Diseases of the pituitary gland
Synonyms: Hypopituitarism Inflammation, injury, radiation, or bleeding can lead to disorders of the pituitary gland. This can result in the production of hormones in the posterior lobe of the pituitary gland as well as in the anterior lobe of the pituitary gland. Usually, hormone failures occur in combination.
This means that either all the hormones of the front lobe (anterior pituitary lobe insufficiency), the rear lobe (posterior pituitary lobe insufficiency) or all the hormones are reduced simultaneously. The consequence is that the downstream hormone systems release fewer hormones, which results in disturbances of the corresponding body function.Symptoms of hypofunction of the pituitary gland can be, for example, reduced growth in the absence of STH, menstrual disorders and lack of sexual organs during puberty in the absence of LH and FSH, drops in blood pressure and greatly increased water excretion in the absence of ADH. To make a diagnosis, hormone levels are determined by taking a blood sample and a CT or MRI of the skull is performed.
The therapy of a hypofunction of the pituitary gland consists of the drug administration of the missing hormones. Benign growths can occur in the front part of the pituitary gland. These are called adenomas.
Mostly these adenomas produce hormones, which are then elevated in the blood. The pituitary adenoma is divided into a micro adenoma (smaller than 1 cm) and a marrow adenoma (larger than 1 cm). The most common benign tumor of the pituitary gland is the prolactinoma, a prolactin-producing tumor.
The consequences are breast growth and milk leakage even without pregnancy. STH-producing tumors lead to high growth before the end of growth, after puberty to acromegaly, a disease in which fingers, nose, mouth, tongue and ears become very thick. ACTH-producing tumors stimulate the adrenal cortex to produce cortisol and lead to Cushing’s disease with trunk obesity, full moon face, muscle breakdown, high blood pressure, susceptibility to infections and high blood sugar.
TSH-producing adenomas cause hyperthyroidism with sweating, palpitations and weight loss. Tumors of the pituitary gland can cause headaches and pressure on the optic nerve junction, which can result in blinkered vision. These hormone-forming tumors are detected by detecting elevated hormone levels in the blood.
If all values are normal, a non-hormone producing adenoma may still be present. In addition, imaging with CT or MRT must be performed. Due to their anatomical location, tumors of the pituitary gland are usually operated on via a so-called transsphenoidal approach.
The surgeon has the possibility to remove the proliferating part of the pituitary gland without visible scarring via the nose, the paranasal sinus behind it and by breaking through the thin bony floor under the pituitary gland. If surgery is not possible or desired, there are drugs to suppress hormone production.
