anterior pituitary disease

Question 1

overall forms of pituitary disease

Answer 1

non-functioning / silent pituitary adenomas
endocrine active pituitary adenomas
functional and non-functional pituitary carcinoma
metastases from elsewhere
pituitary cysts - rathkes
developmental abnormalities - craniopharyngioma
RELEVANT
tumors of cns
vascular tumours
vascular aneourthyms

Question 2

MRI

Answer 2

• preferred imaging for pituitary
• good to visualise soft tissue and vascular structures
• no exposure to ionising radiation

T1
- fat - bright

T2
- structures with high water content eg cycts

Question 3

CT

Answer 3

• better at visualising bony calcified structures
• calcified tumors such as craniopharyngiomas and meningomas
• useful when patients cannot have an MRI

Question 4

CT disadvantages

Answer 4

less optimal soft tissue imaging compared to MRI
use of intravenous contrast media
exposure to radiation

Question 5

what is Craniopharyngioma and the different histological types.

Answer 5

• benign tumour which infiltrates surrounding structures
• solid, cystic, mixed
• extends into suprasellar regions
• arises from squamous epithelial remnants of rathkes pouch

2 types:
adamantinous - cyst formation and calcification
squamous papillary - well circumscribed

Question 6

peak ages for Craniopharyngioma

Answer 6

5 to 14 years; 50 to 74 years

Question 7

Craniopharyngioma signs

Answer 7

• raised intercranial pressure
• visual disturbances
• growth failure
• pituitary hormone deficiency
• weight increase