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Hormones of the Pituitary Gland01:27

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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.
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The female breast is a hemispheric projection of variable size positioned anterior to the pectoralis major and serratus anterior muscles. A fascia layer composed of dense, irregular connective tissue connects it to these muscles.
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Hormones, the biochemical messengers produced by endocrine glands, are pivotal in regulating bodily functions and maintaining homeostasis. Each hormone's balance is crucial; imbalances can lead to significant physiological disruptions. Major hormones include oxytocin, cortisol, epinephrine, estrogen, testosterone, thyroxine, growth hormone, insulin, and glucagon.
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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.
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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...
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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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[Prolactinoma].

Andrea Glezer1, Marcello D Bronstein1

  • 1Laboratório de Endocrinologia Celular e Molecular, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.

Arquivos Brasileiros De Endocrinologia E Metabologia
|May 17, 2014
PubMed
Summary
This summary is machine-generated.

Prolactinomas, common pituitary tumors, cause hormonal imbalances. Dopamine agonists like cabergoline are primary treatments, but surgery or radiotherapy may be needed for resistant or invasive cases.

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Area of Science:

  • Endocrinology
  • Neurosurgery
  • Oncology

Background:

  • Prolactinomas are the most frequent pituitary adenomas, primarily impacting women of reproductive age.
  • Hyperprolactinemia, a condition of elevated prolactin, leads to hypogonadism, menstrual irregularities, infertility, and sexual dysfunction in both sexes.
  • Larger prolactinomas (macroprolactinomas) can present with headaches, visual disturbances, and hypopituitarism.

Purpose of the Study:

  • To review the clinical presentation, diagnosis, and management of prolactinomas.
  • To outline current therapeutic strategies, including pharmacological and surgical interventions.
  • To discuss the specific considerations for prolactinoma management during pregnancy.

Main Methods:

  • Review of current clinical guidelines and literature on prolactinoma management.
  • Analysis of treatment efficacy and tolerability of dopamine agonists.
  • Evaluation of indications for surgery, radiotherapy, and novel therapeutic agents like temozolamide.

Main Results:

  • Dopamine agonists, particularly cabergoline, are the first-line treatment for prolactinomas, demonstrating high efficacy and tolerability.
  • Approximately 20% of patients show partial or complete resistance to dopamine agonist therapy, necessitating alternative treatments.
  • Surgery (transsphenoidal) is indicated for treatment-resistant cases, while radiotherapy is reserved for invasive or aggressive tumors.

Conclusions:

  • Cabergoline is the preferred medical treatment for prolactinomas due to superior efficacy and tolerability.
  • Surgery and radiotherapy serve as crucial options for refractory or invasive prolactinomas.
  • Management during pregnancy involves individualized approaches, with bromocriptine often used for ovulation induction and potential suspension of dopamine agonists for smaller tumors.