Diagnosis | Pituitary tumor

Diagnosis

The above-mentioned hormonal changes initially direct the suspicion of a pituitary tumor, which must then be confirmed by imaging procedures. An X-ray and computer tomography (CT) only detect larger tumors, which is why the method of choice is MRI of the brain, in which the pituitary gland is made clearly visible by a contrast medium. Furthermore, the examination of hormone levels in the blood can provide evidence of a pituitary tumor and also makes it possible to distinguish between the different types.

Magnetic resonance imaging (MRI) is the method of choice for detecting a pituitary tumor (adenoma). It allows differentiation between micro- and macroadenomas based on the size of the tumor. The MRI image of the brain usually shows a typical picture of a pituitary tumor.

Due to the suppressive growth, a mass in the area of the saddle of the Turk’s eye (sella turcica) appears, which compresses surrounding structures. This causes, for example, the optic nerves to be lifted, the Turkish saddle to expand and large vessels (internal carotid artery) running nearby to be displaced outwards. By administering a contrast medium, the tumor tissue can be easily distinguished from normal pituitary tissue. The tumor accumulates less contrast medium than the healthy tissue and therefore appears darker.

Therapy

Usually a pituitary tumor is surgically removed. There are two possibilities: Because of its practical location, the tumor can in most cases be removed through the nose and paranasal sinuses. Only if the tumor is very large does the skull need to be opened and operated on.

Often the tumor cannot be completely removed, which is why it is important to perform regular checks after the operation in the form of an MRI or hormone measurements. An exception to this is prolactinoma, which can be treated well with medication alone in about 95% of patients. Only if there is no response to the medication will surgery be resorted to in this type of operation. In rare cases, for example in the event of a relapse (recurrence) or in the case of tumors that cannot be operated on, radiotherapy may also be useful.