English Case reportEnglish Case reportDiagnosis and Therapy of Pituitary pseudotumor (pituitary thyrotroph hyperplasia) Neurosurgery Department English Case reportEnglish Case reportNowadays more and more lesions in saddle area are found by CT and MRI especially pituitary adenoma.Do you think all lesions in saddle area can be diagnosised pituitary adenoma?English Case reportEnglish Case reportMany patients diagnosised pituitary adenoma preoperation was demonstrated to be hyperplasia or Pituitary pseudotumor ,but not tumor.So, what led us to the misdiagnosis? English Case reportEnglish Case reportWhat is so-called “Pituitary pseudotumor or “ pituitary hyperplasia?English Case reportEnglish Case reportPituitary glandPituitary glandPituitary glandThyriod gland, suprarenal gland, ovarianThyriod gland, suprarenal gland, ovarianThyriod gland, suprarenal gland, ovarianhypothalamusThe axis of hormone control in our bodyControl functionReverse feedbackEnglish Case reportEnglish Case reportThat is to say “the shape and function of pituitary is controlled by hypothalamus and feedback-affected by target organs such as Thyriod gland suprarenal gland ovarianEnglish Case reportEnglish Case reportThe way that made these control goes is based on the hormone, such as TSH, ACTH, PRL, FSH, LH, GH T3T4, virosterone, cortisol, E2English Case reportEnglish Case reportCase 1 famale, 15years, complained “delayed growth ,acratia and a blur eyesight for 5 months. Hormone tests showed decreased T3T4 level mardkedly high TSH level(75mIU/L)English Case reportEnglish Case reportpicture A-C demonstrate a larger pitutary gland,which grow upward like a ball with a clear boundary. The optic nerve and chiasm were raised.Theres no difference between lesion and posthypophysis. Picture D shows a delayed growth of the bone in wrist(about 5-6years compared to normal children).English Case reportEnglish Case reportNow, do you still keep the diagnosis of pitutary adenoma in your mind?Why are the lesion not enhanced?How do you think about the thyriod hormone and TSH level?English Case reportEnglish Case reportIndeed, there are something strange in this case which can not be eaplained by pitutary adenoma.After the therapy of levothyroxine for 3 month, the complaint disappeared and nothing was found in MRI scan. English Case reportEnglish Case reportSo, its pituitary pseudotumor. What is so-called “pituitary pseudotumor or pituitary hyperplasia?physiologicalpathological adolescent pregnancy lactation Decreased function of the target gland the hormone therapy of great doesTumors that secrete hormone English Case reportEnglish Case reportThe most likely cause of pituitary pseudotumor is decreased function of the target gland especially thyriod gland. These patients usually come for cure with the syndrome of acratia,edema,delayed growth. Sometimes with damage of eyesight.English Case reportEnglish Case reportThe less likely cause of pituitary pseudotumor is decreased function of the target gland of ovarian and suprarenal gland with the syndrome of lactation, advanced menstruation and puberfy. English Case reportEnglish Case reportThe most important thing is precise dignosis and hormone therpy.Levothyroxine is usually accomdated, if needed, GH can be given at the same time. The Hormone level should be checked usually.English Case reportEnglish Case reportThe MRI scan should be made after 3 months therapy. If the lesion decreased,we call it pituitary pseudotumor and take the way of “look-and-see .If it grows, surgical therpy should be considered.English Case reportEnglish Case reportBefore therpyAfter 3 months hormone therpy English Case reportEnglish Case report