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Pathology: Endocrine Tumors > Pituitary Tumors > Flashcards

Pituitary Tumors Flashcards

1
Q

At what age can pituitary tumors occur?

A

Can occur at any age but mostly found in older adults

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2
Q

Which gender is more likely to develop pituitary tumors?

A

Women are more likely to develop these tumors than men

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3
Q

Which racial group is more likely to develop pituitary tumors?

A

More likely to develop in African Americans than in Caucasians

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4
Q

What are the known risk factors for pituitary tumors?

A

Very few known risk factors. There are no known environmental or lifestyle-related risk factors for pituitary tumors.

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5
Q

What is Multiple Endocrine Neoplasia MEN1?

A

A rare inherited disorder that affects the endocrine glands and can cause tumors in the parathyroid, pituitary glands, and the pancreas.

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6
Q

What effect do tumors from Multiple Endocrine Neoplasia MEN1 have on glands?

A

They cause the glands to secrete high levels of hormones.

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7
Q

What are other syndromes associated with pituitary tumors?

A

Multiple endocrine neoplasia MEN4, McCune-Albright syndrome, and Carney complex.

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8
Q

What is the most common manifestation of an expanding pituitary lesion?

A

The most common manifestation of an expanding pituitary lesion is headache and visual field defects.

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9
Q

What are gonadotropin secreting adenomas associated with?

A

Gonadotropin secreting adenomas can lead to gigantism in children and acromegaly in adults.

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10
Q

What condition is associated with ACTH secreting adenomas?

A

ACTH secreting adenomas are associated with Cushing’s syndrome.

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11
Q

What symptoms are caused by prolactin secreting adenomas?

A

Prolactin secreting adenomas can cause galactorrhea in females and impotence in males.

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12
Q

What condition is associated with thyroid stimulating secreting adenomas?

A

Thyroid stimulating secreting adenomas are associated with hyperthyroidism.

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13
Q

What is the principal imaging study for the pituitary gland?

A

CT or MRI.

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14
Q

Which imaging technique is superior for delineating the extent of tumor processes?

A

MRI is superior to CT.

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15
Q

What critical structures does MRI help to delineate relative to pituitary tumors?

A

Optic chiasm, vascular structures, cranial nerves, and cavernous sinuses.

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16
Q

What lab studies are used to confirm pituitary hormone dysfunction?

A

Blood and urine tests.

17
Q

How do benign pituitary tumors typically spread?

A

Via local invasion.

18
Q

Is there a true staging system for pituitary tumors?

A

No true staging exists; tumor size is used to classify.

19
Q

How are pituitary tumors classified according to Hardy and Venzina?

A

Into 4 grades (0-4) based on the extent of expansion or erosion of the sella turcica.

20
Q

What is the classification system for pituitary tumors primarily based on?

A

The presence of microadenomas (<1cm) and macroadenomas (>1cm) and the amount of tumor invasion.

21
Q

What determines the treatment of pituitary adenomas?

A

Treatment depends on whether the adenoma produces excess hormones and which hormone it produces.

22
Q

What are the two types of pituitary adenomas?

A

Functioning adenomas overproduce hormones, while non-functioning adenomas do not.

23
Q

How are microadenomas treated?

A

Microadenomas are treated with surgery, specifically transsphenoidal surgery.

24
Q

How are macroadenomas treated?

A

Macroadenomas are treated with surgery, specifically craniotomy.

25
Q

What does transsphenoidal mean in the context of surgery?

A

Transsphenoidal means that the surgery is performed through the sphenoid sinus, a hollow space in the skull.

26
Q

When is radiation therapy used for pituitary tumors?

A

Radiation therapy is used in patients who refuse surgery or are medically unfit for surgery.

27
Q

What is the role of postoperative radiation therapy?

A

Postoperative radiation therapy is controversial but may reduce recurrence rates compared to surgery alone.

28
Q

What modern techniques are used in radiation therapy for pituitary tumors?

A

Modern techniques include 3D conformal, SRS, and proton therapy, allowing focused delivery of the prescribed dose.

29
Q

What is the position of the patient during the initial CT simulation for radiation therapy?

A

The patient’s neck is flexed with chin down toward the chest to minimize radiation exposure to the eyes.

30
Q

What devices are used to fixate the position of the chin, mouth, and head during radiation therapy?

A

Bite blocks or intraoral stents are used.

31
Q

What is the typical radiation dose for pituitary tumors?

A

The dose is 45-50 Gy at 1.8-2.0 Gy per fraction.

Larger mass may require a boost to 54 Gy.

32
Q

What are the tolerance doses for organs at risk (OAR) in pituitary tumor treatment?

A

OAR TD 5/5: Optic Chiasm 50 Gy and Lens 10 Gy.

Pathology: Endocrine Tumors (4 decks)

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