Pituitary Disorders

Sylvia Asa, MD, PhD, Clinical Department Head, Department of Laboratory Medicine and Pathobiology, University of Toronto, University Health Network and Ontario Cancer Institute, Toronto, Canada. Edward R. Laws, MD, FACS, Director, Pituitary/Neuroendocrine Center, Department of Neurosurgery, Brigham & Women's Hospital, Harvard University, Boston, Massachusetts, USA. Shereen Ezzat, FACO, FRCPC, MD, Professor of Medicine & Oncology Head, Endocrine Oncology Site Group, Princess Margaret Hospital, Ontario Cancer Institute, University Health Network, Toronto, Ontario, Canada. Linda Rio, MA, MFT, Pituitary Network Association, Los Angeles, California, USA.

List of Contributors, ix

Introduction, xiv
Robert Knutzen

Abbreviations, xvi

Section 1: Overview

1 The Endocrine System, 3
Sylvia L. Asa and Shereen Ezzat

2 Signs and Symptoms of Pituitary Disease, 13

Physical Manifestations of Pituitary Disorders, 13
Eva Fernandez-Rodriguez, Ignacio Bernabeu, and Felipe F. Casanueva

Emotional Manifestations of Pituitary Disorders, 15
Eva N. Kassi, Gregory A. Kaltsas, and George P. Chrousos

Mental Health Aspects of Pituitary Disorders, 17
Valerie Golden

Section 2: Disorders

3 Acromegaly, 23
Shereen Ezzat

4 Secondary Adrenal Insuffi ciency, 32
Tobias Else and Richard J. Auchus

5 Adult Growth Hormone Deficiency, 47
T. Brooks Vaughan III, Kristen Owen Riley, and Lewis S. Blevins Jr.

6 Pituitary Carcinoma, 55
Sylvia L. Asa

7 Craniopharyngioma, 59
Jessica K. Devin

8 Cushing’s Syndrome, 67
Lewis S. Blevins Jr.

9 Empty Sella Syndrome, 77
Michael C. Oh and Manish K. Aghi

10 Familial Pituitary Adenomas, 87
Laura C. Hernández-Ramírez and Márta Korbonits

11 Follicle Stimulating Hormone and Luteinizing Hormone Secreting Tumors, 111
Bahram Khazai, Ronald S. Swerdloff, and Christina Wang

12 Hypopituitarism, 120
Klara J. Rosenquist and Ursula B. Kaiser

13 Clinically Nonfunctioning Pituitary Adenomas, 130
Brandon A. Miller, Adriana G. Ioachimescu, and Nelson M. Oyesiku

14 Prolactinoma, 138
Luis G. Sobrinho

15 Rathke’s Cleft Cysts, 146
Seunggu J. Han, Arman Jahangiri, and Manish K. Aghi

16 Thyroid Hormone Deficiency, 153
Whitney W. Woodmansee

17 Thyroid Stimulating Hormone Secreting Tumor, 159
Andrea Lania, Luca Persani, and Paolo Beck-Peccoz

18 Pituitary Disorders – Specific Issues for Women, 167
Maria Fleseriu, Christine G. Yedinak, Jessica Brzana, and Shirley McCartney

19 Hypogonadism and Male Sexual Function, 179
Prasanth N. Surampudi, Christina Wang, and Ronald S. Swerdloff

20 Pituitary Disorders Specific to Children, 193
Kathryn Pade and Mitchell E. Geffner

Section 3: Diagnosing Pituitary Disorders

21 Physical Examination , 207
Laurence Katznelson

22 Pituitary Endocrine Function Testing , 213
Shereen Ezzat

Section 4: Treatment of Pituitary Disorders

23 Medical Management of Pituitary Adenomas , 227
Paolo Cappabianca, Daniel M. Prevedello, Michelangelo de Angelis, Andressa Bornschein, Leo F. S. Ditzel Filho, Domenico Solari, Ricardo L. Carrau, Felice Esposito, Danielle de Lara, Luigi M. Cavallo, and Annamaria Colao

24 Surgical Management of Pituitary Disorders , 243

Pure Endoscopic Transsphenoidal Surgery, 243
Gautam U. Mehta and John A. Jane Jr.

Open Transcranial Approaches to the Sella, 245
Ian F. Dunn

Endoscopic Skull Base Approaches, 247
Tong Yang and Theodore H. Schwartz

Transnasal Endoscope-Assisted Transsphenoidal Approach for Pituitary Tumors, 248
Huy T. Duong and Daniel F. Kelly

25 Stereotactic Radiosurgery for Pituitary Adenomas, 255
Brian J. Williams, Stephen J. Monteith, and Jason P. Sheehan

26 Hormone Replacement Therapy, 265

Growth Hormone Deficiency in Adults, 265
Joseph A. M. J. L. Janssen and Aart Jan van der Lely

Growth Hormone Deficiency in Children and Adolescents, 269
Alan D. Rogol

Pituitary Hormone Replacement in Women, 272
Adriana G. Ioachimescu

Section 5: Complications that Accompany Pituitary Disease

27 Complications of Pituitary Disease, 279

Cardiac Complications, 279
Ludovica F. S. Grasso, Alessia Cozzolino , and Annamaria Colao

Cognitive Dysfunction, 280
Krystallenia I. Alexandraki, Gregory A. Kaltsas, and George P. Chrousos

Diabetes Insipidus, 281
Marco Faustini-Fustini and Giorgio Frank

Headaches, 282
Paul B. Rizzoli

Obesity, 283
Andrea L. Utz

Osteoporosis, 284
Andrea L. Utz

Permanent Hormone Deficiency, 285
Andrea L. Utz

Visual Deficits Caused by Pituitary Tumors, 286
Sashank Prasad

Section 6: General Psychological and Psychosocial Effects

28 General Psychological and Psychosocial Effects of Pituitary Disorders, 293
Valerie Golden

Section 7: Long Term: What You and Your Patients Can Expect

29 Living with Pituitary Disease, 303
Jessica K. Devin

Section 8: Research and Clinical Trials

30 Research and Clinical Trials, 313
Brittany P. Sumerel and Anthony P. Heaney

Section 9: Resources

31 Fundamentals of Pituitary Pathology, 325
Sylvia L. Asa

Glossary, 333
Pejman Cohan

Index, 347