Pituitary adenoma signs and symptoms in adults and children, diagnosis and treatment

Many diseases are detected accidentally during examination for other reasons. One such disease is a pituitary adenoma. This is a benign neoplasm that is diagnosed in every fifth person. Is it dangerous illness whether it is malignant – the issues that arise in patients with this problem.

What is adenoma of the pituitary gland of the brain

A small but very important for our body, the pituitary gland located on the lower part of the brain in the bone pocket of the cranial bones, the so-called «Turkish saddle.» Is brain appendage rounded shape, which is dominant on the endocrine system. He is responsible for the synthesis of many important hormones:

  • thyrotropin;
  • somatotropin;
  • gonadotropin;
  • vasopressin or antidiureticeski hormone;
  • ACTH (adenocorticotropic hormone).

A tumor in the pituitary gland (code ICD-10 «Neoplasms») are not fully understood. By assumption physicians, it can be formed from cells of the pituitary gland due moved:

  • neuroinfections;
  • traumatic brain injury;
  • chronic poisonings;
  • effects of ionizing radiation.

Although this type of adenomas do not see signs of malignancy, but they are able to increase the mechanical squeeze of the surrounding pituitary brain structures. This leads to visual disturbances, endocrine and neurological diseases, cystic formation, apoplexy (hemorrhage into the tumor). Adenoma of the brain in relation to the pituitary gland can grow within the local location of the gland, and to go beyond the «Turkish saddle». Hence the classification of adenomas according to the nature of the distribution:

  • Adenoma endo – inside bony pockets.
  • Intointerstellar adenoma – growth occurs in a downward direction.
  • Endoscopically adenoma – growth occurs in an upward direction.
  • Endometriosisna adenoma – the spread of the tumor is left and right.
  • Combined adenoma located diagonally in any direction.

Size klassificeret microadenomas and macroadenomas. In 40% of cases the adenoma may be hormonally inactive, and in 60% of cases – hormonally active. Hormonally active education are:

  • gonadotropinov, which abundantly produces gonadotropic hormones. Gonadotropinom not detected symptomatically;
  • tireotropina – is synthesized in the pituitary gland thyroid stimulating hormone controlling thyroid function. When elevated levels of the hormone is accelerated metabolism, rapid uncontrolled weight loss, nervousness. Thyrotropinoma – a rare type of tumor that causes hyperthyroidism;
  • corticotropinomas for the production of glucocorticoids in the adrenal glands respond adrenocorticotropic hormone. Kortikotropinom can become malignant;
  • somatropinne – produced growth hormone, which affects the breakdown of fats, synthesis of protein, glucose, growth of the organism. When excess hormone there is a strong sweating, pressure, heart disorder, curvature of the bite, increase in the feet and hands, coarsening of facial features);
  • prolactinoma is the synthesis of the hormone responsible for lactation in women. Size klassificeret (in the direction of increasing prolactin levels): adenopathy, microprolactinoma (up to 10mm), cysts and macroprolactinoma (over 10 mm);
  • ACTH adenoma (basophilic) stimulates adrenal function and cortisol production, excessive amount of which causes Cushing’s syndrome (symptoms: fat deposits in the upper abdomen and back, chest; elevated blood pressure, atrophy of the muscles of the body, striae on the skin, bruises, Crescent-shaped face);

Pituitary adenoma in men

Statistics show that the disease affects every tenth representative of the stronger sex. Pituitary adenoma in men may not manifest for a long time, the symptoms are not expressed. Very dangerous for men a prolactinoma. Is the development of hypogonadism due to a decrease in testosterone, impotence, infertility, decrease libido, increase breast (gynecomastia), loss of hair.

The pituitary adenoma in women

A tumor in the pituitary gland may form 20% of middle-aged women. In most cases, the disease is sluggish. Half of all cases of pituitary tumors is a prolactinoma. For women it is fraught with menstrual disorders, infertility, galactorrhea, amenorrhea appears as a result of acne, seborrhea, hypertrichosis, mild obesity, anorgasmia.

On hereditary reasons to not speak, but observed that in 25% of cases the incidence of adenoma was the result of multiple endocrine neoplasia of the second type. Some of the causes of tumor formation in the pituitary gland peculiar only to women. The pituitary adenoma in women may occur after abortion or miscarriage, and also after repeated pregnancies. Not been established for certain causes of pituitary tumors, but to provoke the growth of education can:

  • infectious diseases afflicting the nervous system;
  • head injury;
  • long-term use of contraceptives.

Pituitary adenoma in children

If we consider a pituitary adenoma in children, it is mainly somatotropinoma (producing GH), in which children develop gigantism (a change in the proportions of the skeleton), diabetes, obesity, diffuse goiter. We need to be wary if the child has seen:

  • hirsutism – excessive volosistoj on the face and body;
  • hyperhidrosis sweating;
  • the oiliness of the skin;
  • warts, papillomas, nevi;
  • the symptoms of polyneuropathy accompanied by pain, paresthesias, low sensitivity of the limbs.

Signs of pituitary adenoma

Active type of tumor of the pituitary gland manifested by impaired vision, double vision, loss of peripheral vision, headaches. Complete loss of vision is threatened in the case of education 1-2 cm adenomas of the large size of the typical symptoms of hypopituitarism:

  • decreased sex drive;
  • fatigue, hypogonadism;
  • weakness;
  • a set of body weight;
  • depression;
  • cold intolerance;
  • dry skin;
  • headache;
  • dizziness;
  • nausea;
  • the lack of appetite.

Symptoms of pituitary adenoma are often similar to signs of other diseases, so no need to be too insecure, to read about the symptoms, compare them with their complaints and to drive themselves into a stressful state. In any disease the important certainty and precision. If it is suspected, contact your doctor for a full investigation of your illness and, if necessary, treatment.

Diagnosis of pituitary adenoma

Adenomas of the anterior pituitary can be diagnosed by identifying groups of symptoms (Hirsch’s Triad):

  1. Endocrine-metabolic syndrome.
  2. Ophthalmic neurological syndrome.
  3. Deviations from the norm «Turkish saddle», the visible rentgenograficheski.

Diagnosis of pituitary adenoma is performed using these levels of verification:

  1. Clinical and biochemical characteristics typical for hormonally active adenomas: acromegaly child gigantism, a disease Itsenko-Kushinga.
  2. Neuroimaging data and operative findings: localization, size, invasion, growth pattern, heterogeneity of the pituitary gland, the surrounding heterogeneous structures and tissues. This information is of great importance when choosing the treatment and further prognosis.
  3. Microscopic examination obtained by biopsy, material – differential diagnosis between pituitary adenoma and nahimovskii formation (hyperplasia of the pituitary gland, hipofisis).
  4. Immunohistochemical examination of tumors.
  5. Molecular biological and genetic studies.
  6. Electron microscopy.

Treatment of pituitary adenoma

In medical practice treatment of pituitary adenoma of the brain is performed conservative (medical), operational methods and with the help of radiosurgery, external beam radiotherapy, proton therapy, gamma therapy. Medication includes the use of bromocriptine (a prolactin antagonist, normalizes the level of hormones prolactinoma without breaking its synthesis), dostinex and other analogues. Drug therapy is not always able to overcome the disease, but sometimes it makes it easier for the surgeon and increases the chances of recovery.

Stereotactic radiosurgery is a non – invasive method of treatment by irradiation of the tumor with a beam of radiation from different angles. The effect of radiation in this method, to other glandular tissue is minimal. To treat the cancer with radiation convenient because do not need hospitalization, anesthesia and training. If the identified adenoma, not synthesizing hormones, not manifesting any symptoms, the patient was observed in the case of microadenomas every two years is imaging, in the case of macroadenoma to check the condition recommended every six months or annually.

The removal of pituitary adenoma

Modern surgical treatment – removal of pituitary adenoma transnasal (through the nose). This operation is minimally invasive, with the introduction of the endoscope, is effective in microadenoma. If the formation has a pronounced extracellularly growth, we used transcranial intervention. Contraindication to operation is the elderly and children’s age, pregnancy. In these cases, selected another method of treatment. Transcranial operative treatment may cause some consequences:

  • kidney failure;
  • poor blood circulation in the brain;
  • disturbance of functions of genitals;
  • blurred vision;
  • injury to healthy tissue of the gland;
  • liquorrhea;
  • the inflammation and infection.

Transnasally removal of the adenoma is less traumatic and adverse impacts are minimized. After surgery the patient spends in the hospital under observation for up to three days, if the removal of the adenoma has passed without complications. Then recover prescribed rehabilitation measures, in order to prevent recurrence.

Treatment of pituitary adenomas folk remedies

Hearing a bad diagnosis, it is human nature to deny it and look for gentle methods of treatment folk remedies. From the point of view of traditional medicine, treatment of pituitary adenoma folk remedies is very doubtful. Maybe some effect can be obtained, but the gifts of nature will not be able to correct failures of the body caused by hormonal imbalance. Delaying of treatment methods of self can be deadly, especially if in the end found corticotrope adenoma.

In addition to the basic treatment can be taken decoctions of herbs, but after consulting a doctor. In addition, it is necessary to consider that some plants, such as Hemlock, a very poisonous and it should be used very gradually, otherwise the consequences could be devastating. Among the folk remedies are considered effective:

  • tincture of bug-infested 10% on alcohol;
  • a mixture of ground ginger, pumpkin seeds, sesame seeds, herbs, primrose, honey;
  • tincture of Hemlock on the oil (to drip into the nose), drinking alcohol tincture;
  • chaga;
  • Highlander snake;
  • Melissa;
  • psyllium;
  • Valerian;
  • the fruits of mountain ash;
  • sage, calendula, chamomile.

Video: a tumor on the pituitary gland