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Diagnosis and Management of Pituitary Disorders

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Título: Diagnosis and Management of Pituitary Disorders
Autores: Brooke Swearingen, MD
Beverly M. K. Biller, MD
Editorial: Humana Press, Springer Science
ISBN: 978-1-58829-922-2
Año: 2008
Edición: 1st Ed
# Páginas: 475
Idioma: Inglés
Tamaño: 40.7Mb
Categoría: Endocrinología


This book presents a comprehensive update on the current diagnostic and treatment options for the management of disease of the sella, with an emphasis on pituitary adenomas. Over the past several decades, the techniques of molecular biology have been employed to investigate the pathogenesis of these tumors, as discussed by Drs. Lania, Mantovani, and Spada in Chapter 1.

Their pathological analysis is discussed by Drs. Gejman and Hedley-Whyte in Chapter 2. The evaluation of patients presenting with sellar disease is based both on modern endocrine techniques, as discussed by Dr. Snyder in Chapter 3, as well as new imaging modalities, as discussed by Drs. Lysack and Schaefer in Chapter 4. Since Harvey Cushing first plotted visual fields, the intimate anatomic relationship between the sella and the optic structures has required careful neuro-ophthalmologic evaluation in these cases; this is discussed by Drs. Cestari and Rizzo in Chapter 5.

The management of secretory adenomas remains challenging. Prolactinomas, since the introduction of medical treatment in the 1980s, have been primarily managed with dopamine agonists as discussed by Drs. Shibli-Rahhal and Schlechte in Chapter 6. The diagnosis of acromegaly, discussed by Dr. Clemmons in Chapter 7, is made by hormonal testing and depends on reliable GH and IGF-1 assays. The treatment of acromegaly, once primarily a surgical disease, is now increasingly amenable to new medical agents, including somatostatin analogs and growth hormone receptor antagonists. The relative advantages of these approaches are discussed by Dr. Freda, and Drs. Buchfelder and Nomikos, in Chapters 8 and 9, respectively. The patient with Cushing’s disease requires an extensive and sophisticated endocrine evaluation before undergoing transsphenoidal surgery, as outlined by Drs. Findling and Raff in Chapter 10. The surgical approach is described by Dr. Kelly in Chapter 11, with options for medical treatment discussed by Drs. Lindsay and Nieman in Chapter 12. The diagnosis and treatment of the uncommon TSH adenomas is described by Drs. Zemskova and Skarulis in Chapter 13. Nonfunctioning tumors currently remain the province of the neurosurgeon, as discussed by Drs. Muh and Oyesiku in Chapter 14. Drs. Chandler and Barkan describe the surgical techniques used to remove sellar tumors in Chapter 15, while Drs. Barkan, Blank, and Chandler address the perioperative management of patients with these lesions in Chapter 16. Although advances in medical treatment and surgical techniques have made its use less frequent, radiation therapy continues to have an important role in the management of these patients, as described by Drs. Shih and Loeffler in Chapter 17. Finally, a number of specialized and clinically important topics arise in caring for patients with pituitary disorders. The diagnosis and management of inflammatory disease of the pituitary is discussed by Drs. Ulmer and Byrne in Chapter 18, the management of apoplexy by Drs. Russell and Miller in Chapter 19, and the management of pituitary disease during pregnancy by Dr. Molitch in Chapter 20.

Modern imaging techniques will sometimes demonstrate an incidental sellar abnormality when none was suspected; the evaluation of these patients is described by Dr. Frohman in Chapter 21. Although pituitary adenomas are relatively less common in children, other sellar pathologies, especially craniopharyngiomas, are more important and their endocrine management is critical in the developing child; these topics are discussed by Drs. Stanley, Prabhakaran, and Misra in Chapter 22. Finally, the management of cystic disease of the sella can be an especially thorny problem, and therapeutic options are described by Drs. Snyder, Naidich, and Post in Chapter 23.

It has been pleasure to work with some of the leading authorities in the field of pituitary disease in the preparation of this volume and we would like to thank them both for their contributions to this volume and their commitment to the field of pituitary education. In addition, we would like to thank Dr. Michael Conn and Richard Lansing of Springer publishing for conceiving this project and asking us to participate in it, and the editorial staff at Springer for their expert assistance in preparing the volume.


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