SYNDROMES OF ANTERIOR PITUITARY HYPERFUNCTION: THE PITUITARY ADENOMA



Adenomas of the pituitary gland may be non­functioning or they may secrete any of the trophic hormones normally produced by the gland. Hy­persecretion of prolactin, growth hormone, and ACTH occurs commonly, resulting in the syn­dromes of amenorrhea-galactorrhea, acromegaly, and Cushing’s syndrome, respectively. Hyperse­cretion of TSH or of gonadptropins from a pitui­tary adenoma is extremely rare. Whether or not hyperfunction of the anterior pituitary represents a primary disorder therein or is secondary to increased stimulation by hypothalamic releasing factors has still not been resolved. Even the dem­onstration of a microadenoma and reversal of the clinical abnormalities with removal of the neo­plasm does not exclude the latter possibility, since long-term follow-up is necessary to assure that the disease will not recur and pituitary mi­crosurgery is a relatively recent intervention. In the following sections we will discuss the man­agement of pituitary tumors in general as well as the pathogenesis, clinical features, and manage­ment of the specific syndromes produced by ex­cess secretion of prolactin and growth hormone.





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