Pituitary adenoma in adults

Scientists have not yet determined the exact cause of pituitary adenoma. Adenomas can be of different sizes, and not always negatively affect health, hormone synthesis and brain function.

What is a pituitary adenoma

A benign formation in the region of the anterior pituitary gland refers to adenomas. This area produces 6 different hormones that regulate various functions of the peripheral endocrine glands – these are TSH (thyroid stimulating hormone), GH (somatotropic hormone), follicle stimulating hormone, luteinizing hormone, prolactin and ACTH (adrenocorticotropic hormone). With pituitary adenomas, the release of these hormones may suffer, but this is not always the case. Tumors can be hormonally active or non-hormonally active.

When a pituitary adenoma does not have hormonal activity, it is observed by neurologists. If it does not reach a large size, it may not harm the body in any way.

If the adenoma is active, producing any of the pituitary hormones, endocrinologists deal with it, choosing the tactics of treatment. Depending on which of the hormones the tumor secretes, it can be called specifically:

• somatotropinoma – it secretes the hormone STH;
• prolactinoma – it secretes additional portions of prolactin;
• thyrotropinoma – secretes thyrotropin;
• gonadotropinoma – enhances the release of gonadotropic hormones;
• cotrichotropinoma – enhanced synthesis of ACTH.

Based on the size of the tumor, they can be micro-adenomas (less than 20 mm in size) or macro-adenomas (greater than 2 cm in diameter).

Causes of pituitary adenoma in adults

“The reasons for the mutation of the cells of the anterior pituitary gland are currently unknown,” says neurosurgeon Gleb Sergeev. – The exceptions are those cases when, when evaluating a family history, various genetic diseases are identified, in which the formation of such a tumor is natural. For example, this:

• multiple endocrine neoplasia;
• familial isolated pituitary adenoma;
• Carney syndrome.

Symptoms of pituitary adenoma in adults

The appearance of a pituitary adenoma can manifest itself as neurological and ocular symptoms – this is due to the growth of education and pressure on certain structures inside the skull. Most often, the area of ​​uXNUMXbuXNUMXbthe Turkish saddle suffers. If the adenoma produces hormones, endocrine and metabolic disorders are often the first to appear. They depend on the specific type of tumor. Manifestations of panhypopituitarism (violation of the synthesis of all hormones) are also possible if the tumor destroys the pituitary gland itself.

Eye and neurological symptoms are:

• headache of a dull nature, which does not change with a change in body position and does not lead to nausea;
• violations of the visual fields, as well as atrophy of the optic nerve with prolonged presence of adenoma;
• double vision in the eyes;
• violation of eye movements;
• decreased visual acuity;
• nasal congestion similar to sinusitis;
• disturbances of consciousness.

Headaches with pituitary adenoma are poorly suppressed by analgesics, localized behind the eyes, in the forehead and temples. If the pain sharply increases, intensive growth of the adenoma or hemorrhage in its tissue is possible.

If the tumor produces hormones, it may present in different ways, depending on the type.

• Somatotropinoma leads to acromegaly, changes in the skeleton and soft tissues, the development of diabetes and obesity, thyroid problems (goiter formation), increased hair growth, sweating, oily skin, the formation of warts, polyneuropathy with pain and goosebumps, decreased sensitivity in the arms and legs.
• Prolactinoma provokes menstrual disorders in women, infertility and amenorrhea, the flow of milk from the breast. There may be acne, excessive hair growth, obesity, decreased libido. In men – breast growth, milk flow, impotence.
• Corticotropinoma causes Itsenko-Cushing’s disease, increased pigmentation, mental disorders.
• Thyrotropinoma leads to hyperthyroidism, enlargement of the thyroid gland, goiter.
• Gonadotropinoma leads to the release of milk from the breast, problems with menstruation, infertility.

Treatment of pituitary adenoma in adults

The basis of treatment can be conservative measures or surgical removal of the tumor. It depends on its size, growth characteristics and whether it secretes hormones or not. Treatment may be elective or emergency, depending on the severity of the condition.

Diagnostics

Patients can come to an appointment with a neurologist, ophthalmologist or endocrinologist. You can suspect an adenoma by symptoms, but without confirmation by visual tests, treatment does not begin. The doctor prescribes:

• x-ray of the skull with a targeted study of the area of ​​the Turkish saddle;
• pneumocystography to clarify the picture;
• CT or MRI of the brain to clarify the volume and location of the tumor;
• brain angiography.

Hormonal testing is also needed to determine if the tumor is secreting hormones. Determine the levels of cortisol, prolactin, T3 and T4, testosterone, estradiol. An ophthalmological examination is mandatory – visual acuity, perimetry, examination of the fundus, assessment of the condition of the optic nerve papilla.

Modern treatments

Most often, a pituitary adenoma is removed through the nasal passage. This allows you to significantly reduce the recovery period. After such an operation, the patient can quickly return to a full life.

Prevention of pituitary adenoma in adults at home

There are no specific measures to prevent pituitary adenoma. It is impossible to predict who might develop this tumor. It is important to monitor overall health, periodically undergo medical examinations, eat right, control weight.

Popular questions and answers

Pituitary adenoma is one of the most common endocrine tumors that develops in the anterior pituitary gland. In 99% of cases, this is a benign formation. However, in 35% of cases, it can grow rapidly, overgrow the main vessels and brain tissue.

To understand this topic in more detail, to find out the causes of occurrence, symptoms and methods of treatment helped us neurosurgeon Gleb Sergeev.