Before we delve into pituitary adenomas, let's briefly discuss the pituitary gland itself. This pea-sized gland, often called the "master gland," is located at the base of the brain. It's responsible for producing hormones that regulate various bodily functions, including:

• Growth hormone:
• Stimulates growth and development
• Prolactin:
• Stimulates milk production in women
• Adrenocorticotropic hormone (ACTH):
• Stimulates the adrenal glands to produce cortisol
• Thyroid-stimulating hormone (TSH):
• Stimulates the thyroid gland to produce thyroid hormones
• Follicle-stimulating hormone (FSH) and luteinizing hormone (LH):
• Regulate reproductive functions

A pituitary adenoma is a non-cancerous tumor that develops in the pituitary gland, a small gland located at the base of the brain.

Pituitary adenomas can be classified based on the type of hormone they produce:

• Non-functioning adenomas:
• These tumors do not produce excess hormones and often cause symptoms related to their size and pressure on surrounding tissues.
• Functioning adenomas:
  • Prolactinoma:
  • Produces excess prolactin, causing issues like irregular periods, infertility, and decreased libido in women, and erectile dysfunction and decreased libido in men.
  • Growth hormone-secreting adenoma:
  • Produces excess growth hormone, leading to acromegaly in adults (characterized by enlarged hands, feet, and facial features) and gigantism in children.
  • Corticotropinoma:
  • Produces excess adrenocorticotropic hormone (ACTH), leading to Cushing's disease, characterized by weight gain, high blood pressure, and muscle weakness.
  • TSH-secreting adenoma:
  • Produces excess thyroid-stimulating hormone (TSH), leading to hyperthyroidism.

Symptoms of pituitary adenomas can vary depending on the type of tumor and its size. Common symptoms include:

• Vision problems:
• Headaches, blurred vision, or loss of peripheral vision
• Hormonal imbalances:
• Irregular periods, infertility, decreased libido, erectile dysfunction, fatigue, weight gain, and high blood pressure
• Other symptoms:
• Severe headaches, nausea, vomiting, and seizures

Diagnosis of pituitary adenomas typically involves a combination of the following tests:

• Physical exam:
• To assess for signs of hormonal imbalance and neurological symptoms
• Blood tests:
• To measure hormone levels
• Imaging tests:
  • MRI:
  • To visualize the tumor and assess its size and location
  • CT scan:
  • To further evaluate the tumor and surrounding structures

Treatment options for pituitary adenomas depend on the type, size, and symptoms of the tumor. Common treatment approaches include:

• Watchful waiting:
• For small, non-functioning adenomas that are not causing symptoms
• Medication:
• To manage hormonal imbalances
• Surgery:
• To remove the tumor, often performed through a minimally invasive endoscopic approach
• Radiation therapy:
• To shrink the tumor, especially for tumors that cannot be completely removed or for those that recur after surgery