Pituitary Adenoma
The pituitary gland is a small pea-sized structure attached to the base of the brain at the back of the nose. Just above the pituitary gland is the hypothalamus , which controls the release of the pituitary's own hormones . The pituitary gland directly produces hormones that control the function of certain organs, such as the breasts, uterus, and kidneys.
on many systems, including the pituitary, growth, development and reproduction .
Most tumors that arise within the pituitary gland are classified as pituitary adenomas. Pituitary adenomas are benign, slow growing tumors. Most pituitary adenomas are microadenomas less than 1 cm in diameter . However, in some patients they may be larger ( macroadenoma ).
cause symptoms by releasing extra hormones into the bloodstream. However , not all adenomas produce hormones. About one-third of adenomas are classified as non-functioning adenomas. These cause symptoms when they grow and put pressure on the pituitary gland and surrounding brain tissue.
Pituitary adenomas are generally considered benign, although some are more aggressive than others. They do not spread to other parts of the brain, they only remain within the pituitary gland.
Pituitary adenomas are the third most common brain tumors in adults.
Pituitary adenomas can occur at any age, but are more common in people in their 30s or 40s and are rare in people younger than 20.
It is observed more frequently in women than in men.
SYMPTOMS
Because the pituitary gland has a wide variety of functions, symptoms differ from patient to patient. Symptoms are usually caused by changes in the levels of hormones produced by the gland.
- Delayed puberty in children
- Changes in menstrual periods or early menopause in women
- Increased or decreased sex drive
- Attacks of overgrowth in both children and adults, especially in the hands or feet
- Unexplained weight gain or loss, sometimes with loss of appetite
- Extreme tiredness and/or weakness
- Personality changes such as depression, anxiety
- low blood pressure
- Loss of muscle mass in adults
- Easy bruising of the skin, often with muscle weakness
- Changes in sense of smell
- Vision problems such as blurriness, double vision, peripheral vision loss
- Headache
- Nausea and vomiting
If the tumor is large enough to press on the surrounding brain tissue, the symptoms can be very similar to those of other brain tumors found in this part of the brain.
The optic nerves, which carry visual signals, are located just above the pituitary gland. As the pituitary adenoma grows, the tumor grows upward, compressing the optic nerves and can cause visual impairment.
TREATMENT
Treatment options for pituitary adenomas include surgery, medications, and stereotactic radiotherapy is available.
SURGICAL
Endoscopic transsphenoidal pituitary adenoma surgery is performed under general anesthesia. An endoscope (a small light and camera on a long tube) is inserted into the nostril towards the base of the tumor. Surgical instruments are then inserted through the same nostril next to the endoscope . The tumor is removed and the space occupied by the pituitary is closed.
STEREOTACTIC RADIOSURGERY (GAMAKNIFE - CYBERKNIFE)
stereotactic Radiotherapy is used for small brain tumors. Usually only 3-4 cm in diameter and relatively close to the skull in an easily accessible part of the brain are preferred. It is administered by giving very sensitive focused gamma rays or x-rays at higher doses than those used in standard radiotherapy .
CONDITIONS THAT MAY OCCUR AFTER Pituitary Surgery
One of the potential side effects of tumor removal is that the pituitary gland can no longer produce hormones. People may then need to take hormone supplements to bring them back to normal levels and may need to use these supplements for the rest of their lives.