What Causes Pituitary Adenoma? What are The Symptoms And How Are Adenomas Treated?

What is Pituitary Adenoma?

A pituitary adenoma is a tumor on the pituitary. Most pituitary adenomas are slow-growing and benign, which indicates they are not cancer and do not spread to other parts of the body. However, as they become large they can put pressure on nearby structures, such as the nerves that join the eyes to the brain and cause symptoms. This is also recognized as the “mass effect”.

A large adenoma can also damage normal pituitary cells and keep them from working properly, leading to a condition called hypopituitarism. This condition can cause low blood pressure, tiredness, and shifts in your sex drive and function. It can also make you feel less capable to manage stress. Pituitary adenomas are identified based on their sizes. Tumors less than 1 cm are called microadenomas. Tumors more prominent than 1 cm are called macroadenomas. Many adenomas cause signs by releasing extra hormones into the bloodstream, but not all adenomas make hormones. Some, called non-functioning or null cell adenomas, do not produce hormones. Approximately one-third of all pituitary tumors are non-functioning adenomas. They normally become large and are found because they begin symptoms due to the mass effect.

What Causes Pituitary Adenomas?

The definite cause of pituitary adenomas is not understood. However, some have been connected to accidental changes in DNA, the material within a cell that makes up our genes. These variations cause the cells in the pituitary to be abnormal and rise out of control, making a tumor. The changes can be moved down from the parents to their children but usually, appear on their own sometime during a person’s life.

Symptoms

The symptoms of a pituitary tumor, other than mass effect commonly result from endocrine dysfunction. For instance, this dysfunction can cause excess growth hormones as in acromegaly or underproduction of thyroid hormone as in hypothyroidism. Hormonal imbalance can affect fertility, menstrual periods, heat and cold sensitivity as well as the skin and body in other ways.

Because of the pituitary gland’s strategic location within the skull, tumors of the pituitary can decrease important brain structures as they enlarge. The most common causes involve compression of the optic nerves leading to a gradual loss of vision. This vision loss usually starts with a deterioration of peripheral vision on both sides.

The appearance of three or more of the following symptoms may indicate a pituitary tumor:

  • Vision problem
  • Headaches
  • Nausea or vomiting
  • Depression
  • Fatigue
  • Osteoporosis
  • Unexplained weight gain
  • Easy bruising
  • Aching joints
  • Carpal tunnel syndrome
  • Disrupted menstruation
  • Muscle weakness
  • Galactorrhea
  • Sexual dysfunction

Treatment

Early intervention provides the best chance for the cure or control of a pituitary tumor and its side effects. There are three types of treatment done for pituitary tumors: Surgical removal of the tumor, radiation therapy using high-dose x-rays to kill tumor cells, and medication therapy to shrink or eradicate the tumor.

Surgery

The transsphenoidal procedure involves accessing the tumor through the nasal cavity using either a microsurgical or endoscopic approach, whichever the surgeon prefers. Surgically is regularly combines with the use of computer guidance, allowing a minimally invasive approach. Transsphenoidal surgery is constantly the procedure of choice in small functional adenomas and in most macroadenomas with the exception of prolactinomas. This surgery is usually very well tolerated because of its minimally invasive characteristics, few side effects, and quite a patient recovery, Patients can leave the hospital as early as two or three days after surgery.

Radiation Therapy

Radiation therapy uses high-energy x-rays to destroy abnormal pituitary tumor cells. Radiation is remarkably effective in stopping tumor growth and with time, will lead to tumor shrinkage. Radiation therapy may be an alternative if the tumor cannot be treated effectively through medication or surgery.

Medication Therapy

Prolactinomas are the most frequent secreting pituitary adenoma seen clinically. In usual, medical therapy is the first course of treatment. With medical management, about 80 percent of patients have prolactin levels replaced to normal through dopamine agonist therapy. The most commonly practiced agents are bromocriptine. The size of the tumor will be decreased in the majority of the patients to varying degrees, often resulting in improved vision, resolution of headaches, and restored menstruation and fertility in women.

Cabergoline is currently the most generally used of the two drugs, having fewer side effects and usually requiring only twice a week dosing schedule. Bromocriptine needs a once-a-day dosing regime and generally has more side impacts including gastrointestinal upset, nausea, and dizziness with getting up too fast. It has also been proved to be effective in patients who are resistant to bromocriptine therapy.

Last Updated on July 28, 2023 by john liam