I. Classification of pituitary adenoma.
1.Functional classification
Functional pituitary adenomas are classified into functional pituitary tumors and non-functional pituitary adenomas. This classification method is most commonly used in clinical practice.
2.Tumor size classification
According to the size of tumor diameter, tumors ≤ 1 cm are called microadenoma; 1-4 cm are called macroadenoma; > 4 cm are called giant adenoma.
3.Biological behavior classification
There are invasive pituitary adenoma and non-invasive pituitary adenoma.
II. Clinical manifestations.
Pituitary tumors may have clinical manifestations of one or several pituitary hormone hypersecretion. There may also be different degrees of hypopituitarism caused by the compression and destruction of normal pituitary tissues around the tumor, as well as the expansion of the tumor outside the saddle and compression of adjacent tissue structures.
1. Symptoms of excessive hormone secretion.
(1) PRL tumor: It is common in women, with typical manifestations of amenorrhea, breast overflow and infertility. In men, it is characterized by loss of libido, impotence, breast development, and infertility.
(2) GH tumor: Overgrowth and gigantism can occur in immature patients. In adulthood, it is a manifestation of acromegaly.
(3) ACTH tumor: Clinical manifestations include centripetal obesity, full-moon face, buffalo back, polycythemia, purple skin lines, and increased pubic hair.
(4) TSH tumor: Rarely, it causes hyperthyroidism symptoms due to excessive secretion of more thyroid stimulating hormones by pituitary gland.
(5) FSH/LH tumor: very rare, with hypogonadism, amenorrhea, infertility, decreased sperm count, etc.
2.Decrease in hormone secretion
Excessive secretion of certain hormones interferes with the secretion of other hormones, or the tumor compresses normal pituitary tissue and reduces hormone secretion, which manifests as secondary hypogonadism, hypothyroidism and hypoadrenocorticism.
3.Peripituitary tissue compression sign group
(1) Headache: Because of the increase of intersaddle pressure caused by tumor, most patients have headache, mainly located in forehead, retro-orbital and bilateral temporal areas, with different degrees of severity and intermittent attacks.
(2) Visual acuity loss and visual field defects: The tumor develops anteriorly and superiorly to compress the visual cross, most of them are temporal hemianopsia or bilateral temporal hemianopsia.
(3) Cavernous sinus syndrome: The tumor develops laterally and compresses the third, fourth and sixth pairs of cranial nerves, causing ptosis, extraocular muscle paralysis and diplopia.
(4) Hypothalamic syndrome: tumor develops superiorly and affects hypothalamus may lead to uveitis, sleep abnormality, thermoregulation disorder, eating abnormality and personality change.
(5) Pituitary stroke: hemorrhage and necrosis within the tumor may cause.
The onset of the disease is rapid, with severe headache and rapid visual loss of varying degrees. In severe cases, the eyes can be blinded within a few hours, often accompanied by extraocular muscle paralysis, and there can be confusion, disorientation, neck straightening and even sudden coma.
Third, treatment methods
“There are three main treatment methods for pituitary tumors: medication, surgery and radiation therapy.
Except for PRL tumor, the first choice of treatment for other pituitary tumors is still surgery.