Pituitary tumors

Pituitary tumors

Pituitary tumors or pituitary adenomas account for 15% of cerebral tumors. They are almost all benign tumors of the anterior (front) of the pituitary gland, which creates a number of important hormones that control other glands in the body, such as the thyroid, testes, and ovaries. Other pituitary tumors can produce hormones, due to overproduction of these hormones. For example, a prolactinoma can lead to loss of periods, infertility or leakage of milk from the breast in women; or reason impotence in men.

Tumors that secrete growth hormone can reason acromegaly, where soft tissues in the body enlarge, such as the nose, tongue, fingers, and heart. They can also reason other situation such as hypertension and diabetes. In children, excess growth hormone produces gigantism.

An over-secretion of ACTH can reason Cushing’s disease, where patients develop high blood pressure, depression, diabetes, osteoporosis, and other problems. On rare occasions, pituitary tumors can secrete TSH, which can reason hyperactivity of the thyroid gland.

The anterior pituitary gland produces the following hormones

Follicle Stimulating Hormone (FSH) – stimulates the ovaries to make eggs but is also important in the male for fertility.

Adrenocorticotropic Hormone (ACTH) – stimulates the adrenal gland to produce cortical and aldosterone, two very important hormones.

Thyroid Stimulating Hormone (TSH) – stimulates the thyroid.

Luteinizing Hormone (LH) – stimulates the ovaries to produce progesterone to help prepare the uterus for the reception of a fertilized egg.

Growth Hormone (GH) – stimulates the liver to produce ILF-1, which stimulates many cells in the body to grow.

Prolactin (PRL) – is necessary for milk production in pregnant females.

The posterior pituitary gland produces two hormones

Anti Diuretic Hormone (ADH) – this hormone concentrates water in the kidney; stop the kidneys from losing many litres of water per day.

Oxytocin – this is significant for the release of milk when a baby suckles the breast of its mother.

Broadly speaking, there are two types of pituitary tumours:

Macro adenomas- which are tumours over one cubic centimeter.

Micro adenomas– which are less than one cubic centimeter.

Pituitary tumours can reason problems by growing too large and compressing adjacent structures, such as the optic nerves or the nerves that control eye movement. Sometimes these tumours expand suddenly, causing headaches and a rapid onset of blindness.

surgery is needed there are two approaches

  1. Pituitary surgery

This is regularly performed through the nose with an endoscope and in conjunction with an ear, nose and throat surgeon who specializes in anterior fossa surgery.

An endoscope is placed in one nostril. A small amount of bone is removed from the base of the brain at the back of the nose, allowing access to the pituitary gland. The tumour is removed using special endoscopic equipment. This exposure avoids the need for a craniotomy.

  1. Craniotomy

Some pituitary tumours will necessitate a craniotomy, which means performing a skull opening through the side of the skull. This is rarely necessary and only used when the tumours are large and extend laterally or up further into the brain.