Showing papers on "Hypophysectomy published in 2014"
TL;DR: The authors report two cases of a plurihormonal pituitary adenoma expressing the rare combination of ACTH and GH, and long-term post-operative follow-up revealed no evidence of tumour recurrence.
Abstract: Plurihormonal pituitary adenomas are tumours that show immunoreactivity for more than one hormone that cannot be explained by normal adenohypophysial cytodifferentiation. The most common combinations in these adenomas include growth hormone (GH), prolactin (PRL) and one or more glycoprotein hormone sub-units (β-TSH, β-FSH, β-LH and αSU). The authors report two cases of a plurihormonal pituitary adenoma expressing the rare combination of ACTH and GH. They both underwent successful transphenoidal hypophysectomy (TSH). Long-term post-operative follow-up revealed no evidence of tumour recurrence. Due to the multiple secretions and plurihormonal characteristics clinical diagnosis of composite pituitary adenomas can be difficult. The authors discuss the diagnosis and management of composite pituitary adenomas and review the literature regarding this rare phenomenon.
17 citations
01 Jan 2014
TL;DR: The genetic and molecular regulation of POMC, the processing and secretion of ACTH under physiological and pathological conditions, and how ACTH and the adrenal interact in health and disease are reviewed.
Abstract: Adrenal derived production and secretion of corticosteroids under control of pituitary-derived adrenocorticotropic hormone (ACTH) plays a central role in maintaining equilibrium during chronic stressful conditions. A 39-amino acid bioactive peptide, ACTH, is under the control of hypothalamic-derived corticotrophin releasing hormone (CRH), and this hypothalamic-pituitary-adrenal (HPA) axis regulates cell proliferation and vascularity to preserve adrenal cortex growth and organ architecture. The critical role of ACTH in adrenal hemostasis is highlighted by early observations of adrenal cortical atrophy following hypophysectomy, the profound phenotype of human proopiomelanocortin (POMC) gene defects resulting in obesity, hypopigmentation and adrenal dysfunction, and the small litter size in homozygous POMC null mice due to massive perinatal lethality. This article reviews the genetic and molecular regulation of POMC, the processing and secretion of ACTH under physiological and pathological conditions, and how ACTH and the adrenal interact in health and disease.
1 citations
01 Jan 2014
TL;DR: A situation in which gonadotrophin concentrations are so low as to be completely unable to stimulate follicle development and oestrogen production from the ovaries, there are several possible causes, which may be hypothalamic or pituitary origin.
Abstract: Hypogonadotrophic-hypogonadism (hypothalamic-pituitary failure -WHO Group I), is a situation in which gonadotrophin concentrations are so low as to be completely unable to stimulate follicle development and oestrogen production from the ovaries. Anovulation, amenorrhea and hypo-oestrogenism are the consequences. There are several possible causes for this condition which may be hypothalamic or pituitary. Hypothalamic causes include: Weight-related amenorrhea, stress, strenuous exercise, Kallmann’s syndrome, craniopharyngioma, debilitating systemic diseases, idiopathic. Pituitary causes: Hypophysectomy, radiotherapy, Sheehan’s syndrome. If infertility is not a concern, every patient with hypogonadotrophic-hypogonadism over the age of menarche should be treated with hormone replacement therapy with cyclical oestrogen and progestins. For those desiring a pregnancy, if the pituitary is intact and the hypothalamus is failing to function, ‘replacement therapy’ with pulsatile GnRH is highly effective, if a little cumbersome. Direct stimulation of the ovaries with gonadotrophins serves the purpose for ovulation induction whether the cause is of hypothalamic or pituitary origin. If the cause of the amenorrhea is an extreme low body weight, every attempt should be made to increase weight before starting treatment.