PITUITARY ADENOMA BRAIN TUMOR

Pituitary adenoma and pituitary adenoma brain tumor.

The pituitary adenoma is a mass that develops in the pituitary gland. Some pituitary adenomas cause excessive production of hormones that regulate important body functions. Other pituitary adenomas can restrict normal pituitary functions, creating pituitary insufficiency, thus producing lower levels of hormones.

The overwhelming majority of pituitary adenomas are non-carcinoma. Adenomas are usually restricted to the pituitary gland (pituitary adenoma brain tumor) or expanded locally to surrounding tissues, but never spread to other parts of the body.

Treatment for the pituitary adenoma brain tumor includes several options:

Surgical removal– Endoscopic sphenoidal pituitary surgery
Medication to control growth and manage hormone levels
Monitoring – or “seeing and doing” approach.
Radiosurgery
Combination of surgical removal – Radiotherapy

Pituitary adenoma and pituitary adenoma brain tumor - Symptoms

A pituitary adenoma may be functional if it causes hormone secretion by the pituitary or non-functional, i.e. it does not produce hormones but causes pressure on the pituitary itself and surrounding nerve structures.

Thus, adenomas are distinguished in:

Functional, if they produce hormones and
Non-Functional, if they do not produce hormones,

while depending on their size they are divided into:

Microadenomas (less than 1 cm) and
Macroadenomas (more than 1 cm)

Symptoms that are caused by pituitary adenomas are distinguished according to:

The pressure they exert on the pituitary gland and surrounding tissues
The hormones they produce

Symptoms related to tumor pressure on the pituitary gland and surrounding structures may be:

Headache
Loss of vision, especially the loss of peripheral vision
Nausea and vomiting

Symptoms from pituitary hormone secretion deficiency:

Weakness
Menorrhagia, Amenorrhoea or Omenorrhoea
Reduced hair growth
Sexual dysfunction
Increased frequency and amount of urination (Polyuria)
Introvoluntary weight or weight gain

Symptoms associated with hormonal changes are analogous to the hormone they overproduce and are:

Cushing’s disease

It is caused when the adenoma of the pituitary gland produces Adrenocorticotropic hormone or else ACTH. Increase in levels of ACTH causes adrenal stimulation and excessive cortisol secretion.

As a clinical result of increased cortisol in the body, one can notice:

Accumulation of fat around the abdomen and the upper part of the back
Excessive roundness of the face (Moon face)
A characteristic lump at the top of the back at the base of the neck
High blood pressure
High blood sugar
Muscle weakness
Bruising
Stretch marks
Skin tightening
Anxiety, irritability, or depression

Megalacria or Acromegaly

It is caused when the adenoma produces growth hormone.

These tumors produce excessive growth hormone (GH).

The clinical effects of overproduction of growth hormone may include:

Trachy facial features
Increased hand and foot size
Excessive sweating
High blood sugar
Heart problems
Pain in the joints
Distorted teeth
Increased body hair

* In children and adolescents, we see rapid and excessive linear increase in height, in which case we talk about giganticism.

Prolactinoma

Overproduction of prolactin by a pituitary tumor called prolactinoma can cause reduction in sex hormones – estrogens in women and testosterone in men.

Elevated levels of prolactin in the blood affect men and women in a different way. In women, a prolactinoma may cause:

Irregular menstruation
Lack of menstruation
Galactorrhoea (discharge of breast milk to non-lactating women).

In men, a prolactinoma may cause male hypogonadism in the form of:

- Erectile dysfunction (ED)
- Infertility
- Loss of sexual desire

Adenomas producing thyroid stimulating hormones – TSH

Thyroid hormone-producing pituitary adenomas cause stimulation of the thyroid gland, which subsequently produces thyroxine. This is a rare cause of hyperthyroidism.

Hyperthyroidism can accelerate body metabolism, causing:

Sudden weight loss
Tachycardia or arrhythmia
Nervousness
Frequent bowel movements
Burning feeling

Clinical complications from pituitary adenomas

Although pituitary adenomas are basically benign diseases, however, they can adversely affect health, causing:

Loss of vision. Due to pressure on the optic nerve, near the pituitary.
Permanent pituitary insufficiency and need for pharmaceutical hormone replacement.
Diabetes Insipidus. This is usually found either in very large pituitary adenomas or after surgical removal. It is due to lack of Vasopresin, a hormone secreted by the posterior pituitary lobe, deficiency in the production of Vasopresin causes polyuria that can lead to dehydration. Diabetes Insipidus must not be confused with diabetes mellitus elevated blood glucose levels!

PITUITARY APOPLEXY OR PITUITARY STROKE

A rare but potentially serious complication of a pituitary tumor is pituitary apoplexy, which is due to sudden bleeding within the tumor.

Pituitary apoplexy requires urgent treatment, usually with corticosteroids and possibly surgery to allow the neurosurgeon to decompress the optic nerves and to prevent blindness and restore normal pituitary function as far as feasible.