Introduction

The anterior pituitary is often referred to as the “master gland” because, together with the hypothalamus, it regulates the functions of multiple other glands (Fig. 171-1. Diagram of Pituitary Axes). The anterior pituitary produces six major hormones: (1) prolactin (PRL), (2) growth hormone (GH), (3) adrenocorticotropin hormone (ACTH), (4) luteinizing hormone (LH), (5) follicle-stimulating hormone (FSH), and (6) thyroid-stimulating hormone (TSH). Pituitary hormones are secreted in a pulsatile manner, reflecting intermittent stimulation by specific hypothalamic-releasing factors. Each of these pituitary hormones elicits specific responses in peripheral target glands. The hormonal products of these peripheral glands, in turn, exert feedback control at the level of the hypothalamus and pituitary to modulate pituitary function. Disorders of the pituitary can be broadly divided into clinical syndromes associated with hormone excess (i.e., benign pituitary tumors) or with hormone deficiency (i.e., infarction, mass effects, autoimmune, granulomatous disease, and genetic disorders).