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Related Concept Videos

Cushing Syndrome II: Pathophysiology01:19

Cushing Syndrome II: Pathophysiology

Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...
Cushing Syndrome I: Introduction01:26

Cushing Syndrome I: Introduction

Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the syndrome.Exogenous...
Adrenal Gland Disorders01:27

Adrenal Gland Disorders

Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Anatomy of the Adrenal Glands01:17

Anatomy of the Adrenal Glands

The adrenal or supra-renal glands, situated above the kidneys and aligned with the twelfth rib, are paired pyramid-shaped structures crucial for the body's stress response. During stress, these glands secrete hormones vital for adaptive physiological reactions.
These glands possess a distinctive yellow tinge due to the stored cholesterol and fatty acids required for hormone synthesis. They are encased in a fibrous capsule and cushioned by fat.
The adrenal gland comprises two distinct regions...
Hormones of the Adrenal Glands01:31

Hormones of the Adrenal Glands

Adrenal hormones play a pivotal role in maintaining the body's electrolyte balance and orchestrating responses to stress, showcasing the intricate functions of the adrenal cortex and medulla.
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and corticosterone...
Sympathetic Pathways: Collateral Ganglia and Adrenal Medulla01:27

Sympathetic Pathways: Collateral Ganglia and Adrenal Medulla

The sympathetic pathways of the collateral ganglia and adrenal medulla serve unique but interconnected roles in the sympathetic response.
Collateral Ganglia
Sympathetic preganglionic axons reach the collateral ganglia along the route of splanchnic nerves. These nerves bypass the sympathetic trunk and communicate with sympathetic postganglionic neurons housed in the prevertebral ganglia. These ganglia supply the organs of the abdominopelvic cavity.
The greater splanchnic nerve, formed by the...

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Related Experiment Video

Updated: Jul 8, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
07:43

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Silent corticotroph adenomas.

Niki Karavitaki1, Olaf Ansorge, John A H Wass

  • 1Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, UK.

Arquivos Brasileiros De Endocrinologia E Metabologia
|January 23, 2008
PubMed
Summary
This summary is machine-generated.

Silent corticotroph pituitary adenomas (SCAs) are rare tumors that lack cortisol excess symptoms. Despite surgical treatment, their aggressive behavior and recurrence potential necessitate careful management.

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Last Updated: Jul 8, 2026

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Area of Science:

  • Endocrinology
  • Neurosurgery
  • Pathology

Background:

  • Silent corticotroph pituitary adenomas (SCAs) are immunohistochemically positive for ACTH but lack clinical hypercortisolism.
  • SCAs constitute 1.1-6% of surgically removed pituitary adenomas and have unclear pathogenesis.
  • Two distinct pathological subtypes of SCAs are recognized.

Purpose of the Study:

  • To review the characteristics, clinical presentation, and management of silent corticotroph pituitary adenomas.
  • To highlight the diagnostic challenges and therapeutic considerations for SCAs.
  • To emphasize the importance of considering aggressive behavior and recurrence in SCA management.

Main Methods:

  • Review of existing literature on silent corticotroph pituitary adenomas.
  • Analysis of pathological subtypes and clinical manifestations.
  • Discussion of surgical and follow-up strategies.

Main Results:

  • SCAs typically present as macroadenomas with suprasellar extension (87-100%).
  • Local mass effects (headache, visual impairment, cranial nerve palsies, endocrine dysfunction) are common.
  • The absence of hypercortisolism manifestations remains unexplained.

Conclusions:

  • SCAs require management strategies that account for their potential for aggressive behavior and recurrence.
  • Long-term follow-up is crucial due to rare reports of recurrence, metastatic disease, and development of Cushing's syndrome.
  • Further research into SCA pathogenesis and predictive markers for recurrence is needed.