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Pituitary adenoma

What is Pituitary adenoma?

Pituitary adenoma is a benign tumor (swelling) of the pituitary gland. When the size of the pituitary swelling (adenoma) is < 1 cm, it is considered as “microadenoma”. When the size of the pituitary swelling (adenoma) is > 1 cm, it is considered as “macroadenoma”.

 

Pituitary adenomas secreting excessive amounts of hormones are considered as “functioning adenomas”. e.g. Prolactinoma, Cushing’s disease, Acromegaly or Gigantism.

 

Pituitary adenomas not secreting excessive amounts of hormones are considered as “nonfunctioning adenomas”. e.g. Nonfunctioning pituitary adenomas.

What are the symptoms?

Usually nonfunctioning adenomas present with headache and visual field defects, when they are big enough to produce symptoms.

If the adenoma is secreting excessive amounts of certain hormones, symptoms & signs will depend upon that particular hormone excess. (Will be discussed in those sections)

How Adrenal Glands are relevant to our body ?

  • Hormone levels
  • Cortisol, Free T4, TSH, FSH, LH, Testosterone, Prolactin, IGF1
  • Perimetry (Visual field charting)
  • Pituitary MRI with contrast

How do we treat?

Nonfunctioning pituitary macroadenomas, when they are producing compressive symptoms like visual field defects they need to be operated. Majority of them can be

operated through nose (Trans sphenoidal approach). If they are not producing any symptoms they need to be just followed up (Once in a year).
Hormone secreting tumors need to be treated on individual basis (discussed in other sections)

How is the prognosis?

Pituitary macroadenomas respond well to surgery. But, they are known for recurrence. If there is recurrence radiotherapy can be given.

When to Contact an Endocrinologist?

If anyone develops symptoms of pituitary adenoma, it is better to consult an Endocrinologist.

Endocrinologists are trained very well in the management of pituitary adenoma.

Key Features of Pituitary adenoma
Headache
Visual field defects
Surgery is not required for everyone.
Trans sphenoidal surgery (through nose) is curative in many (if needed).

Large enhancing mass in the region of the sella (pituitary macroadenoma) that is growing up into and displacing the optic chiasm and hypothalamus

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