APPROACH TO PITUITARY TUMOURS

APPROACH TO PITUITARY TUMOURSChairperson Dr. Raghuvansh Kumar

Speaker Dr. Vivek Rana

1

Normal Pituitary Anatomy

Lechan RM. Neuroendocrinology of Pituitary Hormone Regulation. Endocrinology and Metabolism Clinics 16:475-501, 1987

2

Normal Pituitary AnatomyPituitary gland is oval in shape, measuring 8 mm antero-posteriorly and 12 mm transversely.

It weighs around 600 mg and is located in sella turcica ventral to diaphragma sella.

It comprises anatomically and functionally distinct anterior and posterior lobes.

The sella is contiguous to vascular and neurologic structures, including the cavernous sinuses, cranial nerves and optic chiasm.

3

Normal Pituitary Anatomy

Modified from Lechan RM. Neuroendocrinology of Pituitary Hormone Regulation. Endocrinology and Metabolism Clinics 16:475-501, 1987

4

Normal Pituitary PhysiologyAnterior pituitary is often referred to as master gland because, together with hypothalamus, it orchestrates the complex regulatory function of multiple endocrine glands.The anterior pituitary gland produces 6 major hormones

Prolactin(PRH)Growth hormone(GH)Adrenocorticotropin hormone(ACTH)Luteinizing hormone(LH)Follicle stimulating hormone(FSH)Thyroid stimulating hormone(TSH)

5

EpidemiologyPituitary adenomas are most common cause of pituitary hormone hypersecretion and hyposecretion syndromes in adults.

They account for 15% of intracranial neoplasm.

At autopsy up to one quarter of all pituitary glands harbor an unsuspected microadenoma(