Pituitary tumors: Pathology review

00:00 / 00:00



Pituitary tumors: Pathology review

Endocrine system


Pituitary tumors: Pathology review

USMLE® Step 1 questions

0 / 7 complete


USMLE® Step 1 style questions USMLE

of complete

A 10-year-old boy is brought to the pediatrician by his parents for worsening headaches that have interfered with his ability to concentrate at school. The patient describes the pain as dull and continuous. The rest of the history is noncontributory. Vitals are within normal limits. Physical examination is unremarkable. Visual testing reveals reduced peripheral vision in both eyes. A head CT is ordered, and the results are as follows:

Image reproduced from Wikimedia Commons

The mass is surgically resected. Subsequent histology reveals calcifications as well as cysts filled with brownish, cholesterol-rich fluid. The mass is most likely a derivative of which of the following structures?  

Memory Anchors and Partner Content


While doing your rounds, you see a 6 year-old named Alex who presents with severe headaches and vision impairment which began six months ago. More specifically, he has some difficulty seeing things on the periphery, what he describes as tunnel vision. Examination reveals bitemporal hemianopia and a much taller stature than expected for his age, with disproportionately long arms and legs. Soon after, you see Maria, who says she has been unsuccessfully trying to have a baby for the last two years. She also mentions that she hasn’t had her menstruation in 3 months, but had milky nipple discharge. Hormone serum measurements were performed in both, showing an increase in insulin-like growth factor-1 levels in Alex and an increase in prolactin levels in Maria.

Now, both seem to have a disease affecting the pituitary. But first, a bit of physiology. The pituitary is a small gland situated in a tiny bony space called the sella turcica. It is linked to the hypothalamus by the pituitary stalk, and it is divided into the anterior pituitary and the posterior pituitary. The posterior pituitary is not glandular; thus it doesn’t make its own hormones. Instead, it stores and secretes oxytocin and antidiuretic hormone which are produced in the hypothalamus. By contrast, the anterior pituitary has five types of hormone producing cells. First, lactotrophs secrete prolactin, which stimulates breast milk production and inhibits ovulation and spermatogenesis. Second, somatotrophs secrete growth hormone, or GH. GH acts directly on target tissues to stimulate growth and development. Then, corticotrophs secrete adrenocorticotropic hormone, or ACTH for short. ACTH makes the adrenal glands secrete cortisol. Cortisol is in charge of the stress response and keeping blood pressure and blood sugar in the normal range. Fourth, thyrotrophs secrete thyroid stimulating hormone, or TSH. TSH makes the thyroid gland release thyroid hormones, T3 and T4. Thyroid hormones speed up the basal metabolic rate in all cells, so it keeps cellular processes going at an optimal rate. And finally, gonadotroph cells secrete luteinizing hormone, or LH, and follicle-stimulating hormone, or FSH, that stimulate ovarian or testicular production of sex cells and sex hormones.


  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  3. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  4. "Greenspan's Basic and Clinical Endocrinology, Tenth Edition" McGraw-Hill Education / Medical (2017)
  5. "The prevalence of pituitary adenomas" Cancer (2004)
  6. "Evaluation and Treatment of Adult Growth Hormone Deficiency: An Endocrine Society Clinical Practice Guideline" The Journal of Clinical Endocrinology & Metabolism (2006)
  7. "Nelson's syndrome" European Journal of Endocrinology (2010)

Copyright © 2023 Elsevier, its licensors, and contributors. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Cookies are used by this site.

USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.