Pituitary Adenoma

A pituitary adenoma is a slow-growing and typically benign tumor arising from cells in the pituitary gland. Because they originate from cells in the pituitary gland, they often cause problems related to hormonal dysfunction. A large proportion of these tumors grow to a size where they cause symptoms because they compress surrounding structures. For these reasons, larger pituitary tumors (called macroadenomas) often present with headache, visual loss and pituitary gland dysfunction. Changes in energy level, sexual function and libido, and many other symptoms may be a result of a dysfunctional pituitary gland (called hypopituitarism).

Other types of tumors and cysts are also often seen in the pituitary area, and some require surgical management. These include craniopharyngiomas, Rathke’s cleft cysts, meningiomas, and other less common neoplasms and inflammatory processes.

Causes of pituitary adenomas
The specific cause of pituitary adenoma development is unknown, although they are likely to be caused in part by random mutations in cells of the pituitary gland. Congenital syndromes known to be associated with some pituitary adenomas make up only a minority of patients with these tumors.

Treatment for pituitary tumors involves various options, including removing the tumor, controlling its growth and managing your hormone levels with medications.

Signs and symptoms of pressure from a pituitary tumor may include:

Headache
Vision loss, particularly loss of peripheral vision
Nausea and vomiting
Symptoms of pituitary hormone deficiency
Weakness
Less frequent or no menstrual periods
Body hair loss
Sexual dysfunction
Increased frequency and amount of urination
Unintended weight loss or gain

Risk factors:

Although pituitary tumors can occur at any age, they're most likely to occur in older adults. People with a family history of certain hereditary conditions, such as multiple endocrine neoplasia, type I (MEN I), have an increased risk of pituitary tumors. In MEN I, multiple tumors occur in various glands of the endocrine system. Genetic testing is available for this disorder.

COMPLICATIONS

Vision loss, permanent hormone deficiency and diabetes insipidus.

A rare but potentially serious complication of a pituitary tumor is pituitary apoplexy, when sudden bleeding into the tumor occurs. Pituitary apoplexy requires emergency treatment, usually with corticosteroids and possibly surgery.

Tests and diagnosis: Blood and urine tests to determine whether there is any over production or deficiency of hormones.
Brain imaging: CT and MRI to judge the location and size of pituitary tumor.
Vision testing: Such tests can determine if growth of a pituitary tumor has impaired your sight or peripheral vision.

Treatment involves a team of medical experts, possibly including a brain surgeon (neurosurgeon), endocrine system specialist (endocrinologist) and a nervous system specialist (neurologist). Doctors generally use surgery, radiation therapy and medications, either alone or in combination, to treat a pituitary tumor and return hormone production to normal levels.

Surgery include: Endoscopic transnasal transsphenoidal and Transcranial approach (craniotomy).
Radiation therapy include: External beam radiation and Gamma Knife stereotactic radiosurgery.