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Related Concept Videos

The Pituitary Gland01:17

The Pituitary Gland

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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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Cushing Syndrome II: Pathophysiology01:19

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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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Cushing Syndrome I: Introduction01:26

Cushing Syndrome I: Introduction

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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...
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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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Related Experiment Video

Updated: Apr 28, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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[Clinically Non-Functioning Pituitary Adenoma/Pituitary Neuroendocrine Tumor (PitNET)].

Shigeyuki Tahara1

  • 1Department of Neurological Surgery, Nippon Medical School Musashikosugi Hospital.

No Shinkei Geka. Neurological Surgery
|April 27, 2026
PubMed
Summary

Non-functioning pituitary neuroendocrine tumors (PitNETs) are common and often found due to mass effects. This review details their diagnosis, pathology, and endoscopic endonasal transsphenoidal surgery (eTSS) for optimal outcomes.

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Area of Science:

  • Neurosurgery
  • Endocrinology
  • Pathology

Background:

  • Clinically non-functioning pituitary neuroendocrine tumors (PitNETs) are the most common pituitary tumors, often discovered due to mass effects like visual impairment or as incidental findings.
  • The 2022 World Health Organization classification renames pituitary adenomas to PitNETs, acknowledging their diverse biological nature.

Purpose of the Study:

  • To review diagnostic evaluations, surgical indications, pathological characteristics, and surgical techniques for non-functioning PitNETs using endoscopic endonasal transsphenoidal surgery (eTSS).

Main Methods:

  • Preoperative assessment involves detailed endocrine evaluation and MRI to define tumor extent and neurovascular relationships.
  • Surgical intervention is the primary treatment for symptomatic tumors; asymptomatic cases with radiological risk factors are also considered.
  • Pathological review categorizes heterogeneous PitNET subtypes based on transcription factors, noting aggressive behaviors in some.

Main Results:

  • Endoscopic endonasal transsphenoidal surgery (eTSS) techniques, including intrasellar, extracapsular, and extended approaches, are discussed for safe and effective tumor resection.
  • Individualized surgical strategies tailored to specific tumor characteristics are crucial for achieving optimal patient outcomes.

Conclusions:

  • Effective management of non-functioning PitNETs requires a comprehensive approach integrating advanced diagnostics, pathological understanding, and tailored surgical techniques.
  • Endoscopic endonasal transsphenoidal surgery offers a safe and effective modality for resecting these tumors, emphasizing personalized treatment plans.