Pituitary adenoma - causes and symptoms, classification and methods of treatment of a tumor

Pituitary adenoma( hereafter for convenience of hypertension) is benign tumor of glandular tissues of the pituitary located in its anterior lobe.

Adenomas that are located at the base of the skull - in the area of ​​the Turkish saddle, according to statistics, constitute 10% of all primary brain tumors.

It should be noted that every third person has this or that pathological abnormality of the pituitary gland.

The main danger of such tumors is their ability to germinate and then squeeze adjacent tissues and brain structures - this can manifest itself as impaired vision, endocrine system and general neurological abnormalities.

Causes of the tumor

To date, medicine does not indicatefull-time factors that may cause pituitary adenoma. But there are a number of factors contributing to the emergence of AG:

• various neuroinfections - for example, encephalitis, meningitis, poliomyelitis, brucellosis, neurosyphilis, tuberculosis, brain abscess;
• craniocerebral trauma;
• pathology of intrauterine development;
• according to some data is dangerous for long-term use of oral contraceptives.

All causes of pituitary adenoma can be combined according to their effect - they all cause hyperplasia ( excessive multiplication of cells) of the pituitary tissues due to hormonal disorders.

These factors describe the theory of hypotholeamic regulation of rhizome-releasing hormones.

According to her teaching, it is believed that this is preceded by a decrease in the synthesis of hormones of the peripheral endocrine glands( due to disease, trauma or excess of hormones taken) and there is an excess of liberins or a lack of statins( the first and second are the pituitary hormones).

On the other - the theory of internal "defect" of the pituitary gland - hyperplasia cause genetic abnormalities in one cell, which regenerates and becomes the first cell of the neoplasm.

Classification of pituitary adenoma

There are 6 types of classification.

For size

Allocate:

• microadenoma - up to 10 mm;
• macroadenoma from 10 to 30 mm or beyond the Turkish saddle;
• mesodenoma from 10 to 20 mm or within the Turkish saddle;
• giant adenoma - more than 30 mm.

By the nature of the distribution

The nature of the distribution happens:

• endosellar - within the Turkish saddle;
• with supersellar growth;
• with parasellar growth - sprouts into cavernous sinuses;
• with infrasonic growth;
• with retrosellar growth.

By the nature of staining

For this indication, is isolated:

• is eosinophilic;
• are basophilic;
• are chromophobic.

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For hormonal activity

According to the activity of hormones, there are:

• active;
• inactive.

By type of produced hormones

There are following :

• prolactinoma;
• somatotropinoma;
• corticotropin;
• of thyrotropinoma;
• gonadotropinoma;
• producing alpha subunit;
• is a mixed type of secretion.

By type of origin

By origin are:

• primary-pituitary;
• secondary, arising due to decreased function of peripheral endocrine glands;
• appearing due to abnormalities in the functions of the hypothalamus or the synthesis of releasing hormones.

Symptoms and signs of pituitary adenoma

Symptoms and signs of pituitary adenoma in women and men are divided into ophthalmic-neurological complex of symptoms and endocrine-exchange.

Symptoms of the first complex depend on the nature of tumor growth( direction and localization).

is a dull headache due to the compression of tissues in the area of ​​the Turkish saddle, with no vomiting and no correlation with the position of the body, the patient feels it in the temporal and frontal areas and behind the orbits, analgesics do not give an analgesic effect.

If the pain increases, it is due to the growth of the tumor or hemorrhage. Also characterized by visual impairment - diplopia( double vision), changes in visual fields and oculomotor disturbances.

Violation of the functions of the hypothalamus can lead to a change in consciousness.

For the endocrine-exchange complex are characterized by:

1. Gigantism( in children) and acromegaly( in adults) occurs with somatotropinome. Characteristic of diabetes and obesity, an increase in thyroid gland, various skin disorders.
2. Prolactinoma causes disorders in the genital area - in women the disorder of the menstrual cycle, in men - impotence and a decrease in sexual desire.
3. Corticotropinoma manifests itself in the form of enhanced skin pigmentation and mental disorders
4. Thyrotropinoma is characterized by nervousness, imbalance, persistent fear, protrusion of eyeballs, mid-vascular disorders.
5. Gonadotropinoma is characterized by nonspecific symptoms of an ophthalmic-neurological nature.

Treatment Procedures

For the first symptoms of pituitary adenoma, treatment is prescribed using an ergot formulations - bromocriptine.

In the fight against other types of small-sized adenomas, is often used with in the form of gamma or proton therapy, sometimes radioactive substances are injected directly into the tumor.

For larger adenomas or certain complications( hemorrhages, cysts, visual impairment) surgical intervention is used.

In the case of a macroadenum, is used for trephination of the skull of , with smaller dimensions - transnazal operation is possible.

Prediction and consequences of

Despite the fact that AG belongs to benign neoplasms, it is dangerous for its growth, which causes compression of neighboring tissues of the brain.

Also, if the tumor size exceeds 20 mm, a relapse of the disease is possible within 5 years after the operation.

The most favorable prognosis for microcorticotropinomas is 85% of the probability of complete recovery of all pituitary functions, 20-25% for somatropinoma and prolactinoma.

Relapses account for 12% of the total number of operations and 67% of the operated patients recover. Sometimes prolactinomas self-cure.

Video: Pituitary adenoma - manifestations, diagnosis, treatment

Symptoms and signs of pituitary adenoma, diagnosis and types of tumor and their clinical manifestations. Also in the video about the treatment of pituitary adenoma.