Endo: Pituitary Pathology

Question 1

How invasive are pituitary adenomas?

What is their WHO grade?

Answer 1

• Pituitary adenomas can cause problems due to compression of local structures, but DO NOT SPREAD
• They are benign (Grade 1)

Question 2

What is the treatment for pituitary adenomas? (2)

Answer 2

• Prolactinomas are treated medically (cabergoline)
• All other pituitary adenomas are treated with surgery

Question 3

What is the embryologic origin of anterior and posterior pituitary?

Answer 3

• Anterior pituitary = oral ectoderm (Rathke’s pouch)
• Posterior pituitary = neuroectoderm

Question 4

What are the contents of the cavernous sinus?

Answer 4

• Internal carotid artery
• CN 3/4/6, CN V1/2

Question 5

What familial tumor syndrome is associated with pituitary adenomas?

Answer 5

MEN 1

Question 6

Why do you get these symptoms with a pituitary adenoma?

• Headaches
• Visual field deficits
• Cranial nerve palsies
• Pituitary hormone deficits

Answer 6

• Headaches: due to irritation of surrounding structures
• Visual field deficits: due to compression of optic chiasm
• Cranial nerve palsies: due to compression of cavernous sinus structures
• Pituitary hormone deficits: due to compression of normal pituitary

Question 7

What is the order in which pituitary hormones are lost?

Answer 7

Go Look For The Adenoma Please

• GH
• LH
• FSH
• TSH
• ACTH
• PRL

Question 8

Define pituitary apoplexy

Answer 8

Sudden infarction or hemorrhage of pituitary gland