This document discusses various endocrine disorders and tumors, including: - Pituitary tumors, which are most commonly benign adenomas. Rare pituitary cancers exist. - Thyroid neoplasms include benign adenomas and follicular/papillary carcinomas. Papillary is most common. - Parathyroid disorders include hyperparathyroidism from benign tumors and rare parathyroid cancer. - Pancreatic endocrine tumors include benign insulinomas and rare glucagonomas/somatostatinomas. - Adrenal cortex tumors include benign adenomas and rare carcinomas. The adrenal medulla can have pheochromocytomas.

1. Benign and Malignant
Endocrine Disorders

2. Endocrine Glands
• PITUITARY
• ANTERIOR
• POSTERIOR
• THYROID
• PARATHYROID
• PANCREAS (endo.)
• ADRENAL
• CORTEX
• MEDULLA

3. BETTER ALGORHYTHM
• PITUITARY
• ANTERIOR
• POSTERIOR
• THYROID
• PARATHYROID
• PANCREAS (endo.)
• ADRENAL
• CORTEX
• MEDULLA
• NON-NEOPLASTIC
• HYPER-function
• HYPO-function
• NEOPLASTIC
• FUNCTIONAL
• NON-FUNCTIONAL

4. Pituitary Tumors
A tumor is an abnormal growth of cells. Tumor can start nearly anywhere in the body.
Tumors that start in the pituitary gland are called pituitary tumors. Almost all pituitary
tumors are benign (non-cancerous) glandular tumors called pituitary adenomas.
Pituitary carcinomas
Cancers of the pituitary gland are rare. Only a few hundred have ever been described in
medical journals. They can occur at any age but most are found in older people.
Other Tumors of the pituitary region
There are several other types of benign tumors that grow in the region of the pituitary,
as well as some malignant (cancerous) ones. All are much less common that pituitary
adenomas.
Teratomas, germinomas, and choriocarcinomas are all rare tumors that usually occur in
children or young adults.

6. ANTERIOR PITUITARY
•ACIDOPHILS
•GROWTH HORMONE
•PROLACTIN
•BASOPHILS
•TSH
•ACTH
•LH, FSH

7. POSTERIOR PITUITARY
•OXYTOCIN (contracts uterine
smooth muscle)
•VASOPRESSIN (ADH)
(vasoconstriction, gluconeogenesis, platelet
aggregation, release of Factor-VIII and vWb factor,
concentrates urine, main effects on kidney and
brain)

8. PITUITARY TUMORS
• CLINICAL FEATURES, mimic the endocrine effects or mass effects)
• FUNCTIONING ADENOMAS
• HYPO-PITUITARISM
• POSTERIOR PITUITARY SYNDROMES
• HYPOTHALAMIC (SUPRASELLAR) TUMORS

9. CLINICAL FEATURES
• HYPER: growth, lactation, thyroid, adrenal cortex
• HYPO: growth, thyroid, adrenal cortex
• MASS EFFECT: visual fields, brain

10. GALACTORRHEA:
Galactorrhea in a young woman (non pregnant of course) is often the expression of an
acidophil tumor of the adenohypophysis.

11. GIGANTISM
(excess
somatotropin
[GH]
BEFORE
epiphyseal
closure)

12. ACROMEGALY:
(excess somatotropin
[GH] AFTER
epiphyseal closure)

13. MOON
FACIES
BUFFALO
HUMP
STRIAE
CUSHING’S DISEASE

14. Normal pituitary. Pituitary Adenoma
Pituitary Adenoma

16. Management of Pituitary and Hypothalamic tumors :

17. Thyroid
Thyroid neoplasm is a neoplasm or tumor of the thyroid. It can be benign tumor such as
thyroid adenoma or it can be a malignant neoplasm (thyroid cancer), such as papillary,
follicular, medullary or anaplastic thyroid cancer. Most patients are 25 to 65 years of age
when first diagnosed; women are more affected than men. The estimated number of new
cases of thyroid cancer in the United States in 2010 is 44,670 compared to only 1,690
deaths. Of all thyroid nodules discovered, only about 5 percent are cancerous, and under 3
percent of those result in fatalities.
• Types of Thyroid Cancer
• There are 4 main types of thyroid cancer, and some are more common than others.
• Thyroid cancer type and incidence
• Papillary and/or mixed papillary/follicular thyroid cancer:-80%
• Follicular and /or Hurthle cell thyroid cancer :-15%
• Medullary thyroid cancer :-3%
• Anaplastic thyroid cancer :- 2%

18. Thyroid Neoplasms
Benign
1. Adenoma
•Follicular
•Hurthle cell
2. Teratoma

19. Thyroid Neoplasms
Malignant Tumours:
Papillary
Follicular
Hurthle cell
Anaplastic

20. Papillary carcinoma
• Most common – 60 to 70%.
• Least aggressive cancer.
• Prolonged course.
• 3rd and 4th decades of life.
• More common in women.

21. Treatment
• Near total/total thyroidectomy
• Lobectomy/Hemithyroidectomy
• Modified neck dissection
• TSH suppression

22. Follicular carcinoma
• Occurs in the fifth decade
• More common in females
• 15% of thyroid malignancies
• Occurs more frequently in iodine deficiency areas
• More aggressive and dangerous
• Blood stream spread

23. Treatment
• Total thyroidectomy/Near total thyroidectomy
• Radioiodine
• External beam radiation
• Chemotherapy
• TSH suppression

24. Parathyroid Disorder
Parathyroid Cancer is a very rare disease. Almost all cases of hyperparathyroidism are caused by non-
cancerous (benign) parathyroid tumors. Parathyroid disease is caused by single bad parathyroid gland
(a benign parathyroid tumor about 75-80% of the time)
Parathyroid glands are located in the neck, on the thyroid gland. Most people have four pea sized, oval-
shaped parathyroid glands. Endocrine glands, such as the thyroid and parathyroid, secrete hormones,
which are natural chemicals that regulate body functions.
• Patients with parathyroid cancer have symptoms including:
• Bone Pain
• Kidney disease
• Confusion
• Extremely high level of parathyroid hormone in the blood
• Hoarseness
• Neck masses that can be felt with the hand

25. PARATHYROID DISORDERS
•HYPER-
• PRIMARY (usually adenomas)
• SECONDARY
•HYPO-: Surgical, congenital, familial, idiopathic
•PSEUDO-HYPO-
• (end organ resistance)

26. HYPER-PARATHYROIDISM
• Bone pain, fractures
• Nephrolithiasis
• Constipation, ulcers, gallstones
• Depression, lethargy
• Weakness, fatigue

27. HYPO-PARATHYROIDISM
•Neuromuscular irritability
•Mental status change
•Widened QT interval
•Defective, carious, teeth

28. ENDOCRINE
PANCREAS

29. NEOPLASMS of the Endocrine Pancreas
• Islet cell tumors
• Beta cells INSULINOMAS (NOT rare)
• Alpha cells GLUCAGONOMAS (rare)
• Delta cells SOMATOSTATINOMAS (rare)

30. Pancreatic Cancer
Most pancreatic cancers are exocrine cancers. Pancreatic neuroendocrine
cancers. Pancreatic neuroendocrine tumors (NETs), or islet cell tumors, are less
common but tend to have a better outlook (prognosis).
Which treatments are used for pancreatic cancer?
• Depending on the types and stage of the cancer and other factors, treatment
options for people with pancreatic cancer can include:
• Ablation or embolization treatments
• Radiation therapy
• Chemotherapy and other drugs.
Pain control is also an important part of treatment for many patients.

31. NEOPLASMS
• ADENOMAS of ADRENAL CORTEX
• CARCINOMAS of ADRENAL CORTEX

32. ADRENAL CORTEX
•Glomerulosa (Salt), mineralocorticoids
• ALDOSTERONE
•Fasciculata (Sugar), glucocorticoids
• CORTISOL
•Reticularis (Sex), gonadocorticoids
• ANDROGENS, ESTROGENS

33. Adrenal cortex
Adrenal , or suprarenal , glands are located on the top of each kidney.
These glands produce hormones that you can't live without, including sex
hormones and cortisol, which helps you respond to stress and has many
other functions.
• Types of tumors include
• Adrenocortical carcinoma – cancer in the outer part of the gland
• Neuroblastoma, a type of childhood cancer
• Pheochromocytoma – a rare tumor that is usually benign

34. ADRENAL MEDULLA
•PHEOCHROMOCYTOMAS, primary tumors of the
adrenal medulla
• 10% arise in an MEN setting
• 10% are EXTRA-adrenal
• 10% are bilateral
• 10% are malignant
• 10% are in childhood

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