1. Q: What is the pituitary gland?
A: The pituitary gland, located ventrally in the lower part of the thalamus, is a small ovoid body. It is the most complex endocrine gland in the body and can be divided into two major parts: the adenopituitary gland and the pituitary gland. Adult pituitary gland is about 1*1.5*0.5 cm in size and weighs about 0.5-0.6 g. It can be slightly larger in women during pregnancy.
2. Q: What is pituitary tumor?
A: Pituitary tumors are a group of tumors that occur in the cells of the anterior and/or posterior lobes of the pituitary gland.
3. Q: Why do pituitary tumors occur?
A: The true pathogenesis of pituitary tumors has not yet been found.
4. Q: Can pituitary tumors be inherited?
A: No conclusive evidence has been found that pituitary tumors are hereditary.
5. Q: What are the symptoms of pituitary tumor?
A: To answer this question, we must first know the classification of pituitary tumors: pituitary tumors can be classified according to the type of hormone secreted into.
1) Lactogenic pituitary tumors: men show decreased libido, women show irregular menstruation or even amenorrhea, and overflow of milk (milk production).
2) Growth hormone pituitary tumor: The main manifestations are gigantism, facial changes, enlarged hands and feet (increased shoe size), and increased blood sugar.
3) ACTH pituitary tumor: The main manifestations are obesity, full-moon face, hirsutism, and purple lines (purple-red skin lines on the body).
4)Hormone-free adenoma: It does not secrete hormones, and the enlarged tumor causes vision loss, visual field defects, and headache.
5)Others are FSH, LH, TSH type pituitary tumors, which are rarely seen. In addition to their respective symptoms, common manifestations include polyhydramnios (thirst and urination), headache, dizziness, significant loss of vision, and visual field defects (difficulty seeing on both sides). In case of pituitary tumor stroke (tumor bleeding), there can be severe headache, nausea, vomiting, and even blindness.
6. Q: Why is MRI better than CT in detecting pituitary tumors?
A: Magnetic resonance imaging (MRI) is the imaging method of choice for screening suspected pituitary adenomas. MRI is better than CT in showing the outline of lesions in the pituitary gland and in determining the relationship between the tumor and the soft tissue structures in the saddle, and can show the cavernous sinus, optic nerve, optic cross, suprasellar pool and other tissue structures more clearly.
7. Q: What should I do if I find pituitary tumor? Should I take medicine or open surgery?
A: You should go to the regular hospital for standard treatment in time. At present, the treatment of pituitary tumor is still mainly surgery, supplemented by drug therapy, radiation therapy, gamma knife. Bromocriptine is commonly used to relieve the symptoms of prolactinoma and growth hormone tumor, and SMS-201-995 and its long-acting analogue Somatuline are also used.
8. Q: Can pituitary tumors be treated with only medications without surgery?
A: There is no effective plan to treat pituitary tumor with medication alone. Medication mostly inhibits the secretion of related hormones, which is effective in relieving symptoms, but cannot eliminate the tumor, and is prone to recurrence after stopping medication.
9. Q: My MRI report shows pituitary hyperplasia, what is it?
A: Pituitary gland hyperplasia is due to the change of human endocrine environment, such as puberty, pregnancy, etc., which stimulates the growth of pituitary gland, usually not very big and does not require surgery.
10. Q: What are the risks of pituitary tumor surgery?
A: The main risks are intraoperative large vessel rupture and optic nerve (optic cross) injury as well as postoperative cerebrospinal fluid nasal leakage, intersaddle hematoma, pituitary hypoplasia, uveitis (mostly transient), and water-electrolyte disturbance. Generally speaking, the larger the tumor volume, the higher the risk.
11. Q: Is Gamma Knife effective for pituitary tumors?
A: Gamma knife can not be used for relatively large (more than 1CM), cystic, close to the optic nerve pituitary tumor, so its scope of action is relatively limited, mainly for one centimeter or less, substantial small pituitary tumor, or as an adjuvant treatment after surgery.
12. Q: I have heard that many people have urinary collapse after pituitary tumor surgery, what is it? What other complications can occur?
A: Pituitary tumor surgery more or less always affects the posterior pituitary lobe, which can easily cause the posterior pituitary hormone secretion after surgery, and one of the functions of the posterior pituitary hormone is to control urine volume, so it can lead to increased urine volume and even urinary collapse. The majority of patients can be cured by drinking more water and using drugs such as posterior pituitary hormone and mydriasis.
13. Q: Will pituitary tumor recur after surgery?
A: Pituitary tumor is a benign tumor, but there is a certain recurrence rate, about 10%. It is mainly related to the characteristics of the tumor itself. For example, aggressive pituitary tumors are very prone to recurrence. As for which is aggressive pituitary tumor, according to the magnetic resonance and pathology report can help doctors identify. Therefore, patients need to follow up and review one week, one month, three months, six months, one year after surgery and every year afterwards.
14. Q: Do you want to do radiotherapy after pituitary tumor surgery?
A: general pituitary tumor, as long as the surgery cut clean, do not need to make radiotherapy, only some invasive pituitary tumor, postoperative residual or recurrence, to radiotherapy or gamma knife treatment.
15. Q: What foods are helpful for recovery after discharge from hospital?
A: Don’t take a big tonic just after surgery, you should take a light tonic after a period of time. Intraoperative blood loss will cause the loss of protein and nutrients in the surgical patient, and pre-operative and post-operative dietary restrictions within a few days also make nutritional intake is insufficient, thus depleting the body’s nutrient stores, if not timely replenishment of adequate nutrition, will delay wound healing time, if infection occurs wound will heal poorly. Wound healing requires reasonable and adequate nutrition, especially high-quality protein (poultry, livestock, fish, eggs, milk and other animal foods), zinc, iron and other trace elements and vegetarian C (orange, strawberry, jujube), etc., which are essential nutrients for wound healing.
16. Q: What is Rathke´s cyst? What is the difference between it and pituitary tumor?
A: Rathke´s cyst is a less common congenital cyst in the saddle area that also causes endocrine symptoms, so it should be operated. It has a good surgical outcome, a better prognosis than pituitary tumors, and does not recur.