ACTH secreting tumor
ACTH secreting tumor: Description, Causes, and Risk Factors:
ACTH - the pituitary gland or "master gland" is extremely important in regulating the function of many other glands and organs of the body. It lies behind and between the eyes at the base of the brain, just beneath the hypothalamus to which it is connected by a thin stalk.
Adrenocorticotropic hormone (ACTH): A polypeptide hormone, consisting of 39 amino acids, which is synthesized from proopiomelanocortin (POMC) and secreted from corticotropes in the anterior lobe of the pituitary gland in response to the hormone corticotropin-releasing hormone (CRH) released by the hypothalamus. Adrenocorticotropic hormone is secreted in short bursts every few hours and is increased by stress. In turn, it controls secretion of corticosteroids, including cortisol, aldosterone, and androgens, by the adrenal glands. Most important of these is its stimulation of cortisol production.
ACTH production is partly controlled by the hypothalamus and partly by the level of cortisol in the blood. When ACTH levels are high, the production of cortisol is increased; this, in turn, suppresses the release of this from the pituitary. If ACTH levels are low, cortisol production falls and the hypothalamus releases factors that stimulate the pituitary to increase ACTH production.
These pituitary glands secretes hormone called adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to make proteins called glucocorticoids. When the body makes too much ACTH, it causes a disorder such as ACTH-secreting tumor. Most patients who develop this disorder are women in their 30s and 40s. This tumors account for 10 to 15 percent of pituitary tumors.
Most ectopic adrenocorticotropic hormone ACTH-secreting tumors are bronchial carcinoids and many are malignant.
Symptoms of ACTH-secreting tumor:
- Unexplained weight gain.
- Increased blood pressure.
- Easy bruising.
- Moodiness or depression.
- Irregular or absent menstrual periods.
Localization of ectopic ACTH-secreting tumors can be extremely difficult and continues to be a challenge for endocrinologists. The majority of these tumors are of neuroendocrine origin and consequently may show high expression of somatostatin receptors.
This disease is diagnosed using blood tests that look for abnormal secretion of a hormone called cortisol. MRI may also be employed, but sometimes a pituitary tumor that causes this tumor is so small that it may not be visible using this imaging test.If the tumor cannot be seen on MRI or if the diagnosis is uncertain, a test called petrosal venous sampling may be necessary. This is a procedure during which a sample of blood is taken from the petrosal sinuses -which drain the pituitary gland on both sides -- and checked for elevated cortisol levels. The test can also help locate the tumor within the pituitary gland if the cortisol level is found to be higher on one side compared to the other.
Surgery to remove the tumor is the primary therapy ACTH-secreting tumor. The surgery is often performed through a minimally invasive approach called transsphenoidal transnasal resection, whereby the surgeon removes the tumor through an incision in the nasal passage. In cases where the tumor is too large to be removed through this approach, the surgeon performs a craniotomy, removing the tumor through an incision in the front of the skull.
Disclaimer: The following tests, drugs and medications, surgical procedures are in some way related to, or used in the treatment. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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