If the origin of the pituitary tumor is on the anterior lobe of the pituitary gland, it is called a pituitary adenoma. The reason why such a tumor develops is unclear. However, the course of the disease is not life-threatening.
What is a pituitary adenoma?
Schematic diagram showing the location of a brain tumor in the brain. Click to enlarge. Under the term pituitary gland, doctors refer to a hormone gland that is just about the size of a cherry. This hormone is connected to the brain, via a relatively thin stalk. The pituitary gland is the classic interface that connects the brain to the endocrine system and thus represents a major factor in hormone regulation in the human body. The pituitary gland does not contain brain tissue, which is why the tumor does not fall under the category of brain tumor. However, it is treated by a neurosurgeon. The pituitary gland is divided into anterior and posterior lobes, and the tumor usually originates from the anterior lobe, resulting in a pituitary adenoma. The tumor is relatively common; physicians discover a formation of the pituitary tumor in almost every tenth autopsy, which the patient did not notice during his lifetime. Usually, individuals between the ages of 35 and 45 develop the disease.
Causes
So far, medical experts have not succeeded in finding a cause why a pituitary adenoma develops. However, it is a fact that the tumor originates in the anterior lobes of the pituitary gland. The cell does not develop normally, so growth, division as well as aging and death of the cell is hindered. It is not known why a disorder occurs and then the tumor forms. In individual cases, however, a hereditary cause is sometimes a reason why the pituitary adenoma forms. Here, MEN-1 syndrome is often held responsible, which has been shown to cause patients to develop pituitary adenoma.
Symptoms, complaints, and signs
Because a pituitary adenoma usually grows slowly, the first symptoms may not be noticed for years in some cases. When and which signs of the disease appear depends mainly on the exact location of the tumor. At first, there may be restrictions of the visual field such as hemiparesis. Often, other visual problems occur, such as double vision or blurred vision. Most sufferers experience headaches in the area of the forehead and eyes. In addition, the outer halves of the face often fall out. These complaints can change and occur with varying intensity. The secretion of sex hormones may be disturbed. Even in the early stages of a pituitary adenoma, many patients experience a marked loss of libido. Men often have erection problems and women may experience menstrual disorders. They often experience a lactation without an existing pregnancy. In male sufferers, the breasts grow in size and take on a more feminine shape. An increasing hormone deficiency can manifest itself as general fatigue, freezing, low blood pressure or circulatory disorders. These complaints can lead to circulatory failure during exertion. In a larger untreated pituitary adenoma, general symptoms of a brain tumor such as hydrocephalus, vomiting, nausea or muscle paralysis occur. Furthermore, blindness of one or both eyes may occur.
Diagnosis and course
The physician determines – with the help of imaging techniques – whether it is a pituitary adenoma. Here, he makes an MRI – a magnetic resonance imaging – of the patient’s head. For this, the patient is administered a specific contrast agent so that the physician can clearly see on the images whether or not there is a tumor. If the doctor is unsure, he or she can have a CT – a computer tomography – done. Furthermore, various blood tests help the physician to make sure that it is a pituitary adenoma. The hormone level is of particular importance here. If the prolactin level is above 200 nanograms, the chance that it is a pituitary adenoma is relatively high. A measurement of growth hormone can also sometimes confirm that the patient is suffering from a corresponding tumor. Other diagnostic measures also include visual acuity testing. Many pituitary adenomas cause visual impairment, so it is advisable to check the patient’s visual acuity.The disease itself is not life-threatening. The pituitary adenoma grows relatively slowly, so that some people may suffer from it, who do not experience any symptoms and finally only at the autopsy it is determined that the patient suffered from a pituitary adenoma. However, once diagnosed, treatment should be initiated without fail. If left untreated, a course cannot be accurately predicted.
Complications
As a rule, a pituitary adenoma is not a life-threatening symptom. However, treatment is still required, although complications do not occur. Pituitary adenoma results in a tumor that leads to a loss of various facial functions. The affected person can thus no longer control various areas and suffers from severe paralysis. Likewise, visual disturbances can occur, so that the patient suffers from veil vision and double vision. Due to increased brain pressure, severe headaches also occur. The patient feels ill and fatigued and the resilience decreases extremely. Furthermore, complete blindness or, in the worst case, cardiac arrest may occur. In women, sexual dysfunction is not uncommon. In most cases, in addition to the physical complaints, depression or other psychological complaints also occur, which strongly influence the life of the patient and considerably reduce the quality of life. Removal of the tumor is usually necessary only when symptoms occur. No particular complications occur and the patient’s life expectancy is not limited.
When should one go to the doctor?
People who suddenly suffer from recurrent visual disturbances, headaches, or circulatory problems should see a doctor. If a pituitary adenoma underlies the symptoms, treatment must be initiated quickly. Early therapy can slow the growth of the adenoma and prevent complications. Women who suffer from unusually severe menstrual cramps are best to talk to their gynecologist immediately. Nonspecific symptoms such as low blood pressure or feeling cold should also be clarified promptly. If a genetic defect such as MEN-1 syndrome was detected during a previous examination, a pituitary adenoma can be assumed if the symptoms mentioned occur. Affected patients should consult a physician on the same day. At the latest when complications such as severe visual disturbances or migraine attacks develop, a visit to the doctor is indicated. In addition to the family doctor, a neurologist or an internist can be consulted. If the symptoms are severe, the emergency physician is ideally called, as there may be a serious underlying complication that can cause serious damage to health if left untreated.
Treatment and therapy
Therapy, once diagnosed, is not always necessary. If the tumor is relatively small, it is sufficient for the physician to check it regularly and monitor its growth. If the patient does not suffer from any symptoms, therapy is also not necessary. However, if symptoms occur, the physician recommends surgery and removal of the tumor. Especially in the case of visual disturbances, it is advisable to have the tumor surgically removed. As a rule, the tumor is removed through the nose. This is due to the quite favorable positioning of the tumor. However, if the tumor has reached a considerable size, the skullcap must be opened. A complete removal is not always possible. If there are still remnants after the operation, these must be further observed (with the help of MRI examinations or also a check of the hormone level). If the tumor changes in size, further surgery may be performed. There is also the possibility that radiation therapy is prescribed to combat it. However, this occurs only in the rarest of cases.
Prevention
Since there are no known causes of why pituitary adenoma forms, it is also impossible to say how the tumor can be prevented. However, medical professionals advise that people should avoid unnecessary radiation as well as chemicals. Likewise, a varied and healthy diet as well as abstaining from alcohol and nicotine and regular sports (thus strengthening the immune system) are good clues so that a possible tumor formation can be prevented.
Aftercare
In the case of a pituitary adenoma, the affected person should first and foremost see a doctor very quickly to avoid further complications or further worsening of symptoms. In this case, in the worst case, the death of the affected person can occur if the pituitary adenoma is not treated. This disease cannot heal on its own. Therefore, the main focus is on early detection of the disease, although the measures of aftercare are usually severely limited. In most cases, the treatment is radiation therapy. Most patients are dependent on the help and support of their own family and friends in everyday life. Furthermore, intensive and loving conversations are necessary, especially to prevent or treat psychological upsets or depression. If the pituitary adenoma is removed by surgery, the affected person should in any case rest and take care of his body after the procedure. They should refrain from exertion or from stressful and physical activities. It cannot be universally predicted whether the pituitary adenoma will result in a reduced life expectancy for the affected person.
Here’s what you can do yourself
Pituitary adenoma is one of the benign tumors and can be treated well in very many cases. For the patient, a positive attitude towards life and a basic desire to beat the disease is a very great psychological help. As with many serious illnesses, the help of a therapist can be enlisted for better coping. Pituitary adenoma cannot be treated by the patient himself and requires constant medical monitoring and control. It is very important that the patient establishes a trusting relationship with his treating physician and agrees to the therapy plan. Only then will the patient consistently carry out the part of the therapy that is his own responsibility and, for example, take his medication regularly and in the agreed dose. The patient can actively participate in his recovery by supporting and carrying out the necessary measures. The patient can usually make everyday life easier for himself by outsourcing things that are increasingly difficult for him or that cause him great stress to other people. For example, household help can be called upon for a limited period of time. A healthy lifestyle basically promotes well-being. Regular light exercise in the fresh air boosts the immune system and has a positive effect on the cardiovascular system.
