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Pituitary Tumor Microchapters
Pituitary tumors are tumors that occur in the pituitary gland and account for about 10% of intracranial neoplasms. Pituitary adenomas are often remain undiagnosed. Small pituitary tumors are found in 6 to 24 percent of adults at autopsy. Pituitary tumors arise within the anterior lobe (adenohypophysis) of the gland. They may be classified according to the size of the tumor and type of hormone secretion. Pituitary adenomas subtypes include corticotrophic, somatotrophic, thyrotrophic, gonadotrophic, and lactrotrophic adenomas. There are no established causes for pituitary tumors. Patients with pituitary tumors may progress to develop lethargy, headache, nausea, and vomiting. Common complications of pituitary adenoma include bitemporal hemianopia, anosmia, acromegaly, gigantism, and Cushing's syndrome. Prognosis is generally good, and approximately 18% of patients with macroadenoma require further treatment. Pharmacologic medical therapy is recommended among patients with prolactinoma, thyrotrophic, somatotrophic, and adrenocorticotropic adenomas. The transsphenoidal microsurgical approach is the mainstay of treatment for growth hormone producing adenomas, adrenocorticotropic hormone-(ACTH) producing adenomas, and macroadenomas.
Pituitary tumors classified according to the 2017 World Health Organization (WHO):
|Pituitary adenomas||Somatotroph adenoma|
|Tumors of posterior pituitary||Pituicytoma|
|Pituitary tumors||Craniopharyngioma||Adamantinomatous craniopharyngioma|
|Mesenchymal and stromal tumors||Meningioma|
|Germ cell tumors||Germinoma|
|Disease||Clinical Findings||Laboratory Findings||Management|
|Somatotroph adenoma:||Clinical features of acromegaly are due to high level of human growth hormone (hGH):
|Corticotroph adenoma:||Clinical features of Cushing's syndrome are due to increased levels of cortisol:
|Hypothyroidism||Clinical features of hypothyroidism are due to deficiency of thyroxine:|
|Chronic renal failure||There are no pathognomonic symptoms associated with chronic renal failure. Common non-specific symptoms of chronic renal failure include:||Urinalysis:
Fluid and electrolyte disturbances:
|Liver disease: Cirrhosis||The clinical features of liver cirrhosis are very nonspecific. These include:||
|Seizure disorder||The clinical features of seizure disorder may include:
|Medication-induced||Clinical features of hyperprolactinemia after a specific period of regular medication ingestion||
- Lopes MBS (2017). "The 2017 World Health Organization classification of tumors of the pituitary gland: a summary". Acta Neuropathol. 134 (4): 521–535. doi:10.1007/s00401-017-1769-8. PMID 28821944.
- Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA; et al. (2011). "Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline". J Clin Endocrinol Metab. 96 (2): 273–88. doi:10.1210/jc.2010-1692. PMID 21296991.