Pituitary Adenomas
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What is Pituitary Adenomas?

Pituitary adenomas are pituitary gland tumors that are not cancerous. The majority are found in the gland’s front lobe (front section). These adenomas remain in the pituitary gland or the tissue around it, and they grow slowly. They rarely spread to other sections of the body.

The pituitary gland is a tiny gland the size of a pea that connects to the hypothalamus (the base of your brain) just behind your nose. Some pituitary adenomas secrete an excessive amount of one or more hormones. Even when small, endocrine-active pituitary tumors can produce hormonal imbalances that impact physiological processes.

Pituitary adenomas can occur at any age.

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Types

Pituitary adenomas come in the following types:

  • Functioning (secreting) adenomas – Depending on the hormones they release, these adenomas cause different symptoms and/or disorders.
  • Nonfunctioning (non-secreting) adenomas – These adenomas do not release hormones, but if they expand, they can squeeze adjacent structures. Nonfunctioning pituitary adenomas are the most prevalent adenomas diagnosed by healthcare practitioners.
  • Pituitary Microadenomas – Microadenomas are tumors with a diameter of less than one centimeter. The majority of pituitary adenomas are microadenomas that rarely cause symptoms. Microadenomas are typically discovered during an MRI to screen for another medical problem.
  • Pituitary Macroadenomas –  Macroadenomas are glandular tumors with a diameter of more than one centimeter. Pituitary macroadenomas put pressure on the brain and pituitary gland, which results in more symptoms than microadenomas.

Causes

DNA mutations cause uncontrolled cell growth and division in the pituitary gland, which leads to the development of pituitary adenomas. Experts are unsure of the exact etiology of these genetic abnormalities. Pituitary tumors rarely run in families, but in the majority of cases, there is no clear genetic component. The risk of pituitary tumors and other endocrine system malignancies may be higher in people with multiple endocrine neoplasias, type I. Even so, many pituitary tumors have no known cause.

Risk factors

Some people inherit from their parent’s gene mutations (changes) that enhance their chance of developing pituitary tumors. a few of these genetic syndromes are caused by these mutations.

External exposures like radiation or cancer-causing substances can result in acquired gene alterations in some cancer forms. However, no known environmental causes of pituitary tumors have been identified. The gene changes in these cancers could simply be random events that occur when a cell divides, with no outside cause.

Sometimes the tumor cells in pituitary tumors that don’t run in families have developed mutations in genes such as AIP, GNAS, USP8, USP48, and BRAF. Some forms of pituitary adenomas exhibit these mutations far more frequently than others. Source

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Symptoms

Pituitary adenomas can lead to various symptoms, depending on several circumstances, including:

  • Vision issues (blurred or double vision, drooping eyelid)
  • Headaches in the area of the brow
  • nauseousness or vomiting
  • Sense of smell impairment
  • Sexual impotence
  • Depression
  • Fatigue
  • Infertility
  • Growth issues
  • Osteoporosis
  • Unknown cause of weight increase
  • Unknown cause of weight loss
  • Simple bruising
  • Joint aches
  • The carpal tunnel syndrome
  • Menstrual irregularities
  • Menopause in its early stages
  • Muscle fatigue
  • Galactorrhea (spontaneous breast-milk flow not related to childbirth or the nursing of a newborn) (spontaneous breast-milk flow not associated with childbirth or the nursing of an infant)
Headaches in the area of the brow

Diagnosis

The diagnosis of pituitary adenomas is dependent on the type of adenoma and the extent to which it is generating symptoms.

When a pituitary tumor is detected, a doctor will do a physical exam as well as vision testing to discover visual field abnormalities such as loss of peripheral vision. To confirm the diagnosis, blood and urine hormone testing, as well as brain imaging examinations, are used. Magnetic resonance imaging (MRI), conducted with and without a contrast agent, is the most accurate diagnostic imaging test.

Pituitary adenomas are sometimes discovered by chance when you get a brain imaging exam for another condition. The adenoma in these circumstances is usually tiny and nonfunctional.

Treatment 

Pituitary adenomas are typically treated with surgery, observation, medicine, radiation, or a combination of these methods. Because each pituitary adenoma is unique, you and your healthcare team will build a treatment strategy that is right for you.

  • Observation entails seeing a neurosurgeon or endocrinologist, who can prescribe a regular schedule of imaging tests to monitor the tumor’s progress.
  • Some hormone-producing pituitary tumors can be treated extremely effectively with medication (drug therapy).
  • External beam radiation therapy and stereotactic radiosurgery are two types of radiation therapy for pituitary tumors.
  • In rare cases, a craniotomy may be necessary during surgery to remove a pituitary adenoma, but this is less common and instead employs a minimally invasive technique termed endonasal endoscopic surgery, in which the tumor is removed through the nose.

When to see the Doctor

Consult your doctor if you experience symptoms that could be caused by a pituitary adenoma. Treatment for pituitary adenoma can often restore hormone levels to normal and alleviate symptoms.

Some pituitary tumors are inherited, notwithstanding their rarity. That is, they are passed on through families. Pituitary adenoma can be caused by the inherited illness of multiple endocrine neoplasia type 1 (MEN 1). If MEN 1 run in your family, talk to your doctor about tests that can help detect a pituitary tumor early.

Prevention

There is nothing you can do to avoid having a pituitary adenoma. Most pituitary adenomas develop at random, however, they are also linked to some rare hereditary disorders.

Your doctor may advise you to have frequent blood testing for pituitary hormone levels to maximize your chances of detecting and treating a pituitary tumor before it causes difficulties.

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