Pituitary adenoma is a benign tumor of the “main gland” of the body, located in a bony recess, called the Turkish saddle, at the base of the brain. We received detailed information about this disease from the neurosurgeon of the National Hospital, Abzal Kairatovich Zhumabekov.
The pituitary gland is a part of the brain that regulates the work of the thyroid gland, adrenal glands and gonads, as well as growth and metabolism. As the adenoma grows, it can compress adjacent anatomical structures of the brain (for example, the optic nerve). It can also disrupt the production of hormones or change their level. This affects human health. The tumor is most often found in healthy people aged 20 to 50 years, equally often in men and women, and sometimes in children.
What types of pituitary adenomas exist?
By size: microadenoma – up to 10 mm, macroadenoma – more than 10 mm, giant adenoma – more than 40 mm. By hormonal activity: hormonally active (prolactinoma, somatotropinoma, corticotropinoma, etc.). Hormonally inactive: clinically manifested mainly by the size of the tumor and pressure on the adjacent areas of the brain.
The main manifestation is adenoma
The clinical picture and symptoms of the disease depend on the size of the tumor and hormonal activity. Pressure on the brain and optic nerve, constant headaches (most often in the frontal-temporal region, behind the eyes), narrowing of the field of vision (“what you see on the sides”), decreased vision, double vision, “fog” before the eyes, progressive loss of vision. Basically, these symptoms are caused by the fact that the optic nerves are located near the pituitary gland, forming a junction called a chiasm, says Abzal Kairatovich.
Symptoms associated with changes in hormone levels
The type of adenoma depends on the hormone produced by the tumor. And sometimes they lead to the development of their combination. Prolactinoma causes an imbalance of sex hormones. It is manifested by a decrease in the production of estrogen in women and testosterone in men. Symptoms characteristic of prolactinoma: in women — menstrual cycle disorders, absence of menstruation, breast discharge, inability to conceive. In men – decreased potency and libido, infertility and breast enlargement (gynecomastia). Somatotropinoma (excess hormone growth). When developing acromegaly in adults, such signs are observed as: enlargement of arms and legs, change in the shape of the face, violation of bite, pain in the joints, increase in blood pressure, change in voice, metabolic disorders, hair growth all over the body. In children, the tumor leads to progressive, disproportionately high growth. Corticotropinoma (excess of adrenocorticotropic hormone — ACTH) increases the production of cortisol. Cushing’s syndrome: accumulation of adipose tissue in the abdominal cavity and cervical spine, rounding of the face, thinning of the arms and legs, muscle weakness, increased blood pressure, blood glucose levels, acne, stretch marks, bone fractures, anxiety, irritability, depressive mood.
Increased production of thyrotropin hormone. Under the influence of adenoma, the thyroid gland increases the synthesis of the hormone thyroxine. This leads to the following conditions: irritability, tremors, weight loss, rapid heartbeat, frequent urination, excessive sweating.
What is the danger of adenoma?
If not treated in time, adenoma can lead to vision loss, even blindness, and hormonal imbalance (infertility, osteoporosis, hypertension, diabetes, etc.). The person also experiences chronic headaches and deterioration of well-being.
Sometimes hypophysis apoplexy occurs. Hemorrhage in an adenoma causes a sudden severe headache, loss of vision, nausea, weakness and loss of consciousness. In such cases, immediate hospitalization is required.
Diagnosis adenoma hypophysis
The diagnosis of pituitary adenoma is not made immediately, because the symptoms of the tumor are similar to the symptoms of other diseases. The diagnosis is based on the clinical picture, characteristic symptoms and the following studies: MRI of the brain with a focus on the Turkish saddle, hormonal tests (prolactin, growth hormone/IGF-1, ACTH, cortisol, TSH, T4, sex hormones, etc.). You should also be examined by an ophthalmologist to determine the state of vision and field of vision. It is necessary to consult with an endocrinologist. If necessary, other studies are appointed. Based on the results of the examination, a diagnosis is made and a treatment plan is drawn up.
Method of treatment
The choice of treatment strategy always depends on the size of the adenoma, its type, the degree of pressure on other anatomical structures, the presence of complications, age and other factors. Drug therapy: Prolactinoma is often treated with drugs that reduce the level of prolactin. Sometimes, the tumor may decrease on its own and may require surgical intervention. Surgical treatment: Currently, the standard method is to remove the tumor using endoscopic transnasal surgery through the nasal passages.
In this case to this met, pressure on brain structures is reduced by decompressing the optic nerves. Radiation therapy is also used for residual tumors, recurrences, and in cases where radical surgery is not possible. Monitoring: Small, hormonally inactive microadenomas without symptoms can be dynamically monitored using MRI, hormone levels, and scheduled consultations with specialists.
Can adenoma development be prevented?
There is no specific method for preventing its development, but early diagnosis and prevention of complications are important. To achieve this, it is necessary to monitor blood pressure and blood sugar levels. Do not take hormonal medications without a prescription. If signs of changes in the endocrine system appear (obesity, menstrual irregularities, decreased potency, infertility, or changes in appearance), get examined. Do not delay a visit to the doctor if you have headaches or vision problems. If your menstrual cycle has changed, you have breast discharge outside of pregnancy or breastfeeding, or your acromegaly symptoms have worsened (enlarged hands and feet, facial changes, weight gain, weakness, increased blood pressure, visual field narrowing, blurred vision, and double vision), you should consult an endocrinologist or neurosurgeon. An MRI has revealed a tumor in the pituitary gland. A pituitary adenoma is curable if detected early. An urgent consultation with a specialist can help preserve your vision, hormonal balance, and life, says A. Zhumabekov.
