Alerting patients to hypopituitarism after pituitary tumor surgery

Most people think that after suffering from pituitary tumor, the disease will be cured by surgical removal of the tumor or radiation therapy to eliminate the tumor. In fact, after surgery/radiotherapy for pituitary tumor, many patients have potential sequelae, which will seriously affect their health and quality of life if they do not pay attention to them and seek timely consultation and treatment. Pituitary tumors are tumors that grow from the pituitary gland and are quite common in clinical practice, with an incidence rate of about one case in 100,000 people. In recent years, due to the advances in endocrine laboratory tests and CT and MRI examination techniques, the incidence of pituitary tumors has increased by 7 to 10 times, i.e., there are 7-10 cases of such tumors in 100,000 people each year. Although the pituitary gland is very small and weighs less than one gram, it is an important endocrine organ and the endocrine center of the human body. It contains several kinds of endocrine cells, secretes many kinds of endocrine hormones, and governs and regulates the physiological activities of the whole body. If a certain type of endocrine cell is compressed by a primary tumor, surgery, radiation damage, etc., endocrine hypocrisy may occur, which is medically called hypopituitarism. Hypopituitarism refers to a series of clinical syndromes caused by a decrease in hormone secretion from the pituitary gland, which can be a single hormone deficiency or multiple hormone deficiencies at the same time. It manifests as a decrease in the function of one or more peripheral glands, such as hypothyroidism, hypoadrenocorticism, hypogonadotropic hypogonadism, or adult growth hormone deficiency. Clinically, hypopituitarism is characterized by a decrease in the function of the target glands (gonads, thyroid, adrenal glands). Deficiencies of gonadotropins, growth hormone, and prolactin are the earliest manifestations of pituitary hypoplasia. When hypogonadism (ovarian and testicular) occurs, women of childbearing age may develop breastlessness, followed by amenorrhea, atrophy of the sex organs, and infertility. In men, there is loss of libido, impotence, and shrinkage of the testicles. Both sexes show loss of pubic and axillary hair. When adult growth hormone deficiency occurs, the main manifestations include weakness, changes in body composition (decrease in lean body tissue; increase in visceral adipose tissue), dyslipidemia, insulin resistance, cardiovascular structural and functional abnormalities, osteoporosis, decrease in muscle strength and mobility, and psychological disorders. When hypothyroidism occurs, it can be manifested as generalized weakness, fear of cold, less sweat, bloated body, and dry skin hair. In severe cases, edema is present without goiter. In the presence of hypoadrenalism, there is generalized skin hypopigmentation, pallor, and pale areola. Generalized weakness, low blood pressure, electrolyte disorders, and decreased resistance. If there is total hypopituitarism, patients may be induced to develop pituitary crisis due to various colds, gastroenteritis, trauma and other stresses and the use of sedative drugs, which manifests as shock, coma and other serious dying states. Therefore, after pituitary tumor surgery, patients should go to the hospital for regular follow-up, head CT, MRI review, to know whether the tumor recurs or not, and monitor the level of target gland hormones. If the above symptoms occur, they should seek timely medical treatment from endocrine specialists, check the corresponding endocrine function, establish the diagnosis as early as possible, and carry out the necessary hormone replacement therapy, so as to improve the quality of life and avoid the occurrence of pituitary crisis.