Endocrine Updates

By: Michael C. Sheppard (Editor), Paul M. Stewart (Editor)

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Hardcover | 31 August 2002

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304 Pages

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23.5 x 15.88 x 1.91

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Pituitary Disease brings together an international panel of experts who summarize the most recent and exciting advances in the diagnosis and treatment of pituitary disease. Coverage includes pathogenesis and pathology of pituitary tumors; clinical scenarios underpinning each type of pituitary tumor as well as their diagnosis and treatment. It is a useful resource for clinicians, students or researchers with an interest in the pituitary and its disorders.

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You Can Find This Book In

Non-Fiction Medicine Clinical & Internal Medicine Endocrinology Medical Diagnosis Pre-Clinical Medicine & Basic Sciences Physiology Metabolism Veterinary Medicine Veterinary Medicine for Laboratory Animals Neurology & Clinical Neurophysiology Diseases & Disorders

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Paperback

Published: 20th November 2012

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List of Figures	p. xiii
List of Tables	p. xv
Preface	p. xvii
Contributing Authors	p. xix
Etiology of Pituitary Tumours	p. 1
Introduction	p. 1
Pituitary Tumor Initiation	p. 1
Tumor models	p. 2
Oncogene Activation	p. 4
Pituitary Tumor Transforming Gene (PTTG)	p. 4
Activating gsp mutations	p. 7
Activated cAMP-response element binding proteins (CREB)	p. 8
Protein Kinase A and C	p. 8
Ras oncogenes	p. 9
Cyclin Dl	p. 9
Tumor Suppressor Genes	p. 9
Retinoblastoma (Rb)	p. 9
Cyclin-Dependent Kinase Inhibitors	p. 10
P16 / CDKN2A	p. 10
P27	p. 11
Growth Factors	p. 11
Fibroblast Growth Factors (FGF's)	p. 11
FGF-2 (Basic FGF)	p. 11
FGF-4	p. 12
Vascular Endothelial derived Growth Factor (VEGF)	p. 12
Transforming Growth Factors (TGF's)	p. 12
TGF-[beta]	p. 12
TGF-[alpha]	p. 13
Angiogenesis	p. 13
Hypothalamic Factors and Their Receptors	p. 14
GHRH and Somatostatin	p. 14
Corticotrophin releasing hormone (CRH)	p. 14
Thyrotrophin Releasing Hormone (TRH)	p. 15
Gonadotrophin Releasing Hormone (GnRH)	p. 15
Hereditary Syndromes	p. 15
Multiple endocrine neoplasia	p. 15
Carney Complex	p. 16
McCune-Albright syndrome	p. 16
Familial acromegaly	p. 16
Estrogen and Estrogen Receptor	p. 17
Transcription Factors	p. 17
Pathology of the Pituitary	p. 33
Introduction	p. 33
Normal Anterior Pituitary	p. 34
Anterior pituitary development and cytodifferentiation	p. 35
Neuropeptides, growth factors and cytokines	p. 36
Pituitary Adenomas	p. 37
Classification	p. 37
Growth hormone secreting tumours	p. 39
Prolactin secreting adenomas	p. 40
TSH secreting adenomas	p. 41
Corticotroph adenomas	p. 41
Gonadotroph adenomas	p. 42
Plurihormonal adenomas	p. 42
Non-functioning/silent adenomas	p. 42
Other investigations	p. 43
General immunohistochemistry	p. 43
Pituitary hyperplasia	p. 43
Other tumours	p. 44
Imaging the Pituitary	p. 51
Imaging Techniques and Normal Anatomy	p. 51
Pathology	p. 54
Congenital	p. 54
Pituitary Tumours	p. 56
Adenoma	p. 56
Craniopharyngioma	p. 66
Meningioma	p. 66
Other Tumours	p. 66
Non-Functioning Pituitary Tumours	p. 75
Introduction	p. 75
Definition of Non-Functioning Tumours (NFA)	p. 76
Histological classification of non-functioning tumour	p. 76
Cytogenesis of NFA's	p. 78
Incidence and prevalence of pituitary tumours	p. 79
Presentation and Evaluation of NFA	p. 81
Management of NFA's - Surgery and Radiotherapy	p. 83
What Should Be the Policy for Use of Rt for NFA's?	p. 86
Hypopituitarism is associated with increased mortality	p. 86
Prolactinoma	p. 95
Introduction	p. 95
Production and Effects of Prolactin	p. 95
Presentation	p. 97
Endocrine Effects	p. 97
Mass Effects of Pituitary Lesion	p. 97
Diagnosis	p. 98
Biochemical Evaluation	p. 98
Radiological Evaluation	p. 99
Treatment	p. 100
Why Treat?	p. 100
Dopamine Agonists	p. 101
Bromocriptine	p. 101
Cabergoline	p. 101
Quinagolide	p. 102
Pituitary Surgery	p. 103
Radiotherapy	p. 104
Monitoring Treatment	p. 104
Macroprolactinomas	p. 105
Macroadenomas with Moderate Prolactin Excess	p. 105
Microadenomas with Minimal Hyperprolactinaemia: No treatment?	p. 105
Pregnancy	p. 105
Hormone Replacement and Menopause	p. 106
Resolution of Disease and Cessation of Treatment	p. 107
Acromegaly	p. 113
Introduction	p. 113
Clinical Features of Acromegaly	p. 113
Effects on the cardiorespiratory system	p. 114
Acromegaly and cancer risk	p. 115
Diagnosis of Acromegaly	p. 116
Approach to diagnosis	p. 119
Treatment of Acromegaly	p. 119
Cure and remission of disease in acromegaly	p. 119
Mortality and disease control	p. 120
Treatment goals for acromegaly	p. 121
Approach to treatment	p. 121
Surgery	p. 121
Radiotherapy	p. 121
Medical Treatment	p. 122
Dopamine (D2) receptor agonists	p. 122
Somatostatin analogues	p. 122
GH receptor antagonists	p. 123
Summary	p. 124
Cushing's Disease	p. 127
Clinical History	p. 127
Minnie G	p. 127
Clinical Features	p. 128
Infections in Cushing's syndrome	p. 131
Vascular complications	p. 132
Sexual Dysfunction	p. 132
Psychiatric Manifestations	p. 132
Childhood Cushing's Syndrome	p. 132
Intermittent, Periodic and Cyclical Cushing's Syndrome	p. 133
Alternative Diagnoses to Cushing's Syndrome	p. 134
Biochemical Diagnosis of Cushing's Syndrome	p. 135
Serum cortisol	p. 136
Salivary cortisol	p. 136
Urinary cortisol	p. 136
Low dose dexamethasone suppression test	p. 136
Single-dose dexamethasone suppression test	p. 137
Other methods	p. 137
Differential Diagnosis of Cushing's Syndrome	p. 137
Therapeutic Intervention and Follow-Up of Cushing's Disease	p. 145
Pituitary surgery	p. 145
Methods to Determine Whether Pituitary Surgery Has Been Curative	p. 146
Clinical assessment	p. 146
Unmeasurable early serum cortisol	p. 146
Serum or urinary cortisol	p. 147
Pituitary irradiation	p. 148
Bilateral adrenalectomy	p. 149
Choice of Therapy	p. 150
Drug therapy	p. 150
Nelson's Syndrome	p. 151
Conclusions on therapy and follow-up	p. 152
Summary	p. 152
Thyrotropin-Secreting Pituitary Adenomas	p. 167
Introduction	p. 167
Occurrence	p. 168
Pathology and Molecular Aspects	p. 168
Clinical Manifestations	p. 171
Laboratory and Biochemical Findings	p. 172
Serum thyroid hormone and TSH levels	p. 172
Pitfalls in thyroid hormone and TSH determinations	p. 173
Other useful biochemical parameters	p. 174
Dynamic Testing	p. 175
Imaging Studies and Localization of the Tumor	p. 175
Differential Diagnosis	p. 176
Treatment and Outcome	p. 177
Criteria of Cure and Follow-Up	p. 179
Craniopharyngioma	p. 185
Introduction	p. 185
Pathology	p. 185
Adamantinous craniopharyngioma	p. 186
Papillary craniopharyngioma	p. 188
Epidemiology	p. 188
Aetiology	p. 189
Diagnosis	p. 189
Radiology	p. 191
Differential diagnosis	p. 191
Treatment of Primary Craniopharyngioma	p. 191
Surgery	p. 192
Adjuvant radiotherapy	p. 192
Radiosurgery	p. 193
Intracystic brachytherapy	p. 194
Intracystic bleomycin	p. 194
Treatment Outcomes in Craniopharyngioma	p. 194
Overall standard outcome data	p. 195
Surgery: gross total excision or sub-total resection?	p. 195
Adjuvant radiotherapy	p. 196
Endocrine outcomes of craniopharyngioma	p. 196
The Management of Recurrent Disease	p. 197
Monitoring of recurrent disease	p. 198
Surgery for recurrent disease	p. 198
Adjuvant radiotherapy and radiosurgery in recurrent disease	p. 198
Options for recurrent cystic disease: drainage or intracystic therapy	p. 199
Systemic treatments for recurrent and resistant disease: cytotoxic and immunomodulatory therapy	p. 199
An Integrated Approach to the Management of Craniopharyngioma	p. 201
Pituitary Incidentaloma	p. 207
Introduction	p. 207
Types of Pituitary Mass Lesions	p. 207
Autopsy Findings	p. 208
Ct and Mri Scans in Normal Individuals	p. 210
Diagnostic Evaluation	p. 211
Endocrinologic Evaluation	p. 211
Radiologic Evaluation	p. 213
Recommendations	p. 214
Summary	p. 215
Pituitary Surgery	p. 221
History of Pituitary Surgery	p. 221
Aims	p. 221
Techniques of Surgery	p. 222
Preparation for Operation	p. 222
Risks of Surgery	p. 223
Technical Aspects of Surgery	p. 223
Transcranial Surgery-Technical Aspects	p. 224
Results of Pituitary Surgery	p. 225
Non Functioning Adenoma	p. 225
Acromegaly	p. 225
Cushing's Disease	p. 225
Prolactinomas	p. 226
Pituitary Apoplexy	p. 226
Pituitary Re-Exploration	p. 226
Complications of Transphenoidal Surgery	p. 226
Nasal Complications	p. 227
Impaired Pituitary Function	p. 227
CSF Leakage	p. 227
Visual Deterioration	p. 227
Meningitis	p. 227
Syndrome of Inappropriate Anti-diuretic Hormone Release (SIADH)	p. 228
Complications of Transfrontal Surgery	p. 228
Frontal Lobe Damage	p. 228
Optic Nerve Damage	p. 228
Vascular Damage	p. 228
Hypothalamic Damage	p. 228
Surgical Experience	p. 229
Future	p. 230
Radiotherapy for Pituitary Tumours	p. 233
Testing of Hypothalamo-Pituitary Axis	p. 247
Introduction	p. 247
Prolactinoma	p. 248
Acromegaly	p. 248
Cushing's Syndrome	p. 249
TSH-Secreting Pituitary Adenoma	p. 250
Nonfunctioning Pituitary Adenoma	p. 251
Diabetes Insipidus	p. 251
GH Deficiency in Adults	p. 252
ACTH Deficiency	p. 253
Hypothyroidism	p. 254
Hypogonadism	p. 255
Hypothalamic-Pituitary Axis Testing	p. 256
Oral glucose tolerance test (OGTT)	p. 256
TRH stimulation test	p. 256
GnRH stimulation test	p. 257
GHRH stimulation test	p. 257
Arginine stimulation test	p. 257
Low dose DST	p. 258
Standard high-dose DST	p. 258
Metyrapone test	p. 258
CRH stimulation test	p. 259
ACTH stimulation test	p. 259
Insulin tolerance test (ITT)	p. 259
Clomiphene stimulation test	p. 260
Fluid deprivation/DDAVP test	p. 260
Table of Contents provided by Syndetics. All Rights Reserved.

Endocrine Updates

At a Glance

Hardcover

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How to return your order

Defective items

You Can Find This Book In

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