Pituitary Neoplasms
Pituitary Gland
Pituitary Gland, Anterior
Pituitary Diseases
Pituitary Hormones
Pituitary Apoplexy
Pituitary Hormones, Anterior
Pituitary Adenylate Cyclase-Activating Polypeptide
Pituitary Gland, Posterior
Prolactin
Trans-sphenoidal surgery for microprolactinoma: an acceptable alternative to dopamine agonists? (1/2178)
AIMS: Reported cure rates following trans-sphenoidal surgery for microprolactinoma are variable and recurrence rates in some series are high. We wished to examine the cure rate of trans-sphenoidal surgery for microprolactinoma, and to assess the long-term complications and recurrence rate. DESIGN: A retrospective review of the outcome of trans-sphenoidal surgery for microprolactinoma, performed by a single neurosurgeon at a tertiary referral centre between 1976 and 1997. PATIENTS: All thirty-two patients operated on for microprolactinoma were female, with a mean age of 31 years (range 16-49). Indications for surgery were intolerance of dopamine agonists in ten (31%), resistance in six (19%) and resistance and intolerance in four (12.5%). Two patients were from countries where dopamine agonists were unavailable. RESULTS: The mean pre-operative prolactin level was 2933 mU/l (range 1125-6000). All but 1 had amenorrhoea or oligomenorrhoea, with galactorrhoea in 15 (46.9%). Twenty-five (78%) were cured by trans-sphenoidal surgery, as judged by a post-operative serum prolactin in the normal range. During a mean follow-up of 70 months (range 2 months to 16 years) there was one recurrence at 12 years. Post-operatively, one patient became LH deficient, two patients became cortisol deficient and two became TSH deficient. Out of 21 patients tested for post-operative growth hormone deficiency, 6 (28.6%) were deficient. Five patients developed post-operative diabetes insipidus which persisted for greater than 6 months. There were no other complications of surgery. The estimated cost of uncomplicated trans-sphenoidal surgery, and follow-up over 10 years, was similar to that of dopamine agonist therapy. CONCLUSION: In patients with hyperprolactinaemia due to a pituitary microprolactinoma, transsphenoidal surgery by an experienced pituitary surgeon should be considered as a potentially curative procedure. The cost of treatment over a 10 year period is similar in uncomplicated cases to long-term dopamine agonist therapy. (+info)Modulation of estrogen action in the rat pituitary and mammary glands by dietary energy consumption. (2/2178)
We are investigating the mechanisms through which estrogens induce development of prolactin (PRL)-producing pituitary tumors and mammary carcinomas in rats and how these mechanisms are affected by dietary energy consumption. The hypothesis under examination is that dietary energy restriction inhibits tumorigenesis in estrogen-responsive tissues by altering cellular responsiveness to estrogenic hormones. In the Fischer 344 (F344) rat strain, a 40% restriction of energy consumption virtually abolishes development of estrogen-induced pituitary tumors. Inhibition of pituitary tumorigenesis in the F344 strain by energy restriction results from modulation of estrogen regulation of cell survival, not cell proliferation. In contrast, energy restriction has no inhibitory effect on estrogen-induced pituitary tumor development in the ACI rat strain. However, energy restriction markedly inhibits induction of mammary carcinomas in female ACI rats treated with 17beta-estradiol. Data presented herein indicate that dietary energy restriction modulates the responsiveness of specific cell populations to estrogenic hormones and thereby inhibits estrogen-induced tumorigenesis in a manner specific to both rat strain and tissue. (+info)IL-8 mRNA expression by in situ hybridisation in human pituitary adenomas. (3/2178)
Several cytokines have been shown to be expressed in normal and adenomatous pituitary tissue. Recently, interleukin-8 (IL-8) mRNA was identified by reverse transcription (RT)-PCR in each of a series of 17 pituitary tumours examined. We have investigated further the presence of IL-8 mRNA, using in situ hybridisation in two normal human anterior pituitary specimens and 25 human pituitary adenomas. IL-8 mRNA was not identified in either of the two normal pituitary specimens. Only three of the 25 adenomas were positive for IL-8 mRNA. In these three tumours, which included two null cell adenomas and one gonadotrophinoma, the majority of tumour cells (>90%) were positive for IL-8 mRNA. The remaining 22 adenomas were completely negative. There was no difference in tumour size or type between the IL-8 positive and the IL-8 negative tumours, and immunocytochemistry for von Willebrandt factor showed that the two groups were also similar in their degree of vascularisation. In conclusion, IL-8 mRNA was found in 12% of pituitary adenomas studied and was histologically identified within the tumour cells. In situ hybridisation is a more appropriate technique for assessing cytokine mRNA production by human pituitary tumours because RT-PCR may be too sensitive, identifying very small, possibly pathologically insignificant, quantities of mRNA that could be produced by supporting cells such as fibroblasts, endothelial cells or macrophages. (+info)Bronchioloalveolar carcinoma with metastasis to the pituitary gland: a case report. (4/2178)
An unusual case of metastatic bronchioloalveolar carcinoma of the lung presented as a pituitary tumour in a young adult Chinese female, who subsequently died after having undergone trans-sphenoidal resection. Metastatic cancers of the pituitary are uncommon even in necropsy series and rarely give rise to clinical symptoms. This case draws attention to the fact that, although uncommon, pituitary metastases have been noted with increasing frequency and their distinction from primary pituitary tumours is often difficult. A metastatic pituitary tumour may be the initial presentation of an unknown primary malignancy, wherein the metastatic deposits may also be limited to the pituitary gland. Clinicians and pathologists alike should consider a metastatic lesion in the differential diagnosis of a non-functioning pituitary tumour. (+info)Apoptosis in nontumorous and neoplastic human pituitaries: expression of the Bcl-2 family of proteins. (5/2178)
Analyses of apoptosis and of the apoptosis regulatory proteins Bcl-2, Bax, Bcl-X, and Bad were done in 95 nontumorous and neoplastic pituitary tissues by terminal deoxynucleotide transferase-mediated dUTP nick-end labeling (TUNEL), immunohistochemistry, and Western blotting. The apoptotic index was relatively low in all groups but was at least fourfold higher in pituitary carcinomas compared with any other groups. Pituitaries from pregnant and postpartum women had a fivefold higher apoptotic index compared with matched controls from nonpregnant females. Preoperative treatment of adenomas with octreotide or dopamine agonists did not change the apoptotic index significantly. The lowest levels of Bcl-2, Bax, and Bcl-X expression were in pituitary carcinomas as detected by immunostaining. An immortalized human pituitary adenoma cell line, HP75, developed in our laboratory using a replication-defective recombinant human adenovirus with an early large T-antigen, had a much higher level of apoptosis than nontumorous and neoplastic pituitaries. Treatment with transforming growth factor (TGF)-beta1 and protein kinase C (PKC) inhibitors increased apoptosis in this cell line. Analysis of the Bcl-2 family of proteins after treatment with TGF-beta1 and PKC inhibitors showed a 20% to 30% decrease in Bcl-X in the treated groups compared with controls. These results, which represent the first study of apoptosis in pituitaries from pregnant and postpartum cases and in pituitary carcinomas, indicate that 1) the apoptotic rate is low in nontumorous and neoplastic pituitary tissues but is relatively higher in pituitary carcinomas, 2) there are alterations in the expression of the Bcl-2 family of proteins in pituitary neoplasms with a decrease in Bcl-2 expression in pituitary carcinomas that may contribute to pituitary tumor pathogenesis and/or proliferation, and 3) cultured pituitary tumor cells respond to TGF-beta1 and PKC inhibitors by undergoing apoptotic cell death. (+info)Post-traumatic pituitary apoplexy--two case reports. (6/2178)
A 60-year-old female and a 66-year-old male presented with post-traumatic pituitary apoplexy associated with clinically asymptomatic pituitary macroadenoma manifesting as severe visual disturbance that had not developed immediately after the head injury. Skull radiography showed a unilateral linear occipital fracture. Magnetic resonance imaging revealed pituitary tumor with dumbbell-shaped suprasellar extension and fresh intratumoral hemorrhage. Transsphenoidal surgery was performed in the first patient, and the visual disturbance subsided. Decompressive craniectomy was performed in the second patient to treat brain contusion and part of the tumor was removed to decompress the optic nerves. The mechanism of post-traumatic pituitary apoplexy may occur as follows. The intrasellar part of the tumor is fixed by the bony structure forming the sella, and the suprasellar part is free to move, so a rotational force acting on the occipital region on one side will create a shearing strain between the intra- and suprasellar part of the tumor, resulting in pituitary apoplexy. Recovery of visual function, no matter how severely impaired, can be expected if an emergency operation is performed to decompress the optic nerves. Transsphenoidal surgery is the most advantageous procedure, as even partial removal of the tumor may be adequate to decompress the optic nerves in the acute stage. Staged transsphenoidal surgery is indicated to achieve total removal later. (+info)Calcium block of Na+ channels and its effect on closing rate. (7/2178)
Calcium ion transiently blocks Na+ channels, and it shortens the time course for closing of their activation gates. We examined the relation between block and closing kinetics by using the Na+ channels natively expressed in GH3 cells, a clonal line of rat pituitary cells. To simplify analysis, inactivation of the Na+ channels was destroyed by including papain in the internal medium. All divalent cations tested, and trivalent La3+, blocked a progressively larger fraction of the channels as their concentration increased, and they accelerated the closing of the Na+ channel activation gate. For calcium, the most extensively studied cation, there is an approximately linear relation between the fraction of the channels that are calcium-blocked and the closing rate. Extrapolation of the data to very low calcium suggests that closing rate is near zero when there is no block. Analysis shows that, almost with certainty, the channels can close when occupied by calcium. The analysis further suggests that the channels close preferentially or exclusively from the calcium-blocked state. (+info)Expression of menin gene mRNA in pituitary tumours. (8/2178)
OBJECTIVE: Multiple endocrine neoplasia type 1 (MEN 1) is an autosomal dominant inherited disorder characterised by the combined occurrence of parathyroid, endocrine pancreas and anterior pituitary tumours. The gene responsible for MEN 1, the menin gene, a putative tumour-suppressor gene located on human chromosome 11q13, has been cloned. To investigate the role of the menin gene in sporadic anterior pituitary tumorigenesis, its mRNA was assessed in a group of pituitary tumours. METHODS: Menin gene expression, along with glyceraldehyde phosphate dehydrogenase (GAPDH) gene expression, has been studied in a group of normal pituitaries and in 23 pituitary tumours not associated with the MEN 1 syndrome. The pituitary tumours included 4 prolactinomas, 11 growth-hormone-secreting tumours and 8 non-functional tumours. Total RNA was extracted from the normal pituitaries and tumours, and cDNA was synthesised with standard reverse transcriptase methods. Duplex polymerase chain reaction (PCR) was standardised in order to quantify the expression of the menin gene using intron-spanning primers across exons 9 and 10 in relation to the 'house-keeping' gene GAPDH. The PCR products were separated on agarose gel and densitometric analysis of the bands allowed semi-quantification. RESULTS: There was no evidence for a change in menin gene expression in any of the pituitary tumours when compared with normal pituitaries. CONCLUSIONS: These studies complement previous work on mutational analysis, and do not suggest a major role for the menin suppressor gene in sporadic pituitary tumorigenesis. (+info)Pituitary neoplasms refer to abnormal growths or tumors in the pituitary gland, a small endocrine gland located at the base of the brain. These neoplasms can be benign (non-cancerous) or malignant (cancerous), with most being benign. They can vary in size and may cause various symptoms depending on their location, size, and hormonal activity.
Pituitary neoplasms can produce and secrete excess hormones, leading to a variety of endocrine disorders such as Cushing's disease (caused by excessive ACTH production), acromegaly (caused by excessive GH production), or prolactinoma (caused by excessive PRL production). They can also cause local compression symptoms due to their size, leading to headaches, vision problems, and cranial nerve palsies.
The exact causes of pituitary neoplasms are not fully understood, but genetic factors, radiation exposure, and certain inherited conditions may increase the risk of developing these tumors. Treatment options for pituitary neoplasms include surgical removal, radiation therapy, and medical management with drugs that can help control hormonal imbalances.
The pituitary gland is a small, endocrine gland located at the base of the brain, in the sella turcica of the sphenoid bone. It is often called the "master gland" because it controls other glands and makes the hormones that trigger many body functions. The pituitary gland measures about 0.5 cm in height and 1 cm in width, and it weighs approximately 0.5 grams.
The pituitary gland is divided into two main parts: the anterior lobe (adenohypophysis) and the posterior lobe (neurohypophysis). The anterior lobe is further divided into three zones: the pars distalis, pars intermedia, and pars tuberalis. Each part of the pituitary gland has distinct functions and produces different hormones.
The anterior pituitary gland produces and releases several important hormones, including:
* Growth hormone (GH), which regulates growth and development in children and helps maintain muscle mass and bone strength in adults.
* Thyroid-stimulating hormone (TSH), which controls the production of thyroid hormones by the thyroid gland.
* Adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to produce cortisol and other steroid hormones.
* Follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which regulate reproductive function in both males and females.
* Prolactin, which stimulates milk production in pregnant and lactating women.
The posterior pituitary gland stores and releases two hormones that are produced by the hypothalamus:
* Antidiuretic hormone (ADH), which helps regulate water balance in the body by controlling urine production.
* Oxytocin, which stimulates uterine contractions during childbirth and milk release during breastfeeding.
Overall, the pituitary gland plays a critical role in maintaining homeostasis and regulating various bodily functions, including growth, development, metabolism, and reproductive function.
The anterior pituitary, also known as the adenohypophysis, is the front portion of the pituitary gland. It is responsible for producing and secreting several important hormones that regulate various bodily functions. These hormones include:
* Growth hormone (GH), which stimulates growth and cell reproduction in bones and other tissues.
* Thyroid-stimulating hormone (TSH), which regulates the production of thyroid hormones by the thyroid gland.
* Adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to produce cortisol and other steroid hormones.
* Follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which regulate reproductive function in both males and females by controlling the development and release of eggs or sperm.
* Prolactin, which stimulates milk production in pregnant and nursing women.
* Melanocyte-stimulating hormone (MSH), which regulates skin pigmentation and appetite.
The anterior pituitary gland is controlled by the hypothalamus, a small region of the brain located just above it. The hypothalamus produces releasing and inhibiting hormones that regulate the secretion of hormones from the anterior pituitary. These hormones are released into a network of blood vessels called the portal system, which carries them directly to the anterior pituitary gland.
Damage or disease of the anterior pituitary can lead to hormonal imbalances and various medical conditions, such as growth disorders, thyroid dysfunction, adrenal insufficiency, reproductive problems, and diabetes insipidus.
Pituitary diseases refer to a group of conditions that affect the pituitary gland, a small endocrine gland located at the base of the brain. The pituitary gland is responsible for producing and secreting several important hormones that regulate various bodily functions, including growth and development, metabolism, stress response, and reproduction.
Pituitary diseases can be classified into two main categories:
1. Pituitary tumors: These are abnormal growths in or around the pituitary gland that can affect its function. Pituitary tumors can be benign (non-cancerous) or malignant (cancerous), and they can vary in size. Some pituitary tumors produce excess hormones, leading to a variety of symptoms, while others may not produce any hormones but can still cause problems by compressing nearby structures in the brain.
2. Pituitary gland dysfunction: This refers to conditions that affect the normal function of the pituitary gland without the presence of a tumor. Examples include hypopituitarism, which is a condition characterized by decreased production of one or more pituitary hormones, and Sheehan's syndrome, which occurs when the pituitary gland is damaged due to severe blood loss during childbirth.
Symptoms of pituitary diseases can vary widely depending on the specific condition and the hormones that are affected. Treatment options may include surgery, radiation therapy, medication, or a combination of these approaches.
Pituitary hormones are chemical messengers produced and released by the pituitary gland, a small endocrine gland located at the base of the brain. The pituitary gland is often referred to as the "master gland" because it controls several other endocrine glands and regulates various bodily functions.
There are two main types of pituitary hormones: anterior pituitary hormones and posterior pituitary hormones, which are produced in different parts of the pituitary gland and have distinct functions.
Anterior pituitary hormones include:
1. Growth hormone (GH): regulates growth and metabolism.
2. Thyroid-stimulating hormone (TSH): stimulates the thyroid gland to produce thyroid hormones.
3. Adrenocorticotropic hormone (ACTH): stimulates the adrenal glands to produce cortisol and other steroid hormones.
4. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH): regulate reproductive function in both males and females.
5. Prolactin: stimulates milk production in lactating women.
6. Melanocyte-stimulating hormone (MSH): regulates skin pigmentation and appetite.
Posterior pituitary hormones include:
1. Oxytocin: stimulates uterine contractions during childbirth and milk ejection during lactation.
2. Vasopressin (antidiuretic hormone, ADH): regulates water balance in the body by controlling urine production in the kidneys.
Overall, pituitary hormones play crucial roles in regulating growth, development, metabolism, reproductive function, and various other bodily functions. Abnormalities in pituitary hormone levels can lead to a range of medical conditions, such as dwarfism, acromegaly, Cushing's disease, infertility, and diabetes insipidus.
Pituitary apoplexy is a medical emergency that involves bleeding into the pituitary gland (a small gland at the base of the brain) and/or sudden swelling of the pituitary gland. This can lead to compression of nearby structures, such as the optic nerves and the hypothalamus, causing symptoms like severe headache, visual disturbances, hormonal imbalances, and altered mental status. It is often associated with a pre-existing pituitary tumor (such as a pituitary adenoma), but can also occur in individuals without any known pituitary abnormalities. Immediate medical attention is required to manage this condition, which may include surgical intervention, hormone replacement therapy, and supportive care.
Anterior pituitary hormones are a group of six major hormones that are produced and released by the anterior portion (lobe) of the pituitary gland, a small endocrine gland located at the base of the brain. These hormones play crucial roles in regulating various bodily functions and activities. The six main anterior pituitary hormones are:
1. Growth Hormone (GH): Also known as somatotropin, GH is essential for normal growth and development in children and adolescents. It helps regulate body composition, metabolism, and bone density in adults.
2. Prolactin (PRL): A hormone that stimulates milk production in females after childbirth and is also involved in various reproductive and immune functions in both sexes.
3. Follicle-Stimulating Hormone (FSH): FSH regulates the development, growth, and maturation of follicles in the ovaries (in females) and sperm production in the testes (in males).
4. Luteinizing Hormone (LH): LH plays a key role in triggering ovulation in females and stimulating testosterone production in males.
5. Thyroid-Stimulating Hormone (TSH): TSH regulates the function of the thyroid gland, which is responsible for producing and releasing thyroid hormones that control metabolism and growth.
6. Adrenocorticotropic Hormone (ACTH): ACTH stimulates the adrenal glands to produce cortisol, a steroid hormone involved in stress response, metabolism, and immune function.
These anterior pituitary hormones are regulated by the hypothalamus, which is located above the pituitary gland. The hypothalamus releases releasing and inhibiting factors that control the synthesis and secretion of anterior pituitary hormones, creating a complex feedback system to maintain homeostasis in the body.
An adenoma is a benign (noncancerous) tumor that develops from glandular epithelial cells. These types of cells are responsible for producing and releasing fluids, such as hormones or digestive enzymes, into the surrounding tissues. Adenomas can occur in various organs and glands throughout the body, including the thyroid, pituitary, adrenal, and digestive systems.
Depending on their location, adenomas may cause different symptoms or remain asymptomatic. Some common examples of adenomas include:
1. Colorectal adenoma (also known as a polyp): These growths occur in the lining of the colon or rectum and can develop into colorectal cancer if left untreated. Regular screenings, such as colonoscopies, are essential for early detection and removal of these polyps.
2. Thyroid adenoma: This type of adenoma affects the thyroid gland and may result in an overproduction or underproduction of hormones, leading to conditions like hyperthyroidism (overactive thyroid) or hypothyroidism (underactive thyroid).
3. Pituitary adenoma: These growths occur in the pituitary gland, which is located at the base of the brain and controls various hormonal functions. Depending on their size and location, pituitary adenomas can cause vision problems, headaches, or hormonal imbalances that affect growth, reproduction, and metabolism.
4. Liver adenoma: These rare benign tumors develop in the liver and may not cause any symptoms unless they become large enough to press on surrounding organs or structures. In some cases, liver adenomas can rupture and cause internal bleeding.
5. Adrenal adenoma: These growths occur in the adrenal glands, which are located above the kidneys and produce hormones that regulate stress responses, metabolism, and blood pressure. Most adrenal adenomas are nonfunctioning, meaning they do not secrete excess hormones. However, functioning adrenal adenomas can lead to conditions like Cushing's syndrome or Conn's syndrome, depending on the type of hormone being overproduced.
It is essential to monitor and manage benign tumors like adenomas to prevent potential complications, such as rupture, bleeding, or hormonal imbalances. Treatment options may include surveillance with imaging studies, medication to manage hormonal issues, or surgical removal of the tumor in certain cases.
Pituitary Adenylate Cyclase-Activating Polypeptide (PACAP) is a neuropeptide that belongs to the vasoactive intestinal polypeptide (VIP)/secretin/glucagon family. It was first isolated from the ovine hypothalamus and later found in various tissues and organs throughout the body, including the brain, pituitary gland, and peripheral nerves.
PACAP exists in two forms, PACAP-38 and PACAP-27, which differ in their length but share the same amino acid sequence at the N-terminus. PACAP exerts its effects through specific G protein-coupled receptors, including PAC1, VPAC1, and VPAC2 receptors, which are widely distributed throughout the body.
PACAP has a wide range of biological activities, including neurotrophic, neuroprotective, vasodilatory, and immunomodulatory effects. In the pituitary gland, PACAP stimulates adenylate cyclase activity, leading to an increase in intracellular cAMP levels, which in turn regulates the release of various hormones, including growth hormone, prolactin, and thyroid-stimulating hormone.
Overall, PACAP is a crucial neuropeptide involved in various physiological processes, and its dysregulation has been implicated in several pathological conditions, such as neurodegenerative diseases, mood disorders, and cancer.
The posterior pituitary gland, also known as the neurohypophysis, is the posterior portion of the pituitary gland. It is primarily composed of nerve fibers that originate from the hypothalamus, a region of the brain. These nerve fibers release two important hormones: oxytocin and vasopressin (also known as antidiuretic hormone or ADH).
Oxytocin plays a role in social bonding, sexual reproduction, and childbirth. During childbirth, it stimulates uterine contractions to help facilitate delivery, and after birth, it helps to trigger the release of milk from the mother's breasts during breastfeeding.
Vasopressin, on the other hand, helps regulate water balance in the body by controlling the amount of water that is excreted by the kidneys. It does this by increasing the reabsorption of water in the collecting ducts of the kidney, which leads to a more concentrated urine and helps prevent dehydration.
Overall, the posterior pituitary gland plays a critical role in maintaining fluid balance, social bonding, and reproduction.
Prolactin is a hormone produced by the pituitary gland, a small gland located at the base of the brain. Its primary function is to stimulate milk production in women after childbirth, a process known as lactation. However, prolactin also plays other roles in the body, including regulating immune responses, metabolism, and behavior. In men, prolactin helps maintain the sexual glands and contributes to paternal behaviors.
Prolactin levels are usually low in both men and non-pregnant women but increase significantly during pregnancy and after childbirth. Various factors can affect prolactin levels, including stress, sleep, exercise, and certain medications. High prolactin levels can lead to medical conditions such as amenorrhea (absence of menstruation), galactorrhea (spontaneous milk production not related to childbirth), infertility, and reduced sexual desire in both men and women.