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PubMed1992

[Hypophyseal dysfunction and tumors].

Some pituitary hormones secrete hormones while others do not. Nonsecreting tumors can interfere with normal pituitary hormone secretion and produce tumor symptoms and signs like headaches and visual field defects. The most frequent hormone-secreting tumors are prolactinomas. Growth hormone or ACTH or gonadotropin or gonadotropin-alpha and beta chain-producing tumors are less frequent, TSH producing tumors are extremely rare. The most important elements of the diagnostic work-up are clinical signs and symptoms, assessment of pituitary function (measurement of TSH, free T4, LH, FSH, oestradiol/free testosteron, growth hormone, IGF-1, prolactin, ACTH, Cortisol, serum and urine osmolality), CT and/or MRI and, in patients with large tumors, a visual field exam. The treatment of choice of pituitary tumors is often surgery. Alternative therapies are radiation treatment (in nonoperable patients or when hormone levels are persistently elevated after pituitary surgery) and drug treatment (dopamine agonists in hyperprolactinemia, somatostatin analogues in acromegaly). Pituitary hormone deficiencies are treated depending on the specific deficiency with thyroxine, cortisone, oestrogen/gestagen/testosterone gonadotropines or ADH analogues.

Adenoma↗
PubMedDate not supplied

MR imaging of the ectopic bright signal of posterior pituitary regeneration.

High-field-strength MR studies of 13 patients with sellar and/or parasellar tumors revealed an aberrant location of the posterior pituitary bright signal in the hypothalamus in seven cases and in relation to the pituitary infundibulum in six cases. Five of the MR studies were obtained in patients who had not had surgery and had pituitary adenomas producing compression and/or destruction of the posterior lobe. In the other eight cases, the aberrant bright signal occurred after hypophysectomy in seven patients and after removal of a craniopharyngioma in the eighth. Accumulation of neurosecretory material and regeneration of pituitary tissue in these ectopic locations have been documented previously in animal experiments and in a few reports in humans after hypophysectomy. MR imaging now provides further corroborative evidence in vivo of this process in which a "miniature posterior lobe" is formed.

Adenoma↗