Pituitary tumor, which should be formally called pituitary adenoma, is one of the three most common intracranial benign tumors, accounting for about 10% of intracranial tumors. Pituitary tumors are tumors growing from the anterior pituitary gland. Most of them have endocrine function and can show some endocrine symptoms, and many patients choose to visit endocrinology or obstetrics and gynecology first, while some patients first visit ophthalmology because of vision loss and are referred to neurosurgery because of surgical needs. The pathogenesis of pituitary tumors remains incompletely understood to date. Its symptoms are mainly as follows: a. Pituitary adenomas with endocrine function behave differently and are mainly divided into the following categories: 1. Prolactin (PRL) pituitary tumors. Most female patients mainly show amenorrhea, lactation and infertility. Male patients mainly present with low male sexual function, such as decreased libido, impotence and infertility.
2. Growth hormone (GH)-type pituitary tumors. The main manifestations are gigantism, facial changes, enlarged hands and feet, excessive sweating, bone and joint lesions, carpal tunnel syndrome, swelling of finger (toe) soft tissues and joints, increased blood pressure, increased blood sugar, coronary heart disease, and tumors of the thyroid and colon, etc.
3.Adrenocorticotropic hormone (ACTH)-type pituitary tumor. The main manifestations are centripetal obesity, full-moon face, acne, hairiness, and purple skin lines.
4.Thyroid hormone (TSH)-type pituitary tumor. The main manifestations are symptoms of hypermetabolism fear of heat, excessive sweating, weight loss, heart panic and atrial fibrillation, etc.
5. Other pituitary tumors are FSH and LH. The main clinical manifestations are menstrual disorders and infertility in women and male hypogonadism and infertility in men. Hormone-secreting tumors can occur alone or be mixed tumors with increased secretion of two or more hormones, and the clinical manifestations also have corresponding mixed symptoms.
(6) Endocrine inactive adenoma: Early patients have no special feeling that the tumor grows up and can compress the pituitary gland causing clinical manifestations of pituitary insufficiency.
Visual field disorders: Early pituitary adenoma is usually no visual field disorders when it is small, but if the tumor grows and extends upward and compresses the visual cross, then visual field defects will appear, mostly bilateral temporal hemianopia. If not treated in time, the visual field defect can be enlarged again, and the visual acuity can also be reduced to total blindness.
Intracranial hypertension symptoms: If the tumor is large or grows posteriorly to block the anterior part of the third ventricle and interventricular foramen, headache and vomiting and other symptoms of increased intracranial pressure may occur.
Other neurological symptoms and signs: If the pituitary tumor grows upward and presses the pituitary stalk or hypothalamus, it may cause polyhydramnios.
Malignant pituitary tumor: Generally the disease progresses faster, the tumor not only grows to compress the pituitary tissue, but also invades to the surrounding area, causing the destruction of saddle base bone or infiltrating into the cavernous sinus, resulting in actinic nerve paralysis or abducens nerve paralysis.