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Tanzina Rahman
 Pituitary Gland
 Sections of Pituitary land
 Types of Pituitary Tumor
 Tests, Diagnosis & Treatment of
pituitary disorders

 Located at the base of the
brain, just behind the eyes
and it sits in a tiny bony
space called the sella turcica.
Small, cherry-shaped
double structure attached by
a stalk to the base of the
brain.
 Pituitary gland is
connected directly to part
of the brain called the
hypothalamus.
 Hypothalamus releases
hormones into tiny blood
vessels directly connected
to the pituitary gland.
These cause the pituitary
gland to make its own
hormones.
 Master Gland
Releases substances which control the basic
functions of
Growth
metabolism
 reproduction
 Anterior lobe
 Intermediate lobe and
 Posterior lobe
Presentation on Pituitary Gland Tumor
Hormone Increased level Decreased level
GH Gigantism (child)
Acromegaly (adult)
Dwarfism (child)
Lethargy, premature
aging
ACTH Cushing’s Disease Addison’s Disease
TSH Goiter, increased
BMR, HR, BP
Graves disease
Decreased BMR, HR,
CO, BP
Cretinism (children)
Prolactin amenorrhea Too little milk
FSH Late puberty, infertility
LH Menstrual cycle
disturbance
Amenorrhea,
impotence
Hormone Increased Decreased
Oxytocin
Precipitates
childbirth,
excess milk
Prolonged
childbirth,
diminished milk
ADH
(vassopressin)
Increased BP,
decreased
urinary output,
edema.
Diabetes
insipidus, dilute
urine &
increased urine
output.
 Pituitary Gland Tumor
 Pituitary tumors are abnormal growths that develop
in your pituitary gland.
 The most frequent type of pituitary disorder is a
pituitary gland tumor.
 10% of all primary brain tumors are pituitary
tumors
 Hypersecretion, Hyposecretion, & Tumor mass
effects are Problems Caused by Pituitary Tumor.
 Benign tumors of the pituitary gland.
 found due to hormonal imbalances that
affect bodily functions.
 relatively small when detected.
 remain confined to the sella turcica.
 People can develop pituitary adenomas at
any age.
 Most pituitary adenomas are in the front
part (anterior lobe) of the pituitary gland.
Produce too
much of
hormone
Secretory
Tumor
Do not
produce too
much
hormone
Non-
Secretory
Tumor
 Prolactinoma
 Acromegaly and Gigantism
 Cushing's disease
 Thyroid stimulating hormone (TSH)-secreting
tumors
 Symptoms
 Changes in menstrual cycle
 Headaches
 Fatigue and decreased energy
 Infertility
 Vision problems
 Osteoporosis or bone loss
 Galactorrhea(breast milk production)
 Diagnosis
 Hormone testing
 Imaging tests
 Treatment
 Medication
 Cabergoline(0.5 mg per week)
 Bromocriptine
 Surgery
 Radiation
 Side Effects
 Dizziness
 Drowsiness
 nausea,
 Vomiting
 Diarrhea or constipation
 Confusion
 Depression
Acromegaly is a rare disease caused by a GH-secreting
pituitary adenoma in more than 99% of patients
 Symptoms
 Acral enlargement
 Excessive sweating
 Hypertension, congestive heart failure, arrhythmias
 Thick and coarse skin, skin tags
 Goiter
 Pituitary insufficiency
 Interrupted menstrual cycle
 Deepening of the voice
 Fatigue
 Osteoarthritis or bone loss
 Treatment
 Somatostatin analogs:
 OCTREOTIDE
 LANREOTIDE
 SIGNIFOR ®LAR
 Growth hormone antagonists:
 PREGVISOMANT
Side effects
 Slowed heart rat
 Nausea
 Vomiting
 diarrhea
 stomach pain
 Dizziness
 Headache
 Cushing's disease occurs when a pituitary tumor secretes too much
ACTH, the hormone that stimulates the adrenal glands. Too much
ACTH causes the adrenal glands to produce excess cortisol.
 Treatment:
 Surgery
 Radiation
 Medication
-Pasireotide
-Cyproheptadine
-ketoconazole
 A TSH-secreting pituitary tumor produces too much thyroid-stimulating hormone,
which then causes the thyroid gland to make too much thyroid hormone. This
leads to hyp.erthyroidism.
 Symptoms
 Fast heartbeat
 Irregular menstrual cycle
 Headaches
 Visual disturbances
 Difficulty sleeping
 More frequent bowel movements
 Inability to tolerate heat
 Excessive sweating
 Fatigue
 Weight loss
 Shakiness
 Nervousness
 Treatment
Transsphenoidal microsurgery through the nasal sinuses.
Somatostatin analogue is an effective medication to reduce
TSH levels, which in turn lowers thyroid hormone levels.
Radiation therapy. Radiation therapy will destroy the
remaining tumor, but the process is slow.
 Non-functioning adenomas:
 some tumors of the pituitary do not secret too many
hormones Instead, they cause health problems because of
their size and location.
 It cause headaches and vision problems.
 It includes-
 Craniopharyingiomas and
 Rathke's cleft cysts
 These masses on or near the pituitary gland are non-
cancerous growths, but they may be mistaken for a pituitary
tumor on an MRI scan.
 Do not arise from the hormone-producing cells of the
pituitary gland.
 Craniopharyngiomas are most common during childhood,
but can also be found and cause problems in older adults.
 Growth failure in children
 Delayed puberty in children
 Reduced or loss of sex drive
 Constipation
 Nausea
 Frequent urination
 Excessive thirst
 Obesity
 Headaches
 Menstrual irregularities/loss of menstrual cycle
 Milk discharge from breasts
 Fatigue
 Dry skin
 Low blood pressure
 Visual disturbances
 Confusion
 Treatment Team
Radiation oncologist
Medical oncologist
An endocrinologist
A neurosurgeon
A Neuro oncologist
A specialist nurse
 Tests and diagnosis
Doctor will use one or more tests to find out
Pituitary adenoma depends on the presenting symptoms
A list of the common tests, procedures, and scans that doctors
can use to find out
 Factors Influencing Diagnostic Test
Doctor may consider these factors when choosing a
diagnostic test:
• Age and medical condition
• Type of tumor suspected
• Signs and symptoms
• Previous test results
 Diagnosis of a Pituitary Tumor (adenoma)
 Blood and Urine tests
 Vision Testing
 Endocrine Diagnostics
 Brain Imaging
- Magnetic Resonance Imaging (MRI) scans
-Computed Tomography (CT) scan
 Blood and Urine tests
A blood test may be recommended to measure the amounts
of certain hormones in the blood.
If Cushing's disease is suspected, samples of saliva may be
collected as well as one or more 24-hour urine samples.
Macro adenoma on magnetic resonance
imaging.
Macro adenoma (arrow) on computed
tomography
Brain Imaging:
 MRI scans use radio waves and strong
magnets to create detailed pictures of the
inside of the body.
 The energy from the radio waves is absorbed
and then released in a pattern formed by the
type of tissue and by certain diseases.
 The CT scan uses x-rays to create detailed
cross-sectional images of part of the body.
 CT scans can find a pituitary adenoma if it is
large enough, but MRI scans are used much
more often to look at the brain and pituitary
gland.
Surgery
1. Endoscopic Transnasal Transsphenoidal Approach:
-remove the tumor through nose and sinuses
without an external incision.
2. Ranial Transapproach (craniotomy):
-Tumor is removed through the upper part of your
skull by way of an incision in your scalp.
 Radiation therapy
1. External beam radiation:
-delivers radiation in small increments over a
period of time.
2. Gamma Knife stereotactic radio surgery:
-focuses radiation beams precisely on the tumor
without an incision.
Presentation on Pituitary Gland Tumor

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Presentation on Pituitary Gland Tumor

  • 2.  Pituitary Gland  Sections of Pituitary land  Types of Pituitary Tumor  Tests, Diagnosis & Treatment of pituitary disorders
  • 3.   Located at the base of the brain, just behind the eyes and it sits in a tiny bony space called the sella turcica. Small, cherry-shaped double structure attached by a stalk to the base of the brain.
  • 4.  Pituitary gland is connected directly to part of the brain called the hypothalamus.  Hypothalamus releases hormones into tiny blood vessels directly connected to the pituitary gland. These cause the pituitary gland to make its own hormones.
  • 5.  Master Gland Releases substances which control the basic functions of Growth metabolism  reproduction
  • 6.  Anterior lobe  Intermediate lobe and  Posterior lobe
  • 8. Hormone Increased level Decreased level GH Gigantism (child) Acromegaly (adult) Dwarfism (child) Lethargy, premature aging ACTH Cushing’s Disease Addison’s Disease TSH Goiter, increased BMR, HR, BP Graves disease Decreased BMR, HR, CO, BP Cretinism (children) Prolactin amenorrhea Too little milk FSH Late puberty, infertility LH Menstrual cycle disturbance Amenorrhea, impotence
  • 9. Hormone Increased Decreased Oxytocin Precipitates childbirth, excess milk Prolonged childbirth, diminished milk ADH (vassopressin) Increased BP, decreased urinary output, edema. Diabetes insipidus, dilute urine & increased urine output.
  • 10.  Pituitary Gland Tumor  Pituitary tumors are abnormal growths that develop in your pituitary gland.  The most frequent type of pituitary disorder is a pituitary gland tumor.  10% of all primary brain tumors are pituitary tumors  Hypersecretion, Hyposecretion, & Tumor mass effects are Problems Caused by Pituitary Tumor.
  • 11.  Benign tumors of the pituitary gland.  found due to hormonal imbalances that affect bodily functions.  relatively small when detected.  remain confined to the sella turcica.  People can develop pituitary adenomas at any age.  Most pituitary adenomas are in the front part (anterior lobe) of the pituitary gland.
  • 12. Produce too much of hormone Secretory Tumor Do not produce too much hormone Non- Secretory Tumor
  • 13.  Prolactinoma  Acromegaly and Gigantism  Cushing's disease  Thyroid stimulating hormone (TSH)-secreting tumors
  • 14.  Symptoms  Changes in menstrual cycle  Headaches  Fatigue and decreased energy  Infertility  Vision problems  Osteoporosis or bone loss  Galactorrhea(breast milk production)
  • 15.  Diagnosis  Hormone testing  Imaging tests  Treatment  Medication  Cabergoline(0.5 mg per week)  Bromocriptine  Surgery  Radiation
  • 16.  Side Effects  Dizziness  Drowsiness  nausea,  Vomiting  Diarrhea or constipation  Confusion  Depression
  • 17. Acromegaly is a rare disease caused by a GH-secreting pituitary adenoma in more than 99% of patients  Symptoms  Acral enlargement  Excessive sweating  Hypertension, congestive heart failure, arrhythmias  Thick and coarse skin, skin tags  Goiter  Pituitary insufficiency  Interrupted menstrual cycle  Deepening of the voice  Fatigue  Osteoarthritis or bone loss
  • 18.  Treatment  Somatostatin analogs:  OCTREOTIDE  LANREOTIDE  SIGNIFOR ®LAR  Growth hormone antagonists:  PREGVISOMANT Side effects  Slowed heart rat  Nausea  Vomiting  diarrhea  stomach pain  Dizziness  Headache
  • 19.  Cushing's disease occurs when a pituitary tumor secretes too much ACTH, the hormone that stimulates the adrenal glands. Too much ACTH causes the adrenal glands to produce excess cortisol.
  • 20.  Treatment:  Surgery  Radiation  Medication -Pasireotide -Cyproheptadine -ketoconazole
  • 21.  A TSH-secreting pituitary tumor produces too much thyroid-stimulating hormone, which then causes the thyroid gland to make too much thyroid hormone. This leads to hyp.erthyroidism.  Symptoms  Fast heartbeat  Irregular menstrual cycle  Headaches  Visual disturbances  Difficulty sleeping  More frequent bowel movements  Inability to tolerate heat  Excessive sweating  Fatigue  Weight loss  Shakiness  Nervousness
  • 22.  Treatment Transsphenoidal microsurgery through the nasal sinuses. Somatostatin analogue is an effective medication to reduce TSH levels, which in turn lowers thyroid hormone levels. Radiation therapy. Radiation therapy will destroy the remaining tumor, but the process is slow.
  • 23.  Non-functioning adenomas:  some tumors of the pituitary do not secret too many hormones Instead, they cause health problems because of their size and location.  It cause headaches and vision problems.  It includes-  Craniopharyingiomas and  Rathke's cleft cysts
  • 24.  These masses on or near the pituitary gland are non- cancerous growths, but they may be mistaken for a pituitary tumor on an MRI scan.  Do not arise from the hormone-producing cells of the pituitary gland.  Craniopharyngiomas are most common during childhood, but can also be found and cause problems in older adults.
  • 25.  Growth failure in children  Delayed puberty in children  Reduced or loss of sex drive  Constipation  Nausea  Frequent urination  Excessive thirst  Obesity  Headaches  Menstrual irregularities/loss of menstrual cycle  Milk discharge from breasts  Fatigue  Dry skin  Low blood pressure  Visual disturbances  Confusion
  • 26.  Treatment Team Radiation oncologist Medical oncologist An endocrinologist A neurosurgeon A Neuro oncologist A specialist nurse
  • 27.  Tests and diagnosis Doctor will use one or more tests to find out Pituitary adenoma depends on the presenting symptoms A list of the common tests, procedures, and scans that doctors can use to find out
  • 28.  Factors Influencing Diagnostic Test Doctor may consider these factors when choosing a diagnostic test: • Age and medical condition • Type of tumor suspected • Signs and symptoms • Previous test results
  • 29.  Diagnosis of a Pituitary Tumor (adenoma)  Blood and Urine tests  Vision Testing  Endocrine Diagnostics  Brain Imaging - Magnetic Resonance Imaging (MRI) scans -Computed Tomography (CT) scan
  • 30.  Blood and Urine tests A blood test may be recommended to measure the amounts of certain hormones in the blood. If Cushing's disease is suspected, samples of saliva may be collected as well as one or more 24-hour urine samples.
  • 31. Macro adenoma on magnetic resonance imaging. Macro adenoma (arrow) on computed tomography Brain Imaging:
  • 32.  MRI scans use radio waves and strong magnets to create detailed pictures of the inside of the body.  The energy from the radio waves is absorbed and then released in a pattern formed by the type of tissue and by certain diseases.
  • 33.  The CT scan uses x-rays to create detailed cross-sectional images of part of the body.  CT scans can find a pituitary adenoma if it is large enough, but MRI scans are used much more often to look at the brain and pituitary gland.
  • 34. Surgery 1. Endoscopic Transnasal Transsphenoidal Approach: -remove the tumor through nose and sinuses without an external incision. 2. Ranial Transapproach (craniotomy): -Tumor is removed through the upper part of your skull by way of an incision in your scalp.
  • 35.  Radiation therapy 1. External beam radiation: -delivers radiation in small increments over a period of time. 2. Gamma Knife stereotactic radio surgery: -focuses radiation beams precisely on the tumor without an incision.