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Pituitary Adenoma

Do you experience erectile dysfunction along with frequent headaches? If yes, you are probably suffering from Pituitary Adenoma (PA) – a common disease of the pituitary gland. Get detailed information about this syndrome including its causes, symptoms, diagnosis and treatment.

What is Pituitary Adenoma?

These are benign tumors which occur in the cells of the pituitary gland (master gland that operates the hormones of the body) and represent 15% of all intracranial neoplasms. Such growths may arise in people of any age and usually develop in the anterior lobe of the pituitary gland.

PA tumors, which are bigger than 10 mm in size, are known as macrodenomas. Those which do not exceed 10 mm are referred to as microdenomas. Such adenomas of pituitary gland are often microadenomas in nature and are generally undiagnosed.

Pituitary Adenoma ICD9 Code

The ICD9 code for this condition is 237.0.

Pituitary Adenoma Incidence

Clinically active adenomas of the pituitary gland are very rare and affect 1 out of every 1,000 inhabitants of the US.

Pituitary Adenoma Types

According to medical researchers, PA tumors can be classified depending on their size and ability to generate hormones. These growths have been mainly classified into two types, which are:

Picture of Pituitary Adenoma

Picture 1 – Pituitary Adenoma

Endocrine-Active Tumors

Also known as secreting tumors or functioning tumors, these abnormal growths produce only one type of hormone generated by the adenomas.

Endocrine-Inactive Pituitary Tumors

These non-functioning tumors cause Cushing’s disease, hypeprolactinemia or acromegaly and generate more than one type of hormone.

Pituitary Adenoma Causes

The causes of pituitary adenoma are still unknown. However, there are few tumors which develop due to genetic changes and are a part of the endocrine disorders. Tumors can also occur due to direct exposure to radiation which causes cancer.

Pituitary Adenoma Symptoms

The symptoms of PA vary from one patient to another. In a few cases, the warning signs are not apparent at all. The appearance of symptoms solely depends on the secreting ability of the hormones and its volume.

Check out the symptoms of this disorder arising from conditions caused by it:

Prolactin Secreting Adenoma

The symptoms include:

  • Loss of or irregular periods
  • Vaginal dryness
  • Low bone density or osteoporosis
  • Milk production from nonlactating females
  • Lack of sex drive

Hyperthyroidism

The symptoms comprise of:

  • Anxiety
  • Tremors
  • Insomnia
  • Heart palpitations
  • Weight loss

Growth Hormone-secreting Adenoma

The symptoms involve:

  • Oily skin
  • High blood pressure
  • Gigantism (child)
  • High blood sugar, even in fasting
  • Acromegaly (adult)
  • Coarse facial features
  • Excess sweating

Corticotropin-secreting Adenoma:

The symptoms include:

  • Skin changes (increased facial hair, acne, bruising, bluish stretch marks)
  • Buffalo hump (increased fatty tissue in back)
  • Obesity, especially around the wrist
  • Round face
  • Menstrual disturbance
  • High blood pressure
  • High fasting glucose

Thyrotropin-secreting Adenoma

The symptom is

  • Enlarged thyroid (e.g. Goiter)

The symptoms resulting from increased size of the tumor are:

  • Tunnel vision
  • Headache

Adenomas of the pituitary are linked with a few medical conditions, which include:

  • Kidney stones
  • High blood pressure
  • Diabetes mellitus
  • Cardiovascular disease
  • Thyroid disease
  • Osteoporosis

Pituitary Adenoma Diagnosis

The diagnosis of this syndrome is dependent on its symptoms. A few tests, which are recommended to help determine the diagnosis of this pituitary disorder, include:

Hormonal Testing

Individuals with suggestive symptoms of Hypopituitarism require a complete examination of the entire endocrine system. Additional hormonal testing is recommended on the basis of the blood test results.

Visual Testing

Adenoma patients experiencing vision problems are recommended to visit ophthalmologists. The process of visual examination comprises of formal visual field testing along with acuity testing of both the eyes to find out if the peripheral vision is lost or not. Patients affected with bitemporal hemianopsia generally undergo visual field testing.

Imaging

An MRI scan can identify the presence of this type of tumor in the pituitary gland of the patient.

Urine Tests

The objective of performing such tests is to determine the excretory level of few pituitary gland hormones.

Pituitary Adenoma Treatment

The healing procedure for adenoma pituitary depends on the size of the tumor and its size. The treatment options include:

Surgery

The main objective of this treatment is to remove the tumor from its base. However, there are chances that the rest of the pituitary gland can severely be disrupted due to the surgery. Such damage can be treated by a hormone replacement therapy. The operative procedures recommended for such disorders may include:

  • Microscopic surgery
  • Transsphenoidal surgery
  • Gamma Knife radiosurgery
  • Endoscopic surgery

Medications

A few medications can curb the symptoms and minimize the size of the tumor, by blocking the hormone secretion. The medication recommended for adenomas which are growth hormone or prolactin-secreting may include:

  • Octreotide or long-acting versions
  • Dopamine agonists (eg cabergoline, bromocriptine)

Radiation Therapy

It comprises of use of radiation to destroy the tumor cells. The types of radiation involved in such therapies are:

  • Stereotactic radiosurgery-an intense radiation beam
  • Conventional therapy-radiation
  • Proton beam radiotherapy-a beam of protons

Pituitary Adenoma Prognosis

Individuals suffering from nonfunctional pituitary adenomas experience a good prognosis. Hypopituitarism patients should be treated with hormone replacement and are diagnosed at an early stage. Such patients are more prone to cardiovascular diseases.

According to medical researchers, individuals suffering from adenomas of the pituitary gland have a low quality of life, as compared to normal people without this syndrome.

Pituitary Adenoma Risk Factors

People affected with this disease are prone to a few other disorders, which include:

Image of Pituitary Adenoma

Picture 2 – Pituitary Adenoma Image

  • Carney Complex
  • Multiple endocrine neoplasia
  • Familial isolated pituitary adenoma

Pituitary Adenoma (PA) is a serious pituitary disorder, arising in the form of a tumor, which affects many US inhabitants. If not treated timely, this condition may lead to severe complications ending in surgery. If you suspect yourself or any of your family members to be exhibiting the signs and symptoms of this disorder, contact your nearest healthcare provider immediately.

References:

http://en.wikipedia.org/wiki/Pituitary_adenoma

http://neurosurgery.ucla.edu/body.cfm?id=1123&ref=80&action=detail

http://www.hopkinsmedicine.org/neurology_neurosurgery/specialty_areas/pituitary_center/pituitary-tumor/types/pituitary-adenoma.html

http://www.mayoclinic.org/pituitary-tumors/clintrials.html

By   Last updated July 7th, 2012

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