Pituitary Sellar Masses

by Carlo Raj, MD

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    Let’s talk about sellar masses. So, whenever you have a mass within the sella, things that you’re always looking for symptomatically are your neurologic issues, especially headaches and visual impairment. We talked about this just now. Often times these sellar masses are incidental on-on MRIs and may often times be known as incidentalomas microadenomas in normal population. So, this might have been there the whole time, an incidentaloma. Hormonal abnormalities may also occur, obviously if there are sellar masses. Here, I want to show you a second messenger system that you want to be clear about. We have GTP beta and gamma. This, as you remember from biochemistry, is inactive G-protein. What must you have so that you can have proper activation of your enzyme? You have to make sure that you hold on to your alpha, right? So, you then become an alpha, active G-protein and when you do so, you might then stimulate an enzyme called adenylyl cyclase. And that adenylyl cyclase will convert your ATP into cyclic AMP. And if you remember correctly that at some point in time, you will then remove a phosphate so that you can inactivate it and then turn into your GDP. Now, with all that said, let’s get into our topic of what’s known as MEN1, multiple-multiple endocrine neoplasia type 1. Your first thing that you want to do is, well, identify your patient. Usually, family history is taking place and when you deal with MEN1, it is a triade. The triade here is going to be called pan-para-pit, as we’ll talk about later. You’ll have pancreatic tumour, you’ll have a hyperparathyroid, hence the hypercalcemia and the kidney stone. So, some of the things that you want to pay attention to right off the bat with MEN1 is family history and...

    About the Lecture

    The lecture Pituitary Sellar Masses by Carlo Raj, MD is from the course Pituitary Gland Disorders.

    Included Quiz Questions

    1. Compression of optic chiasm
    2. Compression the visual cortex
    3. Increased intracranial pressure
    4. Hormonal abnormalities cause parasympathetic response
    5. Decreased blood flow to orbit
    1. Hyperparathyroidism
    2. Hypocalcemia
    3. Prolactinemia
    4. Increased cysteine
    5. Decreased phosphate
    1. Sheehan's syndrome
    2. PTTG
    3. MEN1
    4. FGF receptor-4
    5. Activation of alpha subunit in Gs proteins
    1. Gonadotroph adenoma
    2. Thyrotroph adenoma
    3. Corticotroph adenoma
    4. Lactotroph adenoma
    5. Somatotroph adenoma
    1. Dopamine cannot inhibit it's production
    2. TRH is overproduced
    3. Primary hypothyroidism
    4. Increased circulating TSH
    5. Cushing's disease

    Author of lecture Pituitary Sellar Masses

     Carlo Raj, MD

    Carlo Raj, MD

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