The pituitary adenoma is a benign tumor of slow growth. It originates in the cells that make up the pituitary gland. This gland regulates the function of other glands in the body, which is why it is so important.
The pituitary adenoma is relatively common and manifests with an approximate frequency of 1 in every 1000 adults. In general, it is a benign and slow-growing tumor. On the other hand, Pituitary carcinomas or malignant tumors are very unusual.
There is no distinction in terms of sex, they affect men and women equally. Regarding age, there is a greater incidence between 30 and 40 years.
The actual causes of pituitary adenoma are unknown, although, in some cases, It is related to a genetic disease called Multiple Endocrine Neoplasia Syndrome.
Symptoms of pituitary adenoma
The main symptom that results from these tumors is the alteration in the secretion of hormones. Depending on the incidence of the tumor in the pituitary gland, they can produce too much of one or more hormones.
Due to the alteration in the endocrine system, The symptoms can be:
- Hyperthyroidism: the thyroid gland produces an excessive amount of hormones; This symptom is quite unusual in those affected by a hypophyseal adenoma.
- Cushing's syndrome: the level of the hormone cortisol is higher than normal.
- Acromegaly: in the case of an elevated level of growth hormone in children gigantism will occur. In the case that this occurs in an adult, there is talk of acromegaly.
- Milk secretion and production in men and women.
- Irregular menstrual periods in women, by alteration of sex hormones.
On the other hand, the symptoms that occur when there is compression of brain structures due to a large pituitary tumor They can include:
- Visual alterations such as double vision, loss of visual field, drooping eyelids or changes in color vision.
- Fatigue and drowsiness.
- Nasal flow of clear liquid.
- Nausea and vomiting.
- Problems with the sense of smell
When these symptoms manifest themselves suddenly and simultaneously, they can be serious. Further, they can cause a hypophysis infarction.
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Types of adenomas
Pituitary adenomas can be classified according to size in the following way:
- Microadenomas: less than 1 cm.
- Macroadenomas: greater than 1 cm. This type of adenoma causes a high percentage deficit in one or more pituitary hormones.
Further, They can be classified according to whether they secrete hormones themselves or not. Following this criterion, they can be functional, if they secrete hormones by themselves, and non-functional adenomas, if they do not secrete hormones.
For the diagnostic, it is necessary to perform a physical examination, in which any problem of double vision and visual field is analyzed. In addition, the loss of lateral or peripheral vision and the ability to see in certain areas are also studied.
After, an analysis of endocrine function is performed to look for any sign of hormone excess or irregularity. Parameters are measured such as elevated cortisol levels, Cushing's syndrome or too much growth hormone.
The most relevant tests that help confirm the diagnosis are visual field and CT and brain MRI.
Read also: 14 signals that indicate a high level of cortisol
Treatment of pituitary adenoma
The current therapeutic options include:
- Pharmacological and hormonal substitution treatment: Medications that block hormone secretion can control symptoms and even reduce the size of the tumor.
- Radiotherapeutic techniques: they are usually used to decrease the size of the tumor.
- Surgery of the pituitary adenoma: The removal of most of these tumors is through the nasal cavity. However, in other cases, a craniotomy or opening of the skull is needed.
Endoscopic nasal surgery involves inserting an endoscope through the nostrils, which slides between the middle turbinate and the nasal septum, until the sphenoid hole is located. This orifice is enlarged to achieve a sufficient opening of the sphenoid sinus and visualize the floor of the sella turcica to extract the tumor.
The most serious complication is blindness, in case of serious damage to the optic nerve. In addition, the tumor or its removal can cause hormonal imbalances for life and cause diabetes insipidus. This type of diabetes is characterized by the symptoms of frequent urination and extreme thirst.