Dr. Daniel Kelly, Director of the Pacific Neuroscience Institute, Pacific Brain Tumor Center & Pacific Pituitary Disorders Center, discusses the essential hormonal functions of the pituitary gland, its anatomy in relation to the surrounding skull base and brain, and the wide-ranging effect of pituitary adenomas and related tumors.

The pituitary gland is known as the master gland, because it regulates the function of the great majority of endocrine glands throughout the body. These functions include regulating the body's stress response (through adrenocorticotropic hormone -- ACTH), metabolism (through thyroid stimulating hormone -- TSH), tissue and bone growth (through growth hormone -- GH), sexual function and reproduction (through luteinizing hormone -- LH and follicular stimulating hormone -- FSH), breast feeding and milk production (through prolactin & oxytocin), and water and electrolyte balance (through vasopressin also known as antidiuretic hormone -- ADH). Pituitary tumors and cysts can cause pituitary gland dysfunction by compressing the gland affect its various functions. Symptoms of pituitary hormonal dysfunction (under-production) include fatigue, decreased energy, weight gain, light-headedness, growth delay (in children), infertility, sexual dysfunction, increased urination and increased thirst, to name a few.

The most common pituitary tumors are pituitary adenomas of which there are two major categories. Endocrine-active pituitary adenomas produce excess hormones and include those causing acromegaly from excess GH, Cushing's disease from excess ACTH, prolactinomas from excess prolactin and the rare TSH-secreting adenomas. In contrast, endocrine-inactive adenomas do not produce excess hormones and typically cause symptoms of "mass effect" which may include hormonal loss (hypopituitarism), visual loss, headaches and tumor bleeding (pituitary apoplexy). The other common tumors that may arise in the region of the pituitary gland include craniopharyngiomas, Rathke's cleft cysts, meningiomas and clival chordomas. This video provides a brief description of all these tumor types. Given the complexity of diagnosing and optimally treating pituitary tumors and related hormonal disorders this video also stresses the importance of a multidisciplinary approach to evaluating and treating pituitary patients that includes neurosurgeons, otolaryngologists (ENT surgeons), endocrinologists, neuro-ophthalmologists, radiation oncologists, neuro-pathologists and neuro-radiologists. The great majority of symptomatic pituitary tumors will warrant treatment with endonasal endoscopic surgery although prolactinomas can typically be treated with dopamine agonist medical therapy.

At the Pacific Neuroscience Institute and Pacific Pituitary Disorders Center, we have one of the world's largest experiences in endonasal endoscopic surgery and comprehensive care for pituitary adenomas and related tumors.

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