(Tumor of the pituitary, tumor of the nervous system)
What is Adenoma in the Pituitary
The pituitary is a small gland. It is located at the base of the brain. The gland produces hormones that regulate the growth and activity of other glands. An adenoma in the pituitary is an abnormal bulge or tumor in this gland. The adenomas in the pituitary are benign. This means that they are not cancerous. They do not spread to other parts of the body. Bulging can cause growth and vision problems. They can also break the hormonal balance.
Adenoma in the Pituitary Causes
The cause is unknown. Some tumors have been associated with changes in DNA. They can be hereditary.
Tumors can also result from exposure to substances that cause cancer. In some cases, alterations in DNA can occur for unknown reasons.
Adenoma in the Pituitary Risk factors
Here are some factors that increase the chances of having a pituitary adenoma:
Family or personal history of multiple endocrine neoplasia type 1 (MEN1), a hereditary disease that increases the risk of developing tumors of the pituitary, hypothalamus and parathyroid gland.
Adenoma in the Pituitary Symptoms
The symptoms can be varied. They depend on whether the tumor secretes hormones or not. The location of the tumor at the base of the brain can also cause symptoms.
The general symptoms may include:
- Blurry vision
- Impotence and infertility
- Painful sexual intercourse
Symptoms of prolactin-secreting adenoma (40% of all cases)
- Fractures due to osteoporosis
- Milk production in women who do not breastfeed
- Vaginal dryness
Symptoms of thyrotropin-secreting adenoma
- Thyroid enlargement (eg, goiter)
Medications can control the symptoms and, sometimes, reduce the tumor. They can block the secretion of hormones.
Symptoms of corticotropin-secreting adenoma
- Menstrual disorders
- High blood pressure
- Fasting high glucose
- Changes in the skin (increased facial hair, acne, bruises, blue marks on bands)
- Buffalo hump (increased fatty tissue in the back)
- Obesity, especially around the waist
- Round face
- Growth hormone secreting adenoma
- Acromegaly (adult)
- Gigantism (child)
- High blood pressure
- High fasting blood sugar level
- Coarse characteristics on the face
- Oil skin
- Excessive sweating
- Pituitary adenomas may also be associated with the following diseases:
- Mellitus diabetes
- Kidney stones
- Cardiovascular diseases
- Thyroid disease
Adenoma in the Pituitary Diagnosis
The doctor will ask about your symptoms and medical history. You will have a physical exam. You can be referred to an endocrinologist. It is a doctor who specializes in these glands. Tests may include:
- Blood tests: to measure hormone levels, blood sugar levels (prolactin, TSH, growth hormone, corticotropin or aCTH, beta human gonadotropin, type 1 insulin-like growth factor, alpha subunit and to identify other conditions underlying factors that may be causing the symptoms.
- Urinalysis: to measure the levels of excretion of certain hormones of the pituitary gland (beta human gonadotropin, cortisol).
- Visual field tests: to detect peripheral vision problems.
- MRI: a test that uses powerful magnetic and radio waves to record images of the structures inside the brain.
- Glucose tolerance test: standard test for acromegaly.
Dexamethasone suppression test and corticotropin-releasing hormone (CRH) test: these are the most appropriate tests to identify if the excessive secretion of hormones from the adrenal gland is due to an adenoma in the pituitary.
Adenoma in the Pituitary Treatment
The treatment depends on the presence and type of hormones that are secreted. It is common for these treatment options to be used in combination. Ask your doctor what is the best plan for you.
Treatment options include:
Frequently, surgery is done to remove the tumor. The pituitary gland can be damaged during surgery. This can be treated with medications. Certain hormones produced by the pituitary will be replaced.
Medications can control the symptoms and, sometimes, reduce the tumor. They can block the secretion of hormones. Medications may include:
- Dopamine agonists, p. eg, bromocriptine
Radiotherapy involves the use of radiation to kill tumor cells. The types of radiation therapy used to treat the pituitary adenoma include:
- Conventional therapy: radiation is emitted directly to the pituitary from a source external to the body
- Stereotactic radiosurgery: an intense beam of radiation is emitted directly to the tumor
- Proton beam radiotherapy: a beam of protons (positively charged particles) is focused directly on the tumor
How to Prevent Adenoma in the Pituitary
There are no guidelines to prevent adenoma in the pituitary.