Upload
tanzina-rahman
View
1
Download
0
Tags:
Embed Size (px)
DESCRIPTION
A review on pituitary gland tumor.
Citation preview
Presentation on Pituitary Disorders
Prepared by
Tanzina Rahman
Content
Pituitary Gland Sections of Pituitary land Types of Pituitary Tumor Tests, Diagnosis & Treatment of pituitary disorders
Pituitary gland
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.
Continue…
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
Growthmetabolism reproduction
Continue
Anterior lobe
Intermediate lobe and
Posterior lobe
Sections of pituitary gland
PIYUITARY HORMONE & THEIR TARGETS
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, BPGraves disease
Decreased BMR, HR, CO, BPCretinism (children)
Prolactin amenorrhea Too little milk
FSH Late puberty, infertility
LH Menstrual cycle disturbance
Amenorrhea, impotence
Anterior Pituitary Disorders
Hormone Increased Decreased
OxytocinPrecipitates childbirth, excess milk
Prolonged childbirth, diminished milk
ADH (vassopressin)
Increased BP, decreased urinary output, edema.
Diabetes insipidus, dilute urine & increased urine output.
Posterior Pituitary Disorders
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.
Disorders of the Pituitary Gland
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.
Pituitary Adenoma
Produce too much of hormone
Secretory
Tumor
Do not produce too much hormone
Non-Secreto
ry Tumor
PITUITARY TUMOR TYPES
Secretory Tumors Causes
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)
Prolactinoma
Diagnosis
Hormone testing Imaging tests
Treatment
Medication Cabergoline(0.5 mg per week) Bromocriptine
Surgery Radiation
Continue
Side Effects
Dizziness Drowsiness nausea, Vomiting Diarrhea or constipation Confusion Depression
Continue..
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
Acromegaly and Gigantism
Treatment Somatostatin analogs:
OCTREOTIDE LANREOTIDE SIGNIFOR ®LAR
Growth hormone antagonists: PREGVISOMANT
Side effects Slowed heart rat Nausea Vomiting diarrhea stomach pain Dizziness Headache
Continue..
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.
CUSHING’S DISEASE:
Treatment:
Surgery Radiation Medication -Pasireotide -Cyproheptadine -ketoconazole
Continue..
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
THYROTROPIN (TSH)-secreting tumors
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.
Continue
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
Non-Secretory Tumors Causes
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.
Craniopharyingiomas and Rathke's cleft cysts
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
Symptoms of craniopharyngiomas and Rathke's cleft cysts are similar:
Treatment Team
Radiation oncologist Medical oncologist An endocrinologist A neurosurgeon A Neuro oncologist A specialist nurse
Tests, Diagnosis & Treatment of Pituitary Disorders
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
Continue
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
Continue
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
Continue
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.
Continue
Continue
Macro adenoma on magnetic resonance
imaging.
Macro adenoma (arrow) on computed tomography
Brain Imaging:
Magnetic resonance imaging (MRI) scan:
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.
Computed tomography (CT) scan:
Surgery1. 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.
Treatment of Pituitary Disorders
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.
Continue..
Thank You