Pituitary adenoma is a benign tumor that originates from the glandular tissue of the anterior lobe of the pituitary gland. Clinically, the adenoma of the pituitary gland is characterized by an ophthalmic-neurologic syndrome (headache, oculomotor disorders, doubling, narrowing of the visual fields) and endocrine-exchange syndrome, in which, depending on the type of pituitary adenoma, gigantism and acromegaly, galactorrhea, impaired sexual function, hypercortisy, hypo or hyperthyroidism, hypogonadism. The diagnosis of adenoma of the pituitary gland is established on the basis of X-ray and CT of the Turkish saddle, MRI and angiography of the brain, hormonal studies and ophthalmological examination. The pituitary adenoma is treated by radiation, radiosurgical method, and also by transnasal or transcranial removal.
Causes of pituitary adenoma
The etiology and pathogenesis of the pituitary adenoma in modern medicine remain the subject of research. It is believed that the adenoma of the pituitary gland can occur when exposed to such provocative factors as cerebral trauma, neuroinfections ( tuberculosis, neurosyphilis, brucellosis, poliomyelitis, encephalitis, meningitis, cerebral abscess, cerebral malaria, etc.). Recently, it is noted that the adenoma of the pituitary gland in women is associated with prolonged use of oral contraceptive drugs.
Symptoms of pituitary adenoma
Clinically, the pituitary adenoma manifests itself as a complex of ophthalmic-neurological symptoms associated with the pressure of a growing tumor on the intracranial structures located in the region of the Turkish saddle. If the adenoma of the pituitary gland is hormone-active, then in its clinical picture, the endocrine-exchange syndrome may come to the fore. In this case, changes in the patient’s condition are often associated not with the hyperproduction of the tropic pituitary hormone, but with the activation of the target organ to which it acts. Manifestations of the endocrine-exchange syndrome directly depend on the nature of the tumor. On the other hand, the adenoma of the pituitary gland can be accompanied by symptoms of panhypopituitarism, which develops due to the destruction of the pituitary tissues by a growing tumor.
Treatment of pituitary adenoma
Conservative treatment can be used mainly for prolactin small size. It is carried out by antagonists of prolactin, for example, bromocriptine. With small adenomas, it is possible to use radiation methods to influence the tumor; gamma therapy, remote radiation or proton therapy, stereotactic radiosurgery, the introduction of radioactive substance directly into the tumor tissue.
Patients who have large pituitary adenomas and / or are accompanied by complications (hemorrhage, visual impairment, brain cyst formation ) should undergo a neurosurgeon’s consultation to consider the possibility of surgical treatment. The operation to remove adenoma can be performed in a transnasal way using endoscopic techniques. Macro-adenomas are to be removed transcranially by trepanation of the skull.