Human Diseases; amp Treatment

HYPOTHALAMIC, PITUITARY, AND OTHER SELLAR MASSES PITUITARY TUMORS    Pituitary adenomas are the most common cause of pituitary hormone hypersecretion and hyposecretion syndromes in adults. They account for ~15% of all intracranial neoplasms. At autopsy, up to one-quarter of all pituitary glands harbor an unsuspected microadenoma. Pathogenesis    Pituitary adenomas are benign neoplasms that arise from one of the five anterior pituitary cell types. The clinical and biochemical phenotype of pituitary adenomas depend on the cell type from which they are derived. Thus, tumors arising from lactotrope (PRL), somatotrope (GH), corticotrope (ACTH), thyrotrope (TSH), or gonadotrope (LH, FSH) cells hypersecrete their respective hormones. . Plurihormonal tumors that express combinations of GH, PRL, TSH, ACTH, and the glycoprotein hormone α subunit may be diagnosed by careful immunocytochemistry or may manifest as clinical syndromes that combine features of these hor...

HYPOTHALAMIC AND ANTERIOR PITUITARY INSUFFICIENCY Hypopituitarism results from impaired production of one or more of the anterior pituitary trophic hormones. Reduced pituitary function can result from inherited disorders; more commonly, it is acquired and reflects the mass effects of tumors or the consequences of inflammation or vascular damage. These processes may also impair synthesis or secretion of hypothalamic hormones, with resultant pituitary failure DEVELOPMENTAL AND GENETIC CAUSES OF HYPOPITUITARISM Pituitary Dysplasia Pituitary dysplasia may result in aplastic, hypoplastic, or ectopic pituitary gland development. Because pituitary development requires midline cell migration from the nasopharyngeal Rathke’s pouch, midline craniofacial disorders may be associated with pituitary dysplasia. Acquired pituitary failure in the newborn can also be caused by birth trauma, including cranial hemorrhage, asphyxia, and breech delivery. Septo-Optic Dysplasia Hypothalamic dysfu...