The Pituitary Gland and Adrenal Glands

The authors first discuss pituicytomas, rare primary glial neoplasms that arise in the neurohypophysis (or posterior portion) of the pituitary gland. They typically present with signs and symptoms of a slow growing, non-hormonally active mass of the sellar and suprasellar region, compressing adjacent structures. Following this, the clinical and pathologic features of spindle cell oncocytomas are discussed. Spindle cell oncocytomas are rare tumors, accounting for less than 0.5% of sellar masses. Tumors typically present in adults and most commonly manifest with visual disturbances and pituitary hypofunction. Additionally, the authors review the clinical and pathological features of gangliocytomas, rare benign tumors of the neuroaxis. They are most commonly seen in children and young adults, and most often arise in the cerebellum as part of Cowden's disease, or in the sellar region. The clinicopathologic features of granular tumors, rare neoplasms that most commonly arise in the neurohypophysis or posterior portion of the pituitary gland, are also discussed. This compilation goes on to examine the adrenal glands, paired structures located superior to the kidneys in the retroperitoneal space. Mineralocorticoids, glucocorticoids and adrenal androgens are synthesized respectively in the zona glomerulosa, zona fasciculatis and zona reticularis that make up the cortex, while the inner adrenal medulla produces the catecholamines and peptides. The risk of developing adrenal insufficiency among glucocorticoid users is assessed, and risk factors are identified. Glucocorticoids are widely used for the treatment of various inflammatory conditions and malignancies, as well as after organ transplantation. The closing study explores hypothalamic-pituitary-adrenal axis activation, a potent and complex response to heat stress in domestic livestock. The hypothalamic-pituitary-adrenal axis is activated during stress, which leads to the secretion of cortisol and aldosterone from the adrenal gland.