Items tagged “pituitary”
21 results found
Article
Craniopharyngioma (historical)
Craniopharyngioma is a term used to denote two separate entities (adamantinomatous craniopharyngiomas and papillary craniopharyngiomas), both relatively benign (WHO grade 1) neoplasms that typically arise in the sellar/suprasellar region.
Terminology
Until the 5th edition (2021) of the WHO cla...
Article
Lymphocytic hypophysitis
Lymphocytic hypophysitis is an uncommon non-neoplastic inflammatory condition that affects the pituitary gland. It is closely related to other inflammatory conditions in the region, namely orbital pseudotumor and Tolosa-Hunt syndrome.
Epidemiology
Lymphocytic hypophysitis is seen most frequent...
Article
Pituitary gland
The pituitary gland (a.k.a. hypophysis cerebri), together with its connections to the hypothalamus, acts as the main endocrine interface between the central nervous system and the rest of the body.
Gross anatomy
The pituitary gland sits atop the base of the skull in a concavity within the sph...
Article
Pituitary apoplexy
Pituitary apoplexy is an acute clinical condition caused by either hemorrhagic or non-hemorrhagic necrosis of the pituitary gland. Although presentation is variable, it typically comprises headache, visual deficits, ophthalmoplegia, and altered mental status. An existing pituitary macroadenoma i...
Article
Pituitary stalk
The pituitary stalk, also known as the infundibulum or infundibular stalk, is largely outside the blood brain barrier like the rest of the pituitary and therefore normally enhances following the administration of gadolinium. It gradually tapers inferiorly, and superiorly is spread by the infundi...
Article
Pituitary stalk abnormal enhancement (differential)
Abnormal nodular enhancement of the pituitary stalk can be seen in a number of entities.
Differential diagnosis
tumors
germinoma
craniopharyngioma
hypothalamic glioma
pituitary lymphoma
pituicytoma
granular cell tumor of the pituitary (pituitary choristoma)
pilocytic astrocytoma of the...
Article
Rathke cleft cyst
Rathke cleft cysts, also known as pars intermedia cysts, are non-neoplastic, sellar or suprasellar epithelium-lined cysts arising from the embryologic remnants of Rathke pouch in the pituitary gland. They are common lesions and usually incidentally identified.
Epidemiology
common, found in ~1...
Article
Inferior hypophyseal arterial circle
The inferior hypophyseal arterial circle, also known as the inferior capsular arterial rete, is an anastomotic arterial network formed around the base of the pituitary gland by branches from three vessels, themselves branches off the cavernous portion of the carotid artery. They are:
inferior h...
Article
Granular cell tumor of the pituitary region
Granular cell tumors of the pituitary region, also known as pituitary choristomas, are rare low-grade tumors of the posterior pituitary and infundibulum.
Terminology
Care must be taken when reading older literature as granular cell tumors of the pituitary region, and alternative names includi...
Article
Pituitary tumors
Pituitary tumors, in other words, tumors which arise from the pituitary gland itself, include:
pituitary adenoma
pituitary microadenoma
pituitary macroadenoma
pituitary carcinoma
pituicytoma
pituitary metastases
spindle cell oncocytoma (rare)
pituitary blastoma 2
Often the term is used ...
Article
Sheehan syndrome
Sheehan syndrome is a rare cause of pituitary apoplexy and hypopituitarism. It only occurs in postpartum females who experience large volume hemorrhage and hypovolemic shock, either during delivery or afterward with resultant necrosis of anterior pituitary cells 4.
Epidemiology
Advances in obs...
Article
Pituitary region mass with intrinsic high T1 signal
Pituitary region masses with intrinsic high T1 signal, also referred to as suprasellar hotspots, are relatively frequently encountered, and the presence of high T1 signal narrows the differential somewhat.
Differential diagnosis
The differential can be divided by the substance causing the T1 ...
Article
Solid and enhancing pituitary region mass
Solid pituitary lesions with enhancement are by far the most commonly encountered appearance of pituitary region masses.
Differential diagnosis
macroadenoma
by far the most common entity
typically enhances less vividly than other entities
elevates the dura of the diaphragma sella (as the or...
Article
Mixed cystic and solid pituitary region mass
A mixed cystic and solid pituitary region mass has a limited differential.
Differential diagnosis
craniopharyngioma
both papillary (more solid) and adamantinomatous (more cystic)
macroadenoma
cystic change / necrosis / previous hemorrhage
Most other solid and enhancing pituitary region mas...
Article
Mostly/purely cystic pituitary region masses
Mostly/purely cystic pituitary region masses have a short differential.
Differential diagnosis
Rathke cleft cyst
arachnoid cyst
empty sella
craniopharyngioma (adamantinomatous type): 90% have calcification
epidermoid cyst
Article
Purely intrasellar pituitary mass
Purely intrasellar pituitary masses have a similar differential as the more generic pituitary region mass gamut, or the mnemonic SATCHMO, although some entities are far more common than others.
Differential diagnosis
pituitary hyperplasia
pituitary microadenoma
Rathke cleft cyst
intracrania...
Article
Ectopic posterior pituitary
An ectopic posterior pituitary reflects a disruption of normal embryogenesis of the posterior pituitary and is one of the more common causes of pituitary dwarfism. Although it can be an isolated abnormality, numerous other congenital central nervous system malformations have been identified. Whe...
Article
Pituitary lymphoma
Pituitary lymphoma is very rare, although lymphomatous (or leukemic) infiltration of the perisellar dura is not infrequently encountered as part of more widespread CNS disease. This article concerns itself with involvement of the pituitary itself rather than the region more broadly. For a genera...
Article
Transsphenoidal hypophysectomy
Transsphenoidal hypophysectomy is a commonly used surgical approach for pituitary region masses, with many significant advantages over open craniotomy.
History
The transsphenoidal approach was first described in 1907 by Schloffer, modified by Halstead and subsequently popularized by Harvey Cu...
Article
Pituitary region masses (most common)
The five most common masses in the pituitary region are:
pituitary macroadenoma
meningioma
aneurysm
craniopharyngioma
suprasellar pilocytic astrocytoma
Craniopharyngioma and suprasellar pilocytic astrocytoma are common in children, and pituitary macroadenoma, meningioma, aneurysm are mostl...