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Somatotrophic Pituitary Adenoma
Growth Hormone-Secreting Pituitary Adenoma

Presentation

[…] majority macroadenomas at presentation. [emedicine.medscape.com]

We present a case of synchronous occurrence of a prolactinoma and somatotropinoma. Case presentation A woman presented to an outside clinic at the age of 29 because of menstrual irregularities. [edmcasereports.com]

Rarely presentation can be catastrophic, due to pituitary apoplexy. Hormone imbalance Over half of all adenomas are secretory 2, although even when this is the case this may not be the cause of presentation. [radiopaedia.org]

We have presented a case of pituitary oncocytoma presenting as microadenoma and Cushing's disease, which was contrary to generally held belief about oncocytoma in literature. [ijem.in]

In children, hypopituitarism commonly presents with delayed puberty or impairment of growth. Diabetes insipidus is rarely a presenting feature but may occur following surgery for a pituitary adenoma. [patient.info]

Workup

A careful study of hormonal workup and pre-operative imaging is necessary for synchronous pituitary adenomas to assure resection of both tumors. Summary Pituitary adenomas are usually solitary lesions. [edmcasereports.com]

[…] adenomas show numerous enlarged mitochondria with loss of cristae and presence of electron dense tubular structures ( Brain Pathol 2012;22:443 ) Molecular / cytogenetics description No specific molecular characteristics in routine clinical diagnostic workup [pathologyoutlines.com]

While a majority of patients with endogenous Cushing syndrome have thyrotrophic adenomas (called Cushing Disease - see below), other tumors should also be considered as part of the endocrinologic workup, including adrenal tumors and especially ACTH-secreting [eyewiki.aao.org]

The lab workup of acromegaly is straightforward. Your screening test is a spot blood insulin-like growth factor I (IGF-I). If this is normal, acromegaly is unlikely. [pathguy.com]

Although ultrastructural examination still has an important role in the workup of unusual pituitary adenomas, ultrastructural examination was the only reliable way to subtype and determine the cellular origin of pituitary adenomas in the past. [nature.com]

X-Ray

  • Enlarged Sella

    { 13007 } sella turcica, normal { 13010 } sella turcica, normal { 13013 } sella turcica, normal { 13016 } sella turcica, normal { 13019 } sella turcica, normal { 13022 } sella turcica, normal { 13025 } sella turcica, normal { 13028 } sella turcica, norma [pathguy.com]

Treatment

Doctors want to learn whether the new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. [cancer.net]

Treatment for Hyperpituitarism Treatment can consist of pituitary microsurgery to remove tumor. [healthguidance.org]

In May 2004, recurrence of amenorrhea under treatment motivated a repeat head CT scan which disclosed a small decrease in size of the adenoma. [frontiersin.org]

Surgical Treatment Surgery is an effective treatment for prolactinomas. Transsphenoidal microsurgery, the current method of choice, is reliable, safe, and effective. [pituitaryadenomas.com]

Prolactin-producing tumor — Medical treatment is safe and effective in the great majority of cases, even when the tumor is fairly large. [drugs.com]

Prognosis

Prognosis Recurrent symptoms requiring further intervention is relatively common, with 18% of patients with non-functioning tumors and 25% of patients with prolactinomas eventually needing further treatment 6 . [radiopaedia.org]

The prognosis is highly variable: cerebellar astrocytoma has a good prognosis, pontine glioma has a bad prognosis because of location. [dartmouth.edu]

People with small tumors that do not need immediate treatment or can be completely removed with surgery have an excellent prognosis. Even for large tumors that interfere with vision, surgery can stop further deterioration of vision. [drugs.com]

Prognosis Remission can be obtained in up to 90% of patients with microadenomas and in about 50% to 60% of those with macroadenomas. [ 1 ] [patient.info]

In 1979 Symon etal.[16] introduced the term giant for pituitary adenomas larger than 4 cm in any direction.[2,12] Histologically, micro- and macro adenomas are identical.[14,15] Not surprisingly, however, larger lesions have a worse prognosis than smaller [barrowneuro.org]

Etiology

Thus, a multifactorial etiology may be responsible for its origin. [neurologyindia.com]

Overall, pituitary adenomas have a highly variable etiology that differs from person to person. [virtualmedstudent.com]

[…] of somatotrophs, lactotrophs and thyrotrophs SF-1 (steroidogenic factor 1): gonadotroph cell differentiation T-PIT (T-box family member TBX19): proopiomelanocortin (POMC) lineage with differentiation of corticotrophs ( Acta Neuropathol 2017;134:521 ) Etiology [pathologyoutlines.com]

Histiocytosis X is a non-neoplastic disorder of unknown etiology characterized by masses of proliferating histiocytes, plasma cells, and eosinophilic inflammatory cells forming granulomas within any organ system in the body [ 4 ]. [em-consulte.com]

Most symptoms stem from hypersecretory etiologies, the manifestations of which depend on the hormone secreted, while other hormonal symptoms may be attributed to varying degrees of pituitary insufficiency. [hoajonline.com]

Epidemiology

Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev. 2004; 25 (1): 102-52[ DOI ][ PubMed ] 14. Otsuka F, Ogura T, Yamauchi T, Shikata K, Kageyama J, Makino H. [ijcancerprevention.com]

Epidemiology [ 1 ] Pituitary tumours account for 10% to 25% of all intracranial neoplasms. Adenomas account for the largest portion of pituitary neoplasms (estimated at approximately 17%). Only a minority of adenomas are symptomatic. [patient.info]

Although it is now well recognized that hyperprolactinemiainduced hypogonadism has a deleterious effect on the skeleton in both sexes, the epidemiologic and overall clinical significance of this effect is not known. [pituitaryadenomas.com]

Cree Modern Pathology (2018) Epidemiology and biomarker profile of pituitary adenohypophysial tumors Ozgur Mete, Amber Cintosun, Irwin Pressman & Sylvia L. [nature.com]

[…] less commonly patients may also have Ocular motility deficits and/or Diplopia, certain forms of Nystagmus, signs and symptoms of Increased intracranial pressure due to mass effect, Optic atrophy, or sequelae of Pituitary apoplexy. [3] [4] [5] General Epidemiology [eyewiki.aao.org]

Pathophysiology

[…] pituitary gland C75.1 Sites Majority occur in sella turcica within the adenohypophysis / anterior pituitary lobe Rare examples occur in extrasellar region on pituitary stalk Rare prolactinomas as part of ovarian teratoma ( Endocr Pathol 2014;25:321 ) Pathophysiology [pathologyoutlines.com]

However, in contrast to the patient described here, the primary tumor in their report was an aggressive prolactinoma, suggesting a different pathophysiological mechanism from the start. [frontiersin.org]

The exact pathophysiology of this phenomenon is unknown; however, as most of these lesions involve the chiasm and/or diencephalon, many have proposed that disruption of visual and vestibular input contribute to this pathology. [eyewiki.aao.org]

These changes represent the clinical application of an enhanced understanding of the pathophysiology of prolactin secretion and its systemic effects, advances made in neuroendocrinology, and a heightened recognition of the pathologic changes associated [pituitaryadenomas.com]

Prevention

DES RECIDIVES) LITHIASE BILIAIRE(PREVENTION) LITHIASE CALCIQUE LITHIASE CORALLIFORME(PREVENTION DES RECIDIVES) LITHIASE CYSTINIQUE LITHIASE OXALOCALCIQUE LITHIASE PHOSPHOCALCIQUE(PREVENTION) LITHIASE URIQUE LITHIASE URIQUE(PREVENTION) LOASE LOCALISATION [biam2.org]

Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.com]

Prevention Because doctors do not know why pituitary tumors develop, there is no way to prevent them. [drugs.com]

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