Functioning pituitary adenoma 2: Cushing's Disease-Diagnosis and treatment | Dr.Roopesh Kumar

Functioning pituitary adenoma 2: Cushing's Disease-Diagnosis and treatment, Dr.Roopesh Kumar

We saw about non-functioning adenoma. We saw the problems caused by the tumor that secretes excess prolactin. Now, the third problem - Cushing. That is, in the pituitary gland
A.C.T.H steroid, the control for secreting hormones is in the pituitary. It is called ACTH.
If the ACTH is secreted in high quantities it is called ACTH adenoma.

We are going to see the problems that it can cause. This is a medical related problem. How?
For these people, their body size will gradually keep increasing. Their face will swell up. Their body will gain weight. They will have a big belly. That will lead to stretching of the skin.
We call it Striae. There will be stretch marks in their skin because their skin stretches.

Not just this the other important problem is sugar levels will become uncontrolled. Because, when the steroid hormone is high, their blood sugar levels can increase and they may present it as diabetes. Their BP will be high. Hypertension. Since there are both high sugar levels and BP, the heart will become weak. So it will come as a systemic problem. This is called 'Cushing syndrome'.

When we see a person itself we can understand that they have 'Cushing syndrome'. Their face will be swollen, hands and legs will be small, central body, central obesity that is, truncal obesity, their stomach, chest or breasts, their face - all these parts will be big but their hands and legs will be small. Typically, when you see them you will know that they have Cushing syndrome. This is a medical emergency.

If a person has this syndrome, we do a hormone test using the blood. ACTH will be very high. Cortisol levels will be high. The tumor that secretes high amounts of cortisol. When the tumor is small itself we can identify it because the symptoms will start manifesting due to excess hormones. The tumor will not be big enough to affect your vision. It will be very small.
If we take an MRI scan with contrast, usually we will be able to identify the small adenoma. If it is there, the treatment for them begins with the blood test results using which we can confirm if the cortisol is high and if the small adenoma is seen in the MRI the treatment is similar.

The best treatment for them is using an endoscope where through the nose if the small tumor is removed, all the symptoms that I mentioned will be completely recovered. Their body will slowly shrink to its original state. Sugar level will reduce, blood pressure levels will reduce. There is a lot of chance for them to return to their original condition. Therefore, if there are such symptoms and if there is Cushing's disease, if that hormone is secreted they have to take the treatment and if the tumor is removed, we can recover all the symptoms. They can be cured and brought almost back to their original state of health.

Chapters
00:09 What is Cushing’s syndrome?
00:22 Adenoma
00:48 Why is Cushing syndrome a medical problem?
01:03 Striae
01:13 Uncontrolled Sugar and BP
02:01 Doing Hormone test
02:31 Treatment options



#pituitaryadenoma #syndrome #DrRoopeshKumar

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• Category

  Pituitary Gland Tumor