TUMOR HIPOFISIS

Dosen : Gevi Melliya Sari, S.kep.,Ns.,M.Kep

 Tumor Hipofisis

Tumor hipofisis atau yang dikenal juga dengan sebutan adenoma pituitari (pituitary adenoma) adalah
adanya sel abnormal yang membentuk massa pada kelenjar pituituari (hipofisis) di otak. Kelenjar ini
bertanggung jawab untuk mengatur keseimbangan berbagai hormon pada tubuh.
 Klasifikasi
Klasifikasi dibedakan berdasarkan hormon yang diproduksi oleh
kelenjarhipofisis dan dibedakan menjadi 2 jenis yaitu :

Tumor ini berkisar sekitar 30% dari seluruh

Adenoma hipofisis
tumor pada hipofisis.Biasanya muncul pada
non fungsional
dekade ke 4 dan ke 5 dari kehidupan, dan
biasanya lebih sering ditemukan pada laki-
laki dari pada wanita.

• Adenoma yang bersekresi prolaktin

• Adenoma yang bersekresi growth
Adenoma hipofisis
hormon (GH)
fungsional
• Adenoma yang bersekresi glikoprotein
(TSH, FSH, LH)
• Adenoma yang bersekresi
adrenokortikotropik hormon (ACTH)
 Etiologi

Penyebab tumor hipofisis tidak diketahui. tetapi sejumlah studi menunjukkan keterkaitan
mutasi genetik. Faktor risiko adenoma pituitari diduga adanya riwayat keluarga, jenis
kelamin, dan usia. Selain itu diduga tumor hipofisisjuga bisa disebabkan oleh beberapa factor
dibawah ini yaitu :

a. Cacat genetik
b. Didapat dari hasil penyebaran(metastasis)dari kanker situs lain.
 Patofisiologi
Kemajuan biologi molekuler membuktikan tumor ini berasal dari monoklonal,
yang timbul dari mutasi sel tunggal diikuti oleh ekspansi klonal. Neoplasia hipofisis
merupakan proses multi-step yang meliputi disregulasi pertumbuhan sel atau proliferasi,
diferensiasi dan produksi hormon, Proses aktivasi fungsi onkogen
merupakan hal yang dominan, karenanya gangguan allel tunggal dapat menyebabkan
perubahan fungsi sel Inaktifasi tumor supresor bersifat resesif, karenanya kedua gen allel
harus terlibat untuk mempengaruhi fungsi seluler.
Heterogenitas defek genetik ditemukan pada adenoma hipofisis sesuai dengan
proses neoplastik multi step. Abnormalitas protein G, penurunan ekspresi protein
nm23, mutasi ras gen, delesi gen p53, 14 q, dan mutasi, kadar c-myc onkogen yang tinggi
dapat menyebabkan pertumbuhan adenoma kelenjar hipofisis.
PATWAY
 Manifestasi Klinis
Manifestasi Klinis Adenoma Hipofisis Manifestasi Klinis Adenoma
non fungsional :
Fungsional :

 Nyeri kepala
 Karena perluasan tumor ke area supra
sella, maka akan menekan chiasma
optikum, timbul gangguan lapang  Adenoma yang bersekresi Prolaktin
pandang bitemporal.  Adenoma yang bersekresi growth hormone
 Gangguan fungsi hipofisis yang  Adenoma yang bersekresi glikoprotein
progressif dalam beberapa bulan atau  Adenoma yang bersekresi ACT
beberapa tahun berupa :
1. Hypotiroidism, tidak tahan dingin,
myxedema, rambut yang kasar
2. Hypoadrenalism, hipotensi ortostatik,
cepat lelah
3. Hypogonadism, amenorrhea (wanita),
kehilangan libido dan kesuburan
 Komplikasi

1 2

Komplikasi Komplikasi
2
Kehilangan fungsi
penglihatan (Kebutaan)
Adenoma akan bermetastase
pada organ lain yang akan
menimbulkan kanker dan
organ yang terdekat dapat
diserang adalah otak yang
mengakibatkan menjadi
1
tumor ataupun kanker otak
 Penatalaksanaan

Farmakologis : Non-Farmakologis

Melakukan perbaikan
nutrisi yang masuk ke
MRI dalam tubuh.

Terapi radiasi Perbaikan gaya hidup

Hipofisektomi
Penggantian hormon
hipofisis
TERIMAKASIH
 Penatalaksanaan

CO2 Light O2
Carbon Sun Oxygen
Dioxide
Jupiter is the Mercury is the Neptune is the
biggest planet of closest planet to farthest planet
them all the Sun from the Sun

H2O CH2O
Water Glucose
Despite being red, Venus is the
Mars is a very second planet
cold place from the Sun
 Photosynthesis infographics

Elements Description

Carbon dioxide Mercury is the smallest planet of them all

Water Venus is the second planet from the Sun

Light Mars is actually a very cold place

Chlorophyll Jupiter is the biggest planet of them all

Temperature Neptune is the farthest planet from the Sun

 Photosynthesis infographics

CO2 H2O Sun CH2O O2

Carbon
Water Light Glucose Oxygen
Dioxide

Jupiter is the Despite being Mercury is the Venus is the Neptune is the
biggest planet of red, Mars is a closest planet to second planet farthest planet
them all very cold place the Sun from the Sun from the Sun
 Photosynthesis infographics

Carbon Sun Oxygen

dioxide
Jupiter is the Mercury is the Neptune is the
biggest planet of closest planet to farthest planet
them all the Sun from the Sun

1 2 3 4 5

Water Glucose
Despite being red, Venus is the
Mars is a very second planet
cold place from the Sun
 Photosynthesis infographics

Steps of photosynthesis
The Sun is the star at the center of
the Solar System

Light phase Dark phase

Despite being red, Mars is Mercury is the closest
a very cold place planet to the Sun

Photolysis of water Photo Carbon fixation Assimilation

phosphorylation
Venus is the second planet Neptune is the farthest Earth is the third planet Jupiter is the biggest
from the Sun planet from the Sun from the Sun planet of them all
 Photosynthesis infographics

Calvin cycle Chloroplast

Carbon fixation
Mercury is the closest
planet to the Sun and the
smallest of them all 1

3
Regeneration of 2 Reduction
RuBP
Venus has a beautiful Despite being red, Mars is
name and is the second actually a cold place. It’s
planet from the Sun full of iron oxide dust
 Photosynthesis infographics

NADPH ATP
Despite being red, Mars Mercury is the closest
is a very cold place planet to the Sun
Calvin cycle
NADH Jupiter is the biggest ADP + PI
planet of them all
Saturn is the only Venus has very high
planet with rings temperatures

Carbon Dioxide Sugar

The Sun is the star that Jupiter is the biggest
we all orbit planet of them all
 Photosynthesis infographics

65% 45% 30% 25%

Jupiter Mars Mercury Venus
Jupiter is the Despite being red, Mercury is the Venus is the
biggest planet of Mars is a very closest planet to second planet
them all cold place the Sun from the Sun
 Photosynthesis infographics

Carbon dioxide Chloroplast

Mercury is the closest Despite being red, Mars is
planet to the Sun and the actually a cold place. It’s
smallest of them all full of iron oxide dust

Water Mineral salts

Venus has a beautiful Saturn is composed
name and is the second mostly of hydrogen and
planet from the Sun helium and has rings
 Photosynthesis infographics

Chloroplast Cytoplasm
Venus is the second Mercury is the
planet from the Sun smallest planet

Cell membrane Vacuole

Jupiter is the biggest Saturn is the only
planet of them all planet with rings

Cell wall Nucleus

Mars is actually a Neptune is very far
very cold place from the Sun
Photosynthesis infographics

Cell wall Cytoplasm

Mars is actually a Mercury is the
very cold place smallest planet

Cell membrane Vacuole

Jupiter is the biggest Saturn is the planet
planet of them all with rings

Chloroplast Nucleus
Venus is the second Neptune is very far
planet from the Sun from the Sun
 Photosynthesis infographics

Leaves 2
The leaves take in
carbon dioxide from the
air and release oxygen 3 Chloroplast
Sunline gives chloroplast
energy to make sugar,
glucose food
Roots 1
The plant draws up water
and minerals from the
ground through roots
 Photosynthesis infographics

Mercury
It’s the closest planet to
the Sun and the smallest
in the Solar System

Venus
Venus has a beautiful
name and is the second
planet from the Sun
 Photosynthesis infographics

50% 70% 100%

Phase 1 Phase 2 Phase 3
Jupiter is the biggest Despite being red, Mercury is the closest
planet of them all Mars is a cold place planet to the Sun
Photosynthesis infographics

Light
Jupiter is the biggest
planet of them all

NADPH/NADH ATP
Despite being red, Mars Mercury is the closest
is a very cold place planet to the Sun
Photosynthesis infographics

80 Mars Mars is actually a very cold place

%
75 Jupiter Jupiter is the biggest planet of them all
%
60 Venus Venus is the second planet from the Sun
%
50 Saturn It’s composed of hydrogen and helium
%
40 Neptune It’s the farthest planet from the Sun
%
25 Mercury It’s the closest planet to the Sun
%
 Photosynthesis infographics

40% 60%
C3 photosynthesis C4 Photosynthesis
Neptune is the farthest Jupiter is the biggest
planet from the Sun planet of them all
 Photosynthesis infographics

20% 35%
Phase 1 Phase 3
Neptune is the farthest Mercury is the smallest
planet from the Sun planet of them all

20% 25%
Phase 2 Phase 3
Jupiter is the biggest Mars is actually a very
planet of them all cold place
Follow the link in the graph to modify its data and then paste
the new one here. For more info, click here
 Photosynthesis infographics

Carbon dioxide 1 2 Chloroplast

Mercury is the closest planet to the Despite being red, Mars is actually a
Sun and the smallest of them all cold place. It’s full of iron oxide dust

Water 3 4 Mineral salts

Venus has a beautiful name and is Saturn is composed mostly of
the second planet from the Sun hydrogen and helium
 Photosynthesis infographics

Cell wall Cytoplasm

Mars is actually a 02 Mercury is the
very cold place 01 smallest planet

Plant cell
Cell membrane Vacuole
03
Jupiter is the biggest 06 Saturn is the planet
planet of them all with rings

Chloroplast 05 04 Nucleus
Venus is the second Neptune is very far
planet from the Sun from the Sun
 Photosynthesis infographics

The overall process of photosynthesis takes place in four stages

Stage Description Time scale

1 Energy transfer in antenna chlorophyll thylakoid membranes femtosecond to picosecond

Transfer of electrons in photochemical reactions thylakoid membranes

2 picosecond to nanosecond

microsecond to millisecond
3 Electron transport chain and ATP synthase thylakoid membranes

Carbon fixation and export of stable products millisecond to second

4
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