anterior pituitary disease Flashcards

1
Q

overall forms of pituitary disease

A
  • non-functioning / silent pituitary adenomas (don’t secrete hormones)
  • 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

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2
Q

MRI

A
  • 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

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3
Q

CT

A

THINK C FOR CALCIFIED
- better at visualising bony calcified structures
- calcified tumors such as craniopharyngiomas and meningomas
- useful when patients cannot have an MRI

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4
Q

CT disadvantages

A

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

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5
Q

what is Craniopharyngioma and the different histological types.

A
  • 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

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6
Q

peak ages for Craniopharyngioma

A

5 to 14 years; 50 to 74 years

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7
Q

Craniopharyngioma signs

A
  • raised intercranial pressure
  • visual disturbances
  • growth failure
  • pituitary hormone deficiency
  • weight increase
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8
Q

What is craniopharyngioma?

A

Slow growing benign tumour which compresses the pituaitary gland and optic chiasm leading to symptoms.

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9
Q

Treatment of craniopharyngioma (3)

A
  • Hormone replacement
  • Transsphenoidal surgical removal
  • Radiotherapy
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10
Q

Pathophysiology of craniopharyngioma (4)

A
  • Squamous epithelial remnants of Rathke’s pouch
  • Benign, slow growing tumour infiltrates to surrounding structures
  • Mixed solid and cystic parts
  • Doesn’t spread to other parts of the body but puts pressure on suprasellar region of skull
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11
Q

Diagnosis of Craniopharyngioma (4)

A
  • CT
  • MRI
  • Visual Examination
  • Endocrine examination
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12
Q

Adamantinous vs squamous papillary craniopharyngioma

A

Adamantinous: Cyst formation and calcification
Squamous papillary: Well circumscribed

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12
Q

Cause of meningiomas

A

Complication of radiotherapy

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13
Q

Complications of meningioma (3)

A
  • Loss of visual acuity
  • Visual field defects
  • Endocrine dysfunction
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14
Q

How common are meningiomas?

A

2nd most common (first is pituitary adenoma)

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15
Q

non-functioning / silent pituitary adenomas

A
  • dont secrete hormones
  • don’t cause major diseases like Cushings ect in the same way that functioning pituitary adenomas do
  • account for 25-30% of pituitary adenomas
  • prognosis is good

symptoms:
- visual disturbances
- headaches
- hydrocephalus + inc in intercranial pressure

16
Q

contrast pituitary adenomas and pituitary carcinomas

A

adenomas:
- benign
- do not metastase
- ones found all throughout this block - cushings, addisons ect
- very relevant for course and exams

carcinomas:
- extremerly rare
- malignant
- have the ability to metastase
- poor prognosis
- dont worry about - havent been taught