Ptuitary Tumors

Abnormal growth of cells in the gland. Almost all tumors are benign glandular tumors called pituitary adenomase rarely cancerous.

Causes: no obviuos cause.

1. Some might be caused by stimulation from the hypothalamus.
2. Inherited conditions example: multiple endocrine neoplasia type 1 (MEN 1). Adisorder that causes tumors in the endocrine glands and the first part of small intestines.

Carney complex: a disorder that causes several types of tumours including in the pituitary gland.

Types:

1. Craniopharyngiomas: often press on nerves, blood vessels or part of the brain around the gland. Are benign, are solid tumors or cysts. Commonly seen in children, teenagers and adults older than 50.

Symptoms:

1. Headache
2. Mood swings or behaviour changes
3. Confusion
4. Weight changes
5. Drowsiness or fatigue
6. Nausea
7. Change in vision

Diagnosis:

Blood and urine test, MRI, CT scan

Treatment:

Surgical removal of the tumor including a procedure called orbitozygomatic craniotomy, radiosurgery, hormone replacement therapy.

Pituitary adenoma:

Benign tumors. Some secrete hormones, can develop at any age, mostly are in the anterior lobe of the gland.

Types:

Functioning adenomas: produce hormones. Ptolactinomas, GH secreting adenomas, corticotropin secreting adenomas, gonadotropin secreting adenomas, thyrotropin secreting adenomas.

Non-functioning adenomas: dont produce hormones. Also called null cell adenomas. Usually detected as macroadenomas because they produce pressure symptoms.

Microadenomas:

1. less than 1cm across.
2. small and cause no pressure symptoms unless they produce hormones

Symptoms: headache, vision problems, menstrual cycle changes in women, mood swings or behaviour changes, erectile dysfunction, weight changes.

Macroadenomas:

1. less than 1cm accross
2. Either cause pressure symptoms because of the increased hormone production

Diagnosis:

T1 MRI, blood and urine test for PRC, GH, IGF1, FT4, cortisol and testosterone (males)

Treatment:

Surgery via enonasal transphenoidal endoscopic surgery, radiation therapy, hormone therapy.

Rathke's Cleft Cysts:

Beinign cysts, develop in the space between anterior and posterior pituitary lobes.

Symptoms:

headaches, vision problems, mood swings and behaviour changes, weight changes, diabetes insipidus.

Diagnosis: 

Blood and urine tests, MRI, CT scan.

Treatment:

Eyebrow craniotomy.

Signs and symptoms for Adenomas:

Prolactinomas:

 infertility, amenorhea, oligomenorrhea (irregular menses), decreased libido, galactorhea, osteoporosis, impotence, vaginal dryness, visual loss.

Acromegaly (GH secreting tumours):

Sleep apnea, hand, foot, face or tongue growth or enlargement, swelling (soft tissue enlarge), coarsening of the facial features, changes in ring or shoies size, spreading teeth, bite difficulties (over or under bites), bell's palsy Carpel tunnel syndrome, joint and bone aches, pains and tendernss (foot and tooth pain), gigantism, excessive perspiration, oily skin, impotence, cushing's disease. (ACTH secreting adenomas)

Contributed by:
Madiha Munir Zuberi.