Pituitary adenoma

The pituitary adenoma It is a benign neoplasm originating from one of the five cell types in the anterior pituitary. Depending on the cells affected, the tumor will make one type of hormone or another: growth hormone-producing cells, prolactin-producing cells, thyroid-stimulating hormone-producing cells, adrenal gland-stimulating hormone-producing cells, and adrenal gland-producing cells. stimulating hormones of the ovarian cycle. But some tumors make more than one hormone, the most common being the production of growth hormone and prolactin together. And other tumors that do not manufacture any type of hormone or cause the loss of manufacture of any of the hormones of the pituitary.

Symptoms of pituitary adenoma

The clinical manifestations of pituitary adenoma They will depend on two aspects: the tumors that secrete hormones, the type of hormone or hormones they manufacture; and if they do not manufacture hormones, from the symptoms derived from their growth or from the blockage in the manufacture of other hormones. In the case of prolactinoma (prolactin-producing tumor), there may be milk secretion outside of pregnancy. In the case of growth hormone hypersecretion, there will be an exaggerated growth of the individual (gigantism or acromegaly). The tumor that overproduces the hormone that stimulates the adrenal glands will produce a, and the tumor that makes higher amounts of the thyroid stimulating hormone will cause hyperthyroidism.

The clinical manifestations derived from tumor growth will arise by compression of neighboring structures. In this way, when the adenoma grows in an upward direction, it compresses the optic chiasm, that is, the conjunction of the optic nerves that carry nerve impulses from the retina. Thus, there may be characteristic symptoms such as loss of vision in the most lateral regions of the visual field. At the same time, if the growth of the pituitary adenoma It is performed predominantly through the lateral regions, it may affect the III, IV, and V cranial nerves. Thus, symptoms such as drooping of the eyelid, paralysis of eye movements, and pain with a tingling sensation in the face may appear. If, on the other hand, the growth of the adenoma affects the hypothalamus, symptoms such as excess food intake, disorders of body temperature control, and diabetes insipidus, among others, may be evident.

The growth of the tumor that does not produce hormones can lead to a lack of growth of one or more other hormones, giving a partial or total lack of function of the pituitary gland (what is called pituitary insufficiency).

Diagnosis

The diagnosis of pituitary adenoma It begins with the medical suspicion and blood tests for hormones.

The study will be completed with imaging tests to locate and determine the extent of the adenoma and the possible involvement of neighboring structures. The best technique is magnetic resonance imaging.

Treatment of pituitary adenoma

Treatment may be removing or blocking the tumor, and treating excess hormones. This can be done using three therapeutic modalities: medical treatment, surgical intervention, and radiation therapy.

Surgical treatment is usually performed through the nose (transsphenoidal surgery), and it is a fairly safe technique. In the case of small adenomas, it has a high cure rate, while in larger tumors the cure is less. The results after surgery are usually very fast, although they can recur in subsequent years. The main disadvantage is that when part of the pituitary is removed, they can later present a deficit of one or more pituitary hormones, developing hypopituitarism.

It is usually effective in slowing the growth of an adenoma, although its results usually take time and symptoms are not quickly controlled. It can be used as an adjunct after surgery.

Medical treatment is usually carried out according to the predominant hypersecretory hormone. In the case of prolactinomas, cabergoline or bromocriptine is of choice; in excess secretion of growth hormone and thyroid stimulating hormone, octreotide is the preferred choice.

Tumors that secrete hormone-stimulating adrenal glands and tumors that do not make hormones usually do not respond to medication and require surgery, radiation therapy, or both.

Precautionary measures

There are no measures to prevent the appearance of a tumor in the pituitary gland, but in the event of symptoms of hormonal hypersecretion, a doctor should be consulted for a correct examination. Check the insurance of

Internal Medicine specialist