Endo diseases - pit tumour Flashcards
what type of disease originates from posterior pituitary gland
hypothalamic (central) diabetes insipidus
how common is pituitary tumours
1 in 4 have pituitary microadenoma (doesnt do much)
mostly commonly found in young or middle-aged adults
what are symptopms of pituiutary tumour caused by
- change in pituitary hormone levels = functional pituitary tumours
- direct pressure from the tumour
first thing effected from increased pituitary tumour size
pressure on optic nerves
causes headaches
sight problems
pit tumour >1cm
macroadenoma
pit tumour <1cm
microadenoma
Most common type of pit tumour
Non secreting adenomas
Benign, don’t spread
Hypopituitarism
reduction in pituitary hormone secretions
Most common hromones released by tumours of anterior pit gland
prolactin
Least common hromones released by tumours of anterior pit gland
Thyroid stimulating hormone
What cells are affected in prolactinomas
lactotropes
Common symptoms of prolactinoma
Women: Monthly period stops
Production of small amounts of breast milk
Women and men : Infertility
Mostly diverse and not obvious symptoms
What hormone is in excess when there is adeomma of pituitary somatotope cells
growth hromone
What two disease can be caused by adenoma of somatotrope cells
Gigantism in children
Acromegaly in adults
Depends if growth plates fused or not
Symproms of acromegaly
Enlarged head, hands, Jaw, tongue, lips
Excess sweating
Headaches and vision loss due to pressure on optic nerve
sweating= increased resistance to insulin
increased metabolsim
enlarged
What disease is caused by corticotropic adenoma
Excess production of ACTH
So excess cortisol
Cushings
symptoms of cushings
hyperglycaemia
loss of muscle mass
thin limbs, osteoporosis
fat storage in abdomen, face (adiposity, puffy face)
orange donald trump skin
typical presentations of cushings
- moon face
- reddish cheeks
- truncal obesity
- abdominal striae (look like stretch marks)
effects of gonadotropic adnomas in men and women
men: rise in FSH, not much change in LH levels
women: neither hormone changes
= symptoms usually associated with mass effects of tumour
how are pit tumours usually diagnosed
if non secreting macroadenoma = mass effects of optic nerve
if secreting microadenoma = blood/urine tests
then scan to confirm pit involvement
either CT or MRI (preffered)
resolution of MRI
can resolve tumours of 3mm and up
if not compressing optic nerve, then what is done to manage pit tumour
monitor size and hormone function over time
drug treatment for prolactinoma
dopamine receptor agonist
= inhibit prolactin secretion
growth of tmour can be reversed
drug treatment for adenoma of somatotropes
somatostatin analogues
inhibits growth hormone
most common pit tumour surgery
transphenoidal surgery
when would transfrontal surgery be needed for pit tumour
if very large
uncommon
side effects of dop agonist for prolactinoma
impulse control disorders ICDs
dose dependent
more studied in parkinsons disease, but recent studies have shown this taking an effect in prolactinoma patiens
increased risk of developig gambling addictions, hypersexuality, binge eating disorders
due to the reward pathway dopamine regulates
