Pituitary tumours Flashcards

1
Q

Pituitary adenoma

A

Benign tumour of the pituitary gland

Microadenoma <1cm and macroadenoma >1cm

Secretory/functioning vs non-secretory/functioning

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2
Q

Prolactinomas

A

Most common type

Produce excess of prolactin

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3
Q

Most common

A

Prolactinoma

Then non-secreting adenomas

Then GH secreting and ACTH secreting adenomas

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4
Q

Symptoms if excess hormones

A

Cushing’s due to excess ACTH

Acromegaly due to excess GH

Amenorrhoea and galactorrhoea due to excess prolactin

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5
Q

Symptoms due to depletion of hormones

A

Due to compression of the normal functioning pituitary gland

Present with generalised hypopituitarism

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6
Q

Symptoms due to stretching of dura within/around pituitary

A

Headaches

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7
Q

Symptoms due to compression of optic chiasm

A

Bitemporal hemianopia

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8
Q

Investigations

A

Pituitary blood profile (GH, prolactin, ACTH, LSH, TFTs)

Formal visual field testing

MRI brain with contrast

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9
Q

Differential diagnosis for pituitary adenoma

A

Pituitary hyperplasia

Craniopharyngioma

Meningioma

Brain metastases

Lymphoma

Hypophysitis

Vascular malformation (aneurysm)

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10
Q

Treatment

A

Hormonal therapy

Surgery (transphenoidal transnasal hypophysectomy)

Radiotherapy

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11
Q

First line treatment in prolactinomas

A

Bromocriptine

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12
Q

Hypopituitarism features

A

Depends on which hormones are deficienct

Low ACTH- tiredness, postural hypotension

Low FSH/LH- amenorrhoea, infertility, loss of libido

Low TSH- feeling cold, constipation

Low GH- if in childhood short stature

Low prolactin- problems with lactation

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