Pituitary tumor is a common benign intracranial tumor, and its incidence ranks third in intracranial tumors.
Classification of pituitary tumors: 1. Prolactin-secreting type accounts for 80%-85% of pituitary tumors, and there are 5 times more female patients than male. Symptoms of this type of pituitary tumor include irregular menstruation, amenorrhea and breast overflow, infertility, longer menstrual cycle or even amenorrhea and breast overflow in adolescent or married women, and inability to have children after marriage. Male sexual function changes, male low libido, impotence, no beard, voice thinning, infertility.
2.Growth hormone secretion type Patients with pituitary tumor have changes in face, limbs and body shape. Adults show wide hands and feet, wide head and face, enlarged nose, thickened lips, increased hair and symptoms such as hoarseness, sleep snoring and sleep apnea syndrome.
3.Adrenocorticotropic hormone secretion type centripetal obesity patients will be in the chest, abdomen, buttocks fat accumulation, the limbs are relatively thin, showing “centripetal obesity”, the face is full-moon shape, weight increased significantly, the limbs subcutaneous blood vessels revealed and appear purple lines.
4.Non-functional pituitary adenoma Most of them have no symptoms in early stage, but when pituitary adenoma grows up, it may cause severe headache due to compression of saddle diaphragm, and the pain site is mainly located behind the orbit, forehead and near the temples bilaterally.
Symptoms of posterior pituitary and subthalamic involvement Tumor affecting the posterior pituitary or subthalamic gland may result in salivation, polyhydramnios, polyuria, hypothermia, and impaired water, electrolyte and fat metabolism.
Signs and symptoms of optic nerve compression As the tumor grows in the pterygoid saddle, the upward development will compress the optic cross or optic nerve and cause changes in visual acuity and visual field. The change of visual field may vary depending on the compression of the nerve or optic cross. If the optic cross is compressed, it may produce bilateral temporal hemianopia or temporal blindness in one eye. More than 70% of patients have fundus changes. The majority of patients have primary optic nerve atrophy, the extent of which varies depending on the degree of optic nerve compression, from the optic papillary tinge to the typical primary optic nerve atrophy. Only a few cases have optic nerve papillary edema due to increased intracranial pressure.
Signs and symptoms of endocrine and metabolic disorders The endocrine function of the pituitary gland is complex, mainly under the domination of the central nervous system, which controls the regulation of growth, development, material metabolism, and physiological activities such as sex organs and sexual function of the body through endocrine control. The anterior pituitary gland is known to secrete six hormones, namely growth hormone, adrenocorticotropic hormone, prolactin, thyroid stimulating hormone and two gonadotropins. The eosinophilic and basophilic adenoma cells themselves have endocrine function and can cause excessive hormone levels and hyperfunction of the pituitary gland, but the tumor can also squeeze the normal pituitary gland and cause hypopituitarism. In addition, the tumor can involve the hypothalamus upward and the posterior pituitary gland backward. The posterior pituitary gland contains antidiuretic hormone and oxytocin, so posterior pituitary gland involvement can lead to uremia.
Signs and symptoms of headache and increased intracranial pressure Pituitary adenomas often cause headache. In a few patients, the protrusion of the tumor into the anterior part of the third ventricle causes increased intracranial pressure resulting in headache, vomiting, and optic nerve papilledema. However, most pituitary adenomas do not cause headache due to increased intracranial pressure. Their headache may be caused by increased tension in the saddle diaphragm due to tumor growth in the saddle, or due to involvement of sensitive structures such as meninges, blood vessels and nerves. In addition, headache may also be caused by thickening of skull and bone growth affecting meninges and blood vessels. Patients with eosinophilic pituitary adenoma not only have intractable headache, but also often have pain in the extremities and spine.