Pituitary tumors are tumors originating from the anterior and posterior pituitary lobes and the remnant cells of the craniopharyngeal duct epithelium. Pituitary tumors often have endocrine gland function, which can cause a variety of endocrine function abnormalities.
1.Endocrine manifestation: different types of pituitary adenoma may manifest as acromegaly, amenorrhea, lactation, infertility, headache, hypogonadism and other symptoms.
2.Visual field disorders: early pituitary adenoma symptoms are often not obvious. With the increase of tumor volume, upward extension and compression of the visual cross, visual field defects may appear, with the outer upper quadrant being involved first, and gradually the defects may expand to bilateral temporal hemianopia. If the tumor is not treated in time, the enlarged visual field defect may be accompanied by visual acuity loss and eventually total blindness. If the tumor is biased to one side, it may lead to monocular blindness or blindness.
3. Other neurological signs: Depending on the direction of tumor growth, it may lead to different clinical manifestations. If the tumor grows posteriorly and presses the pituitary stalk or hypothalamus, it may cause polyuria; if the tumor grows laterally and encroaches on the lateral canal, it may cause nerve palsy of the motoneurium or abducens; if the tumor breaks through the saddle septum and grows upward to the ventral part of the frontal lobe, it may cause psychiatric symptoms; if the tumor grows posteriorly and presses the anterior part of the third ventricle and interventricular foramen, it may cause headache and vomiting and other symptoms of increased intracranial pressure. If the tumor grows backward, it can compress the brainstem and cause coma, paralysis or ankylosis of the brain.
4. Tumor stroke manifestation: During the growth of tumor, due to poor vascular supply or abnormal growth of tumor blood vessels, tumor bleeding and necrosis of tumor tissues may occur, resulting in rapid increase of tumor volume.
Most pituitary tumors have the function of hormone secretion, early clinical manifestations are often not obvious, and imaging does not clearly indicate, but pituitary hormone levels have changed, and some pituitary tumor cases can be diagnosed by endocrine testing alone.
In addition, some imaging tests can make the diagnosis clearer, and MRI is currently recommended. MRI can clearly show the size, shape, location and relationship between the tumor and the surrounding structures. With the popularization of 3.0T high-definition MRI, even microadenomas of 2-3 mm can be clearly displayed.
Current treatment for pituitary tumors includes surgical resection, radiation therapy, and medication. The majority of pituitary tumors are treated with surgery, which is relatively mature, with transnasal butterfly microscopic surgery and endoscopic surgery being the most common, while open surgery or combined transnasal butterfly and open surgery can be considered for more complex pituitary tumors. Radiation therapy is often used as an adjunct to surgery to control tumor growth and restore hormone levels. Pharmacological treatment is mainly aimed at microadenomas and postoperative adjuvant therapy to adjust abnormal hormone levels and further shrink the tumor.