What Is a Pituitary Adenoma?

Pituitary tumors are benign adenomas, which are the most common tumors in the saddle area. There are 1 case in about 100,000 people. There has been an increase in recent years, especially women of childbearing age. The diagnosis of pituitary adenoma is mainly based on the clinical manifestations of the patient, visual field disturbance and other nervous system findings, as well as endocrine and radiological examinations.

Basic Information

English name

Hypophysis cerebri adenoma

Visiting department

neurosurgery

Common causes

Genetic factors, physical and chemical factors, and biological factors

Common symptoms

Endocrine changes such as amenorrhea, lactation, infertility, acromegaly, abnormal blood glucose, and pituitary tumors such as visual field loss, vision loss, etc.

Causes of pituitary adenoma

The etiology is unclear, and the possible causes are: genetic factors, physical and chemical factors, and biological factors.

Clinical manifestations of pituitary adenoma

It is related to the patient's gender, age, tumor size and expansion direction, and type of hormone secretion, including the following 4 groups of symptoms:

1. Pituitary tumors cause symptoms and signs caused by excessive secretion of hormones. Common cases are acromegaly, Cushing's syndrome and prolactinoma.

2. The pituitary compression group, mainly the reduction of pituitary hormone secretion, generally affects growth hormone GH first, followed by luteinizing hormone, follicle stimulating hormone, and finally adrenocorticotropic hormone, thyroid stimulating hormone, a few may be accompanied by diabetes insipidus .

3. Compression syndromes around the pituitary gland, including headaches, decreased vision, visual field defects, hypothalamic syndrome and cerebrospinal fluid rhinorrhea.

4. Pituitary apoplexy refers to pituitary adenoma and / or pituitary infarction, necrosis or hemorrhage. Compression symptoms and meningeal irritation symptoms can quickly appear clinically. The clinical manifestations of hyperpituitarism can disappear or be reduced, and even anterior pituitary function is low Less.

Pituitary adenoma examination

Endocrine examination

Using endocrine radioimmunomicro-quantitative method to directly determine growth hormone, prolactin, adrenocorticotropic hormone, thyroid stimulating hormone, melanin stimulating hormone, follicle stimulating hormone, luteinizing hormone, etc. Great help.

2. Imaging examination

(1) The saddle image is one of the basic examinations. When the pituitary tumor is very small, there is no change in the saddle. As the tumor grows, it can lead to the enlargement of the saddle, bone destruction, and invasion of the saddle.

(2) CT examination showed enhancement of pituitary adenoma with a size of 5mm after enhanced with intravenous contrast agent. Smaller tumors still show difficulties.

Pituitary adenoma diagnosis

The diagnosis of pituitary tumors is mainly based on the patient's clinical manifestations, visual field disturbance and other nervous system findings, as well as endocrine and radiological examinations. The typical diagnosis of pituitary tumors is not difficult. However, in early pituitary tumors, when the symptoms are not obvious, the diagnosis is not easy, and even cannot be found.

Pituitary adenoma treatment

Surgical treatment

Including craniotomy and transsphenoidal surgery.

2. Radiation therapy

It has certain effects on pituitary adenomas. It can control the development of tumors and sometimes shrink the tumors, resulting in improved visual field, but it cannot be cured completely.

3. Drug treatment

Bromocriptine is a semi-synthetic ergotamine alkaloid, which can stimulate dopamine receptors in pituitary cells and reduce the effect of prolactin in the blood. After taking bromocriptine, the prolactin adenoma can be reduced, menstruation and ovulation can be resumed, and the galactorrhea can be suppressed. However, bromocriptine cannot cure the prolactin adenoma at all. After stopping the drug, it can continue to increase and the symptoms reappear. In addition, bromocriptine can also reduce the symptoms of growth hormone cell adenomas, but the dose is large and the effect is poor.

Prevention of infection and symptomatic treatment, and those with complications should deal with the complications. To correct cerebral edema and reduce intracranial pressure, 20% mannitol, furosemide, dexamethasone are the main drugs, and even human albumin can be used. Pay attention to the balance of electrolytes and body fluids, and replenish blood loss during the operation.