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.
• Combination of surgical removal – Radiotherapy
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:
• Loss of vision, especially the loss of peripheral vision
• Nausea and vomiting
Symptoms from pituitary hormone secretion deficiency:
• 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:
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
• 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
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)
• 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
• 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.