43

44. On Gastrointestinal Tract
• PTH increases the absorption of Ca ions from the GI tract
indirectly.
• The activated vitamin D is very essential for the absorption
of Ca from the GI tract.
• PTH also increase the absorption of PO4 & mg.
44

45.  Disorders of
Parathyroid Gland
45

46.  Tetany
Manifested by neuromuscular excitability due to plasma
ionized Ca2+
Causes:
a)Hypoparathyroidism
b)Alkalemia :Decrease the solubility product of Ca2+& PO4
and leads to reduced ionized Ca2+ & precipitation of CaPO4
c)Decreased Ca2+ absorption from the intestine:
1.Low calcium intake and Excess intake of antacids (peptic
ulcer) lead to Ca2+ precipitation and decreased absorption.
46

47.  Manifestation of Tetany
• These depend on the degree of red blood Ca2+ level:
1. Manifest tetany:
– Blood Ca2+ level is below 7 mg% (N 9-11 mg%).
– Muscular spasms in the hands and feet (Carpo-pedal
spasm).
2. Latent tetany:
– Blood Ca2+ level is at 7-9 mg%. 47

48.  Treatment of Tetany
1.IV injection of Ca2+ gluconate during spasm. Stops
immediately the tetanic spasms.
2. Calcium level is then maintained by giving vitamin D and
administration of oral calcium.
3.Acidifying salts as ammonium chloride help Ca2+ absorption
as they increase the ionization of Ca2+.
48

49.  Islets of Langerhans
of
Pancreas
49

50.  Pancreas
• A triangular gland, which has both exocrine and endocrine
cells, located behind the stomach
• Strategic location
• Acinar cells produce an enzyme-rich juice used for
digestion (exocrine product)
• Pancreatic islets (islets of Langerhans) produce hormones
involved in regulating fuel storage and use.
50

51. 51

52.  Islets of Langerhans
• 1 Million islets
• 1-2% of the pancreatic mass
• Beta (β) cells produce insulin
• Alpha (α) cells produce glucagon
• Delta (δ) cells produce somatostatin
• F cells produce pancreatic polypeptide
52

53. 53

54.  Insulin
• Hormone of nutrient abundance
• A protein hormone consisting of two amino acid chains
linked by disulfide bonds
• Synthesized as part of proinsulin (86 AA) and then excised
by enzymes, releasing functional insulin (51 AA) and C
peptide (29 AA).
54

55.  Insulin Structure
1- Large polypeptide 51 AA (MW 6000)
2- Tow chains linked by disulfide bonds.
A chain (21 AA)
B chain (30 AA)
3- Disulfide bonds.
55

56. 56

57.  Insulin Action on Cells
• Insulin is the hormone of abundance.
• The major targets for insulin are:
– liver
– Skeletal muscle
– adipose tissue
• The net result is fuel storage
57

58.  Insulin Action on Carbohydrate
Metabolism
Liver:
• Stimulates glucose oxidation
• Promotes glucose storage as glycogen
• Inhibits glycogenolysis
• Inhibits gluconeogenesis
Muscle:
• Stimulates glucose uptake (GLUT4)
• Promotes glucose storage as glycogen
58

59.  Glucagon
• A 29-amino-acid polypeptide hormone that is a potent
hyperglycemic agent
• Produced by α cells in the pancreas
• Its major target is the liver, where it promotes:
– Glycogenolysis – the breakdown of glycogen to
glucose
– Gluconeogenesis – synthesis of glucose from lactic
acid and noncarbohydrates
– Release of glucose to the blood from liver cells
59

60.  Physiological Action of Glucagon
• Stimulates glycogenolysis, gluconeogenesis &
inhabits glycogenesis
• Promotes lipolysis & ketogenesis
• Increases calorigenesis
60

61.  Somatostatin
• Secreted from D cells of pancreas
• Also secreted from hypothalamus & GIT
• A peptide hormones with 2 forms, one with
14 AAs & the other with 28 Aas
Functions
➤ Inhibits secretion of insulin & glucagon
➤ Inhibits GI motility & GI secretions
➤ Regulates feedback control of gastric emptying
61

62.  Diabetes Mellitus (DM)
• A serious disorder of carbohydrate metabolism
• Results from hyposecretion or hypoactivity of insulin
• The three cardinal signs of DM are:
– Polyuria – huge urine output
– Polydipsia – excessive thirst
– Polyphagia – excessive hunger and food consumption
62

63.  Diabetes Mellitus Type l
Type 1: beta cells destroyed- no insulin produced chronic
fasted state, "melting flesh", ketosis, acidosis,
glucosuria, diuresis & coma
Diabetes Mellitus Type ll
• Over 15 million diabetics in USA- 10% type I, 90% type II
• More common is some ethnic groups
• Insulin resistance keeps blood glucose too high
• Chronic complications: atherosclerosis, renal failure&
blindness
63

64.  Symptoms of Diabetes Mellitus
➤ Hyperglycemia
➤ Polyuria
➤ Polydipsia
➤ Polyphagia
➤ Ketoacidosis
➤ Hyperlipidemia
➤ Muscle wasting
➤ Electrolyte depletion
64

65.  Diagnosis
• Demonstrating persistence hyperglycemia & glycosuria
• Glucose Tolerance Test (GTT) – oral is preferred
• Estimation of Fasting Blood Glucose (FBG)
• FBS more than 126 mg% in more than
two occasions confirms DM
Treatment
• Insulin therapy
• Oral hypoglycemic agents
• Life style modifications
65

66. Adrenal Glands
66

67. 67

68. Our body has two adrenal (suprarenal) glands, each located
on the superior pole of each kidney. Each adrenal gland is
Structurally and functionally differentiated into two regions
or zones:
1.Adrenal Cortex
2. Adrenal medulla
68

69.  Adrenal Cortex
This is the outer or peripheral zone of the adrenal
gland, which makes up the bulk of the gland.
The adrenal cortex is divided into three zones. Each
zone has a different cellular arrangements and secrets
different groups of steroid hormones.
69

70.  Layers of Adrenal Cortex
1. Zona-glomerulosa
2. Zona-fasciculata
3. Zona-reticulata
Zona-glomerulosa:
• This is the outermost layer of the adrenal cortex
which secrets mineralocorticoid hormones.
• Immediately beneath the capsule.
• Columnar or pyramidal cells
• Arranged in closely packed, rounded, arched cords or
small clumps.
• Occupy 15% of the adrenal cortex. 70

71.  Zona-fasciculata
:
• This is the middle zone of the adrenal cortex which
secrets glucocorticoids hormone.
• Occupy 65% of the adrenal cortex.
• Polyhedral, often binucleated cells with lipid droplets in
their cytoplasm.
• Cells are also called spongyocytes due to vacuolization.
71

72.  Zona-reticularis
• This is the innermost layer of the adrenal cortex
which secrets androgen but in small quantities.
• Occupy 7% of the adrenal cortex.
• Smaller cells disposed in irregular cords forming
anastomosing network.
• Presence of lipofuscin pigment granules –large and
numerous.
72

73.  Hormones of the Adrenal cortex
The adrenocortical hormones and their functions in the body
are classified into three groups:
1. Mineralocorticoids
2. Glucocorticoids
3. Adrenal androgens.
Biosynthesis of adrenal hormones:
73

74. 74

75.  Mineralocorticoids
Mineralocorticoids:
– secreted from the adrenal cortex-zona glomerulosa.
– Main secreted hormone is aldosterone.
– It also secrets deoxy-corticosterone,9-alpha
flourocortisol, cortisol, cortisone.
Functions:
– Maintain balance of electrolytes content of the body
fluid.
– Increased tubular reabsorption of Na+ ions in the
exchange for K+ and H+ ions.
75

76.  Mineralocorticoids
– Act mainly on the distal kidney tubules, salivary glands
and sweat glands.
– Increase blood volume and cardiac output.
– Increase blood pressure.
Regulations of aldosterone secretion :
– Increased of K+ ions.
– Decreased of Na+ ions.
– Undefined pituitary factors.
– ACTH
– Hypotension
– Increased renin angiotensin 76

77.  Glucocorticoids
Secreted from adrenal cortex-zona fasciculata.
Main secreted hormones are:
• Cortisol
• Prednisone & methyl
prednisone
• Corticosterone
• Cortisone
77

78.  Functions
Effects in the metabolism of carbohydrates, proteins and
lipids.
• Stimulation of gluconeogenesis.
• Mobilization of amino acids from extra
hepatic tissues.
• Inhibition of glucose uptake in muscles
and adipose tissues.
• Stimulation of fat breakdown. .
78

79.  Functions
• Suppress immune response.
• Destroying circulating
lymphocytes.
• Inhibiting mitotic activity.
• Controlling secretion of
cytokines.
– Promotes maturation of lungs and production of
surfactants in fetal development
79

80.  Androgen
• Secreted from the adrenal cortex-zona reticularis.
• Exhibit actions similar to testosterone.
Functions :
• Responsible for the development and maintenance of
reproductive functions.
• Stimulation of secondary sex characteristic.
• Stimulates the production of skeletal muscles and bones
and RBC.
80

81. 81
• Regulations of androgen:
1. Controlled by luteinizing hormone (LH) and follicle
stimulating hormone(FHS).
2. Prolactin shows an inhibitory effects on androgen
secretion.
• Adrenal glands disorders :
1. Tumors including pheochromocytomas. Infections
2. Genetic mutations.
3. Cushing's syndrome.
4. Addison’s disease.
5. A problem in another gland, such as pituitary.
6. Hyperaldosteronism.

82.  Adrenal Medulla
• Structure
• Biosynthesis of hormones
• Functions and regulations
• Disorder of adrenal medulla
82

83. Introduction
• The adrenal medulla is part of the adrenal gland it is
located at the center of the gland. It is surrounded by
adrenal cortex. It is the innermost part of the adrenal gland
and it has such type of cells that secrete epinephrine also
known as adrenaline and norepinephrine which is known
as noradrenaline. It also secretes dopamine at a small
amount in response to stimulation by sympathetic
preganglionic neurons.
83

84. Structure of adrenal medulla
• The adrenal medulla consists of irregularly shaped cells
grouped around blood vessels. These cells are intimately
connected with the sympathetic division of the autonomic
nervous system(ANS).
• The cells of the adrenal medulla are derived from the neural
crest in contrast to the mesodermal origin of the adrenal
cortex. The secretory cells of the adrenal medulla are called
chromaffin cells because of the formation of colored
polymers of catecholamines after exposure to oxidizing
agents such as chromate.
• In fact these adrenal medullary cells are modified
postganglionic neurons and preganglionic autonomic nerve
fibers lead to them directly from the central nervous system.84

85. Structure of adrenal medulla
85

86. Functions of adrenal medulla
• Biosynthesis of hormones:
The adrenal medulla is the principal site of the conversion
of the amino acid tyrosine into the catecholamines
epinephrine, norepinephrine and dopamine.
• Stimulation of the sympathetic nerves to the adrenal
medullae causes large quantities of epinephrine and
norepinephrine to be released into the circulating blood,
and these two hormones in turn are carried in the blood to
all tissues of the body. On average, about 80 percent of the
secretion is epinephrine and 20 percent is
norepinephrine.
86

87. Functions of adrenal medulla
• The circulating epinephrine and norepinephrine have almost
the same effects on the different organs as the effects
caused by direct sympathetic stimulation, except that the
effects last 5 to 10 times as long because both of these
hormones are removed from the blood slowly over a period
of 2 to 4 minutes.
• The circulating norepinephrine causes constriction of most
of the blood vessels of the body; it also causes increased
activity of the heart, inhibition of the gastrointestinal
tract, dilation of the pupils of the eyes, and so forth.
87

88. 88

89. Regulatory activity of adrenal
medulla
• Adrenal medulla is the part of the sympathetic system and
is important for the regulation of blood pressure .
Catecholamines released from the adrenal medulla also
have metabolic effects . The following are the most
important effects of catecholamines:
• They increase blood pressure , skeletal muscle blood flow,
skeletal contractility, heart rate, blood glucose, lipolysis.
• They decrease visceral blood flow ,gastrointestinal
contractility ,urinary output.
89

90. Disorder of the adrenal medulla
• Pathology within the adrenal medulla and the autonomic
nervous system is primarily because of neoplasms. The
most common tumour, called pheochromocytoma when
located in the adrenal medulla, originates from chromaffin
cells and excretes catecholamines.
• Those tumours found in extra-adrenal chromaffin cells are
sometimes referred to as secreting paragangliomas.
Neoplasms may also be of neuronal lineage, such as
neuroblastomas and ganglioneuromas.
90

91. Pheochromocytoma
• Pheochromocytoma is a chromaffin cell neoplasm that
typically causes symptoms and signs from episodic
catecholamine release, including paroxysmal
hypertension.
• In population-based cancer studies, its frequency is
approximately two cases per million of the population. The
diagnosis of pheochromocytoma is typically made in the
fourth or fifth decade of life without gender differences.
91

92. 92

93. Paragangliomas
• Extra-adrenal pheochromocytomas can be referred to as
paragangliomas. They arise from paraganglionic
chromaffin cells in association with sympathetic nerves,
and are found in the organ of Zuckerkandl, urinary bladder,
chest, neck and at the base of the skull.
• They are more common in children than in adults, and are
more frequently malignant. As discussed earlier, mutations
in the SDH family may predispose to head and neck
paragangliomas and pheochromocytoma.
93

94. Paragangliomas
94

95. Neuroblastomas
• Neuroblastomas and ganglioneuromas are tumours of the
primitive neuroblast cells from the sympathetic nervous
system in ganglia and the adrenal medulla. They may
represent a continuum of neuronal maturation and are the
most common malignancy found in children, representing
7–10% of all childhood cancers.
• Because of their more mature ganglion cells which are
histologically benign, ganglioneuromas are often
metabolically inactive and asymptomatic. They are found
incidentally or with compressive symptoms mostly in the
posterior mediastinum or retroperitoneum.
95

96. Neuroblastoma
96

97. ANY QUESTIONS?
ANY SUGGESTIONS?
97

98. THANK YOU
98