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29 matches in All Departments
Master of all endocrine activity and executive organ of one's
quality of life, the pituitary gland is tightly lodged in the"
turkish saddle. " As a bony container, the sella turcica is to the
hypophysis what the skull is to the brain; it can therefore be
looked upon as a little vault within the cranial vault. Just as the
cranium is moulded by the growth of the brain, so is the sella
fashioned by its content. It becomes locally enlarged in response
to expanding intrasellar lesions, and it tends to return to its
original size and shape upon their removal or destruction.
Pituitary adenomas have in the past been diagnosed upon enlargement
of the sella turcica. In the past decade, as a direct result of
interdisciplinary coopera- tion, we have learned that tiny
adenomas, the immediate cause of some cases of acromegaly,
amenorrhea-galactorrhea syndrome, or Cushing's disease, can exist
with minimal or no observable effect on the size of the sella. The
break- through started when radioimmunoassay, as a new method of
accurately measur- ing specific hormonal output, indicated
selective pituitary oversecretions in pa- tients with normal-sized
sellae. Neurosurgeons highly skilled in the transsphenoi- dal
approach with the surgical microscope were obliged to operate on
some of these patients and confirmed the presence of tiny
oversecreting adenomas in their pituitary glands.
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