Prolactinoma Essay

5. It is expected that after his transsphenoidal hypophysectomy, all of B.J.’s anterior pituitary hormones will be deficient (panhypopituitarism). What type of hormone replacement will be needed?

Dr Jennifer Chan, the head of this tumor research, is an Associate Professor & Neuropathologist in the Department of Pathology & Laboratory Medicine, Oncology, and Clinical Neuroscience in the University of Calgary. Besides her work on education, she is also directing a tumorigenesis research team at the University of Calgary, and a tumor banking program which supports pediatric cancer research. Nonetheless, she is also a member of both the Southern Alberta Cancer Research Institute and the Experimental and Applied Therapeutics Program (ExpAT).

2. Vitamin D- A group of steroids; resistant to heat, oxidation, acids, and bases; stored in liver, skin, brain, spleen, and bones. Promotes absorption of calcium and phosphorous; promotes development of teeth and bones. Sources: produces in skin exposed to ultraviolet light; in milk; egg yolk; fish liver oils; fortified foods. Excess: Diarrhea calcification of soft tissues, renal damage. Deficienceis: Rickets,bone decalcification and weakening.

What are the most common genetic/chromosome changes related to this form of cancer? Which genes are responsible? Where are these genes located? How are the genes different from normal individuals?

Vitamin D plays a critical role in many normal bodily functions as well as fighting against a wide number of health barriers. In an article by Jacqueline Kanopa, studies revealed that exposure to ultraviolet rays play a huge part in Vitamin D production, as well as having preventative effects on a disorder known as rickets; which leads to weakened bones due to lack of Vitamin D. This study supports the belief that exposure to UV rays play a critical role in Vitamin D production, and can be beneficial to those prone to certain

Paragangliomas are rare neuroendocrine tumors that arise from the extra-adrenal autonomic paraganglia, small organs consisting mainly of neuroendocrine cells that are derived from the embryonic neural crest and have the ability to secrete catecholamines (1). They are closely related to pheochromocytomas, which are sometimes referred to as intra-adrenal paragangliomas (2). The majority appear to be sporadic, but approximately one-third to one-half are associated with an inherited syndrome (3, 4). The four genetic syndromes that are associated are: multiple endocrine neoplasia 2A and 2B, neurofibromatosis type 1, von Hippel Lindau, and the Carney-Stratakis dyad. The male-to-female ratio is approximately equal among patients with hereditary paraganglioma,

This pituitary tumor can also be referred to as a pituitary adenoma, and they are most often benign. This form of Cushing’s syndrome is more common in women and is the most common form of endogenous Cushing’s disease. The tumor of the pituitary gland secretes overly large amounts of ACTH, which then stimulates the adrenal glands to produce and secrete more cortisol than necessary. Another tumor-related cause of Cushing’s syndrome is when a tumor forms on an organ that does not usually produce ACTH. The tumor produces and secretes excess ACTH which then leads to the overproduction of cortisol. These tumors are called ectopic ACTH-secreting tumors, and they can be malignant or benign. Ectopic ACTH-secreting tumors are commonly found in the pancreas, thyroid, thymus gland, and lungs.

Serum cholesterol rates have been the most reliable means of predicting remission after pituitary surgery to manage Cushing's. However, this study suggests that surgery is not always the best option, and often results in a cyclic form of hypercortisolism.

“The pituitary adenoma itself may put pressure on the remaining normal part of the pituitary gland and limit or destroy its ability to produce hormones appropriately” (Stewart & Vance). With the increase in tumor pressure the patient may experience nausea and vomiting. The pituitary adenoma may cause body hair loss, sexual dysfunction, increase frequency and increase amount of urination. The pituitary adenoma is growth hormone secreting tumor causing the hands and feet to enlarge (www.mayoclinic.org). A growth hormone adenoma is the reason for the unexplained weight gain and the change in shoe size from 10 to 12.

 In the presence of sunlight a sterol (7-Dehydrocholesterol) is converted to vitamin D3. Vitamin D3 is needed for our bones and teeth to grow and is important in making certain types of antibodies. Vitamin D3 also plays an important role in the absorption of calcium for our bones. Relation to Skeletal System – Skin protects the bones, but also synthesizes the vitamin D3 that bones need for normal calcium absorption and deposit of bone (calcium) salts, which make bones hard.

PMP is a rare type of cancer that begins in your appendices as a small growth called polyp. It can also start in your bowel, ovary, or bladder.

Pulmonary neuroendocrine tumors comprise a spectrum of tumors including low grade neuroendocrine tumors (typical carcinoids), intermediate grade neuroendocrine tumors (atypical carcinoids) and high grade neuroendocrine tumors (large cell neuroendocrine and small cell carcinomas). Carcinoid tumors comprise about 0.5 to 5% of all lung tumors and are malignant tumors with the potential to metastasize.2-4 Typical carcinoids comprise about 90% of all pulmonary carcinoids and show a high degree of differentiation, rare mitoses (<3 mitotic figures/10 hpf), scarce pleomorphism or necrosis. The remaining 10% are atypical carcinoids, which are characterized by increased mitotic activity (>3 but <10 mitoses/ 10 hpf, cellular atypia and increased pleomorphism or necrosis. Atypical carcinoids tend to have a higher rate of metastasis and are larger at the time of diagnosis.4 Specimens with >10 mitoses/10 hpf are either small cell or large cell neuroendocrine carcinomas. Of these features, it has been shown that only the number of mitoses is a predictor for prognosis.5

Polyps are small, abnormal growths that occur on the lining of the colon. They vary in size from about a millimeter to several centimeters wide. While most polyps are not pre-cancerous or even have the potential to become cancerous, the connection between some types of polyps and colon cancer has been well-established.

Pheochromocytoma is an adrenal gland tissue tumor. (PubMed) This growth is a result of excessive release of catecholamine’s (hormones). Norepinephrine and epinephrine are the primary hormones secreted while some can produce dopamine. (Medscape) These increased chemicals in the body can influence the persons “heart rate, blood pressure and metabolism”. (PubMed) If not treated these tumors affect the cardiovascular system and can lead to the development of “life threatening hypertension”. (Medscape) These tumors can be seen as a single mass or multiple tumors and can appear unilateral or bilateral in the body. (PubMed) Thirty percent of pheochromocytoma cases are found to be heredity where ten genes have been linked to the condition. Ten percent of pheochromocytomas are malignant and the most common sites of metastasis include “liver, bone and lymph nodes”. (Medscape)

The role of the skin in maintaining adequate serum vitamin D (VD) levels has been well established [6]. VD, or calciferol, is a liposoluble prohormone available in two forms: VD2 and VD3. Many studies have suggested that VD is essential for bone health because of its role in the regulation of calcium and phosphate