Pituitary adenoma

The pituitary gland is located in a fossa at the base of the skull called the sella turcica. The gland consists of two parts: the front and the back.

Pituitary adenoma represents a tumor formation whose origin is the tissues of the frontal lobe.

The gland synthesizes 6 hormones that regulate the function of endocrine glands:

• Thyrotropin;
• Somatotropin;
• Follitropin;
• Prolactin;
• Lutropin;
• Adrenocorticotropin hormone;

According to statistics, benign pituitary tumors represent about 10% of all intracranial tumors encountered in neurological practice.

Most often, pituitary adenomas appear in middle-aged people – in the 30-40-year-olds.

What are the symptoms?

Clinically, pituitary adenoma is manifested by a complex of ophthalmo-neurological symptoms related to the pressure exerted by the growing tumor on the intracranial structures located in the area of the Turkish saddle.

If the neoplasm is hormonally active, it is possible that endocrine-metabolic syndrome will come to the fore in its clinical picture.

Changes in the patient’s condition are often not related to the overproduction of the corresponding pituitary hormones, but are manifested through the organs on which they act.

The manifestations of the endocrine-metabolic syndrome are directly dependent on the type of tumor.

On the other hand, a pituitary adenoma can be accompanied by symptoms of panhypopituitarism, which develops as a result of the destruction of pituitary tissues due to the growing tumor.

What are the causes?

The etiology and pathogenesis of pituitary adenomas in modern medicine remain the subject of scientific research.

It is believed that these benign formations can appear under the influence of triggering factors, such as:

• craniocerebral injuries;

• infections of the central nervous system – tuberculosis, neurosyphilis, brucellosis, poliomyelitis, encephalitis, meningitis, brain abscess, cerebral malaria, etc.;

• adverse effects on the fetus during its intrauterine development;

It has recently been noted that pituitary tumors may be associated with long-term use of oral contraceptives.

Research shows that in some cases pituitary neoplasms arise as a result of increased stimulation of the pituitary gland by the hypothalamus, which is a reaction to a primary decrease in the hormonal activity of the peripheral endocrine glands.

A similar mechanism of the occurrence of adenomas can be observed, for example, in primary hypogonadism and hypothyroidism.

Pituitary adenoma treatment

Conservative treatment can in terms of lowering prolactin levels.

It is carried out with prolactin antagonists, for example bromocriptine.

For smaller adenomas, x-ray methods can be used to affect the tumor: gamma therapy, remote radiation or proton therapy, stereotactic radiosurgery – introduction of radioactive material directly into the tumor tissue.

In patients in whom the pituitary adenoma has larger dimensions and/or is accompanied by complications such as:

• hemorrhages;
• vision disorders;
• formation of cysts;

Consultation with a neurosurgeon is necessary to consider the possible possibility of surgical treatment.

The removal operation can be performed through the transnasal method using an endoscopic technique.

Macroadenomas can be removed by the transcranial method or by craniotomy.

Prognosis

Pituitary adenomas refer to benign neoplasms, but as their size increases, like other tumors of the brain, they begin to proceed as malignant due to the compression they exert on the surrounding anatomical structures.< /p>

The size of the formations determines the possibility of its complete removal.

When the adenoma is over 2 cm in diameter, there is a possibility of postoperative recurrence, which can occur within 5 years after its removal.