{
  "$schema": "https://ui.shadcn.com/schema/registry-item.json",
  "name": "pituitary-adenoma",
  "title": "Pituitary adenoma",
  "description": "A non-functioning pituitary adenoma on the pituitary and its surroundings, from an incidental microadenoma to a macroadenoma pressing on the optic chiasm and stalk, and apoplexy into the cavernous sinus, with visual fields, MRI and pituitary hormones at each stage. Model licensed CC BY-SA 2.1 JP.",
  "registryDependencies": [
    "@organui/disease-viewer",
    "@organui/pituitary"
  ],
  "files": [
    {
      "path": "registry/base-nova/pituitary-adenoma/pituitary-adenoma.tsx",
      "content": "import { diseaseModel, type Disease } from \"@/components/disease-model\"\nimport {\n  DiseaseViewer,\n  type DiseaseViewerProps,\n} from \"@/components/disease-viewer\"\nimport { pituitaryModel } from \"@/components/pituitary\"\n\n// A non-functioning pituitary adenoma: harmless while small, then pressing on\n// the optic chiasm above and the normal gland around it, and occasionally\n// bleeding into itself.\nexport const pituitaryAdenoma: Disease = {\n  name: \"Pituitary adenoma\",\n  code: \"D35.2\",\n  summary:\n    \"A benign tumour of the pituitary. Its effects come from what it makes, what it squeezes out of the normal gland, and what it presses on as it grows.\",\n  scales: [\n    {\n      id: \"pituitary\",\n      label: \"Pituitary\",\n      model: pituitaryModel,\n      findings: {\n        \"pituitary-gland\": {\n          affected: true,\n          description:\n            \"A microadenoma under 1 cm inside the sella, often found by chance on a scan. Most make no hormone and are simply watched.\",\n        },\n        \"optic-chiasm\": {\n          affected: false,\n          description:\n            \"Sits above the sella with a gap of fluid between, out of reach of a small tumour.\",\n        },\n        \"right-cavernous-sinus\": {\n          affected: false,\n          description:\n            \"Beside the sella, carrying the internal carotid and the nerves that move the eye. A growing tumour can invade it.\",\n        },\n        \"hypophyseal-portal-veins\": {\n          affected: false,\n          description:\n            \"Carry dopamine from the hypothalamus down the stalk, keeping prolactin in check.\",\n        },\n        \"sphenoid-bone\": {\n          affected: false,\n          description:\n            \"The route for surgery: the tumour is removed through the nose and sphenoid sinus (transsphenoidal surgery).\",\n        },\n      },\n    },\n  ],\n  stages: [\n    {\n      id: \"microadenoma\",\n      label: \"Micro\",\n      summary:\n        \"Under 1 cm, confined to the sella. Check the hormones once, and repeat the MRI to see whether it grows.\",\n    },\n    {\n      id: \"macroadenoma\",\n      label: \"Macro\",\n      summary:\n        \"Over 1 cm and growing up out of the sella. It presses on the optic chiasm and on the normal gland, which fails one hormone at a time.\",\n      findings: {\n        pituitary: {\n          \"pituitary-gland\": {\n            affected: true,\n            description:\n              \"A macroadenoma squeezing the normal gland: growth hormone and the gonadotrophins fail first, then TSH and ACTH.\",\n          },\n          \"optic-chiasm\": {\n            affected: true,\n            description:\n              \"Pressed from below, so the crossing fibres from the nasal halves of each retina fail first: both outer visual fields go (bitemporal hemianopia), often unnoticed.\",\n          },\n          \"hypophyseal-portal-veins\": {\n            affected: true,\n            description:\n              \"The stalk and its portal veins are compressed, so less dopamine reaches the gland and prolactin rises modestly (stalk effect), unlike the very high levels of a prolactinoma.\",\n          },\n        },\n      },\n      investigations: [\n        {\n          name: \"Visual fields\",\n          result: \"Bitemporal hemianopia\",\n          flag: \"abnormal\",\n        },\n        { name: \"MRI\", result: \"2.4 cm macroadenoma\", flag: \"abnormal\" },\n        { name: \"Prolactin\", result: \"Mildly raised\", flag: \"high\" },\n        { name: \"9 am cortisol\", result: \"Low\", flag: \"low\" },\n      ],\n    },\n    {\n      id: \"apoplexy\",\n      label: \"Apoplexy\",\n      summary:\n        \"The tumour suddenly bleeds or dies: thunderclap headache, vomiting, loss of vision and double vision. Give hydrocortisone first; surgery decompresses it.\",\n      findings: {\n        pituitary: {\n          \"pituitary-gland\": {\n            affected: true,\n            description:\n              \"Haemorrhage into the tumour expands it within hours. Sudden ACTH loss can cause an adrenal crisis, which kills if steroids are not given.\",\n          },\n          \"optic-chiasm\": {\n            affected: true,\n            description: \"Suddenly compressed: vision can fall within hours.\",\n          },\n          \"right-cavernous-sinus\": {\n            affected: true,\n            description:\n              \"Blood and swelling press on the oculomotor, trochlear and abducens nerves in its wall: a drooping lid and double vision.\",\n          },\n        },\n      },\n      investigations: [\n        { name: \"9 am cortisol\", result: \"Very low\", flag: \"low\" },\n        { name: \"Sodium\", result: \"Low\", flag: \"low\" },\n        { name: \"MRI\", result: \"Haemorrhage in tumour\", flag: \"abnormal\" },\n        { name: \"Visual acuity\", result: \"Falling\", flag: \"low\" },\n      ],\n    },\n  ],\n  investigations: [\n    { name: \"MRI\", result: \"8 mm adenoma\", flag: \"abnormal\" },\n    { name: \"Prolactin\", result: \"Normal\" },\n    { name: \"IGF-1\", result: \"Normal\" },\n    { name: \"Visual fields\", result: \"Full\" },\n  ],\n}\n\n/** The pituitary with a microadenoma, the stage the viewer opens on. */\nexport const pituitaryAdenomaModel = diseaseModel(pituitaryAdenoma)\n\nexport type PituitaryAdenomaProps = Omit<DiseaseViewerProps, \"disease\">\n\nexport function PituitaryAdenoma(props: PituitaryAdenomaProps) {\n  return <DiseaseViewer disease={pituitaryAdenoma} {...props} />\n}\n",
      "type": "registry:component"
    }
  ],
  "docs": "Pituitary adenoma docs: https://organui.com/docs/components/pituitary-adenoma. It reuses the pituitary model, licensed CC BY-SA 2.1 JP (https://creativecommons.org/licenses/by-sa/2.1/jp/deed.en); keep the viewer's credit visible. Educational, not for diagnosis.",
  "categories": [
    "disease",
    "endocrine"
  ],
  "type": "registry:component"
}