Sellarsuprasellar tumours pituitary adenoma

Tumours of the pituitary gland constitute about 5-10% of intracranial tumours. They arise from the anterior portion of the gland and are usually benign.

Previous classification

Previously based on the light microscopic appearance of the tumour cell type.

Eosinophilic cells

Basophilic m cells

Chromophobe cells

Prolactin (PRL)

Adrenocorticotropic hormone

Thyroid-stimulating hormone (TSH)-Gonadotrophic hormones

- Follicle-stimulating hormone (FSH)

- Luteinising hormone (LH)

♦ ACROMEGALY

CUSHING'S DISEASE -THYROTOXICOSIS

PRESENT classification Recent immunoassay techniques permit a more practical classification based on the hormone type secreted. About half of the 'non-functioning' chromophobe adenomas are shown to secrete prolactin.

CLINICAL PRESENTATION

Incidence

- GH secreting tumour

20-25%

- Prolactinoma

25-50%

- ACTH secreting tumour

5-10%

- TSH secreting tumour

* rare

- FSH/LH secreting tumour J

- Inactive

25-40%.

Large tumours (macroadenomas)

Excessive secretion

Small tumours (microadenomas)

Compression of adjacent neural structures

Compression of adjacent pituitary gland, diminishing hormonal output

Panhypopituitarism

Raised intrasellar pressure - 'pituitary stalk syndrome' -

Excessive secretion

(occasionally more than one hormone secreted)

LOCAL MASS EFFECTS

ENDOCRINE EFFECTS

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