As a benign tumor, pituitary adenoma is a relatively mature diagnosis and treatment method, and most patients have satisfactory results after regular treatment. However, in reality, some patients have obvious symptoms but do not pay attention to them and thus do not receive timely treatment, which is regrettable. There are also some patients who are very frightened about having pituitary tumors, and it seems unnecessary. I have always felt the need to educate the public about pituitary tumors, and I have recently had the time to write the following article in the hope that it will be helpful to you.
The pituitary gland weighs only 0.6g, and its anterior cells have important endocrine functions, making the pituitary gland an important endocrine organ in the body. In this way, pituitary adenomas originating from the anterior pituitary gland have both endocrinological and oncological properties. Pituitary adenomas account for 10-15% of all primary brain tumors. However, there are data from non-selective autopsy studies of the general population showing a prevalence of about 20-25% of pituitary tumors in patients who are clinically asymptomatic during life. Therefore, in recent years, with the widespread availability of imaging tests incidentally more and more pituitary adenomas are being detected, in fact, only a fraction of them present with clinical symptoms and require treatment.
Classification and clinical manifestations of pituitary adenomas
Currently, pituitary adenomas are classified by function into two categories: functional and non-functional pituitary adenomas. Functional pituitary adenomas include lactogenic pituitary adenoma, growth hormone pituitary adenoma, thyroid stimulating hormone pituitary adenoma and adrenocorticotropic hormone pituitary adenoma.
There are three main clinical manifestations of pituitary adenomas
One is hyperpituitarism due to high secretion of pituitary hormones. This can manifest as amenorrhea-lactation syndrome, acromegaly or gigantism, secondary hyperthyroidism and Cushing’s disease. It can be classified according to the tumor specifically as.
(1) Prolactin cell adenoma.
In women, the main symptoms are amenorrhea, overflow of breast, sterility, axillary hair loss, pale and delicate skin, increased subcutaneous fat, fatigue, fatigue, drowsiness, headache, and hypogonadism. In men, the symptoms include loss of libido, impotence, breast enlargement, thinning of beard, atrophy of reproductive organs, reduction of sperm count, and infertility, etc. There are not many men with female changes.
(2) Growth hormone cell adenoma.
The main manifestation is excessive secretion of growth hormone. In adolescent patients, overgrowth may occur and even develop into giants. As an adult, it is a sign of hypertrophy of the extremities. Some patients have increased meal size, rough hair and skin, pigmentation, and numbness of fingers. In severe cases, there will be general weakness, headache and joint pain, hypogonadism, amenorrhea and infertility, and even complications of diabetes.
(3) Thyroid-stimulating hormone cell adenoma.
It is less common and can cause hyperthyroidism due to excessive secretion of thyroid stimulating hormone by the pituitary gland, and the symptoms disappear after the pituitary tumor is removed. Because of the small size of the early adenoma, it is difficult to detect the tumor on imaging.
(4) Adrenocorticotropic cell adenoma.
Clinical manifestations are centripetal obesity, full-moon face, buffalo back, polycythemia, purple lines on the skin of abdomen and thighs, and increase in fine hair. In severe cases, amenorrhea, loss of libido, general weakness, and even bedridden. Some patients suffer from hypertension and diabetes in combination.
Secondly, the symptoms are caused by pituitary insufficiency due to tumor compression, most commonly as hypogonadism.
The third is the compression symptoms of tumor, such as headache and visual impairment. Patients with early pituitary adenoma often do not have visual field disorder. If the tumor grows and extends upward to compress the visual cross, visual field defect will appear, and gradually the defect may expand to bilateral temporal hemianopia. If left untreated, the visual field defect will continue to expand and be accompanied by vision loss, leading to total blindness. Because pituitary tumors are mostly benign, the initial lesions can last for a long time, but when the disease becomes severe, visual field impairment can suddenly increase, and if the tumor is on one side, it can lead to monocular blindness or blindness.
Other Nerve Compression Symptoms and Signs
If the tumor grows posteriorly and presses on the pituitary stalk or hypothalamus, it may lead to polyhydramnios and polyuria; If the tumor grows posteriorly, it may compress the brainstem and cause coma, paralysis or deactivation of the brain.
In addition, there are very few pituitary adenocarcinomas that originate from the adenopituitary gland and are malignant. The tumor grows to compress the pituitary tissue and invades into the surrounding area, causing destruction of the saddle base bone or infiltration into the cavernous sinus, resulting in actinic nerve palsy or abducens nerve palsy. Patients have central nervous system metastasis. The prognosis for these patients is poor, but fortunately the incidence is extremely low!
Diagnosis and treatment of pituitary adenoma
The diagnosis of patients with pituitary adenoma requires a combination of general clinical manifestations and symptoms, endocrinological examinations and imaging findings.
Individualized treatment plan is currently advocated, i.e., the treatment plan is designed according to the actual condition of the patient. The general principles include surgery, drug therapy and radiation therapy.
We will write more about the treatment plan later.
Finally, we would like to remind you that in view of the infinite development of science and the limitation of personal knowledge, the above scientific knowledge is for your reference only. If you have or suspect pituitary adenoma, please make sure to go to a hospital to receive advice and treatment from an experienced specialist.