Middle aged female with mass in sella turcica hormone increased is
**Core Concept**
The sella turcica is a saddle-shaped depression in the sphenoid bone at the base of the skull, housing the pituitary gland, a crucial endocrine organ regulating various bodily functions. The mass in the sella turcica suggests a potential pituitary tumor, which could lead to excessive hormone production.
**Why the Correct Answer is Right**
A mass in the sella turcica causing hormone increase is most likely due to a pituitary adenoma, specifically a prolactinoma, secreting excess prolactin (PRL). This can be attributed to mutations in the GNAS gene, which encodes the Gαs subunit of G-proteins, leading to constitutive activation of the cAMP signaling pathway. As a result, the lactotrophs in the pituitary gland are stimulated to secrete more prolactin.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect as it does not provide a hormone-related explanation for the mass in the sella turcica. A non-hormone-secreting tumor would not exhibit increased hormone levels.
**Option B:** This option is incorrect as it mentions a tumor in the pituitary gland but does not specify the hormone involved. The question requires identification of the hormone increase associated with the mass.
**Option C:** This option is incorrect as it refers to a tumor in the hypothalamus, which is a different region from the sella turcica. The hypothalamus regulates the pituitary gland but is not directly involved in hormone secretion.
**Clinical Pearl / High-Yield Fact**
It is essential to note that prolactinomas are the most common type of functioning pituitary tumor, accounting for approximately 40% of all pituitary adenomas. They often present with symptoms of hyperprolactinemia, such as galactorrhea, amenorrhea, and infertility.
**Correct Answer:**
Correct Answer: D. Prolactinoma.