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Pituitary adenomas are tumors that occur in the pituitary gland. Most pituitary tumors are benign, approximately 35% are invasive and just 0.1% to 0.2% are carcinomas. [1] Pituitary adenomas represent from 10% to 25% of all intracranial neoplasms, with an estimated prevalence rate in the general population of approximately 17%. [1] [2]
Visual field defects may be one of the first signs of non-functional pituitary tumor. These are much less frequent than functional adenomas. Systemic hormonal aberrations such as Cushing's syndrome, galactorrhea and acromegaly usually predate the compressive signs. Pituitary tumors often encroach upon the middle chiasm from below.
The tumor normally results in acral enlargement, arthropathy, hyperhidrosis, changes in facial features, soft tissue swelling, headaches, visual changes, or hypopituitarism. Since pharmacological therapy has had little effect on these tumors, a trans-sphenoidal surgery to remove part of the pituitary gland is the first treatment option. [5]
Treatments may be aimed at curing the disease or at relieving symptoms . Observation may be feasible for non-functioning low-grade neuroendocrine tumors. If the tumor is locally advanced or has metastasized, but is nonetheless slowly growing, treatment that relieves symptoms may often be preferred over immediate challenging surgeries.
About 3% of tumors secrete ACTH, producing Cushing's disease. Most of the remainder are nonfunctional. Local tumor expansion may cause visual disturbance, headache, and hypopituitarism. Pituitary tumors in MEN 1 patients appear to be larger and behave more aggressively than sporadic pituitary tumors.
Hypophysectomy is the surgical removal of the hypophysis (pituitary gland). It is most commonly performed to treat tumors, especially craniopharyngioma tumors. [1] Sometimes it is used to treat Cushing's syndrome due to pituitary adenoma [2] or Simmond's disease [3] It is also applied in neurosciences (in experiments with lab animals) to understand the functioning of hypophysis.
A prolactinoma is a tumor of the pituitary gland that produces the hormone prolactin.It is the most common type of functioning pituitary tumor. [1] Symptoms of prolactinoma are due to abnormally high levels of prolactin in the blood (hyperprolactinemia), or due to pressure of the tumor on surrounding brain tissue and/or the optic nerves.
In cases of tumor-related hyperprolactinemia, prolactinoma is the most common culprit of consistently high levels of prolactin as well as the most common type of pituitary tumor. [2] For non-tumor related hyperprolactinemia, the most common cause is medication-induced prolactin secretion. [3]
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