Diagnostic and treatment of Pituitary adenoma

About the disease

A pituitary adenoma is a tumor of the pituitary gland, which is usually benign and noncancerous. Located in the brain just behind the eyes, the pituitary gland is an important part of the endocrine system, and is responsible for producing the hormones in the body. In most cases, a pituitary adenoma will develop in the anterior part of the gland.

The various types of pituitary adenoma are generally categorized as functional and nonfunctional. Functional adenomas may secrete hormones such as the growth hormone, prolactin, for example. Nonfunctional hormones do not secrete any hormones. They are also described as macro and micro adenomas, depending on their size. The larger variety of adenoma can grow more than 1 cm in size. These tumors are considered dangerous, as they can have a detrimental effect on a person’s vision or cause hormone deficiency.

Common in adults, especially among the elderly, a pituitary adenoma only rarely develops in children. Although 20% of adults have a pituitary adenoma, most of them are unaware of its presence. Although these adenomas are usually harmless, they can sometimes cause serious health problems because of their affect on the endocrine system. In extremely rare cases, the pituitary adenoma can become malignant.

The impact of the tumor depends on its size and also on whether or not it causes the pituitary gland to secrete the kind of hormones that have a negative effect on the body. There may be no noticeable symptoms for years. However, if the adenoma is very large or has been developing for a long period of time, symptoms may manifest themselves as follows:

Symptoms

• Infertility
• No menstruation in women
• Low libido
• Low testosterone levels and impotence in men
• Increased growth of body hair, in some cases
• Excessive sweating
• Joint and muscle pain
• Weight gain/loss
• Anxiety
• Rapid heartbeat
• Vision loss

Diagnosis

• During a general examination, the doctor will ask the patient if they have experienced any of the symptoms, listed above.
• The doctor will consult the patient’s medical history, to determine whether any other conditions could be causing similar symptoms.
• An ophthalmologist will check the patient’s sight, to find out whether their eyes have been affected.
• The patient’s blood, urine and saliva will be tested, to find out if an excess of particular hormones is causing the problems.
• An MRI or CT scan can be useful in finding out whether or not the patient has a tumor, by creating detailed images of the pituitary gland. 

Treatment

• A transsphenoidal resection is a surgical procedure whereby the tumor is removed, in order to normalize the function of the pituitary gland. The tumor is removed without entering the brain, which lowers the risk of complications.
• Certain medications that block the production of excessive hormones may be prescribed, along with radiation therapy, before or after the surgery.
• If the tumor is large, it will usually need to be operated on. However, if it is relatively small and does not influence the production of hormones, close observation by a doctor may be preferred.

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko