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Related Concept Videos

The Pituitary Gland01:17

The Pituitary Gland

The pituitary is a small endocrine organ in the sphenoid bone under the hypothalamus. Primarily, the pituitary in adults has two distinct anatomical and functional regions— the anterior and posterior lobes. During human fetal development, a third pituitary gland region called the pars intermedia atrophies and disappears. However, some of its cells migrate and exist adjacent to the anterior pituitary in adults.
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...
Hormones of the Pituitary Gland01:27

Hormones of the Pituitary Gland

The small, pea-sized pituitary gland is located at the base of the brain. It is crucial in regulating various bodily functions, from growth to reproduction. The gland is divided into the anterior lobe and the posterior lobe. The secretory cell clusters in the pars distalis of the anterior pituitary lobe are controlled by hypothalamic regulators and synthesize six primary hormones.
The most abundantly secreted hormone from the anterior lobe is the growth hormone, which controls overall growth by...
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...
The Parathyroid Glands00:59

The Parathyroid Glands

The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by producing...
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...

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

Published on: January 17, 2018

Double pituitary adenomas.

D Iacovazzo1, A Bianchi, F Lugli

  • 1Department of Endocrinology, Catholic University, Policlinico A. Gemelli, Largo A. Gemelli, 8, 00168, Rome, Italy. donatoiacovazzo@gmail.com

Endocrine
|January 18, 2013
PubMed
Summary
This summary is machine-generated.

This case study details a rare instance of double pituitary adenomas, one secreting prolactin and the other ACTH, leading to Cushing's disease. Successful surgical removal of the ACTH-producing adenoma resolved symptoms.

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Area of Science:

  • Endocrinology
  • Neurosurgery
  • Oncology

Background:

  • Double pituitary adenomas are rare, accounting for up to 2.6% of cases.
  • Approximately 3.3% of Cushing's disease patients present with double or multiple pituitary adenomas.
  • This report focuses on a unique case of metachronous pituitary adenomas.

Observation:

  • A 60-year-old male initially presented with hyperprolactinemia and a pituitary lesion treated with cabergoline.
  • The patient later developed symptoms suggestive of Cushing's disease, including weight gain and hypertension.
  • Despite initial negative MRI, bilateral inferior petrosal sinus sampling confirmed pituitary origin of ACTH excess.

Findings:

  • Histological examination confirmed an ACTH-producing microadenoma, surgically removed.
  • The prolactin-secreting adenoma, initially treated with cabergoline, showed shrinkage.
  • The patient experienced clinical improvement and secondary hypoadrenalism post-surgery.

Implications:

  • This case highlights the diagnostic challenges of multiple pituitary adenomas, particularly when presenting asynchronously.
  • It underscores the importance of thorough investigation in patients with persistent or evolving endocrine symptoms.
  • The successful management demonstrates the efficacy of combined medical and surgical approaches for complex pituitary adenoma cases.