Types, symptoms and treatment of pituitary adenomas
Pituitary adenoma is a fairly common form of brain tumor. According to statistics, they occupy about 15% of all neoplasms in the brain.
The situation is complicated by the fact that the pituitary gland is the part of the brain that is responsible for the production of almost all major hormones. They, in turn, regulate a large part of the processes in the body.
The location and structure the pituitary gland relates to the nervous system, but functionally it is part of the endocrine. Therefore, if a pituitary adenoma is required to consult as neurologist and endocrinologist.
Types of pituitary adenoma
Adenoma refers to any tumor that has formed in the glandular tissue. The definition of a "pituitary" indicates only its location, but not type, because this part of the brain can develop dozens of kinds of tumors of different nature and with different manifestations. And classification of pituitary adenomas account for various combinations of their features.
Functional features distinguish three large categories:
- Hormonally active. The biggest category, which includes tumors that affect the production of certain hormones.
- Hormonally inactive. In some cases, tumor formation did not affect the synthesis of certain hormonal substances.
- Malignant. Most tumors of the pituitary
Symptoms of pituitary adenoma
The pituitary gland is a relatively small area of the brain, but it produces many important substances to the body. A large part one way or another affects this process. Therefore, the pituitary adenoma may have symptoms that are related to various organ systems. They can unite in a few key areas:
- Change and deterioration of vision. As a rule, it becomes less clear-cut or deteriorating peripheral vision. For large tumors can cause blindness.
- Gynecological pathology. Female infertility, dysmenorrhea, amenorrhea, disorders of pregnancy – it can be a manifestation of pituitary tumors.
- The change in the mammary glands. Breast enlargement not associated with pregnancy and lactation, the secretion of milk from them. It should be noted that these symptoms may occur in women and men. In the latter case is also observed obesity of the female type (chest, abdomen, thighs, buttocks), decreased libido, impotence.
- The impaired growth. Such symptoms peculiar to children and adolescents with somatropina. They are ahead of peers in growth and physical development, have larger facial features. Adults in the same scenario, you may experience enlargement of the hands and feet, increased body weight.
- Disease Itsenko-Kushinga. This is one of the private cases of pituitary adenomas, in this case the characteristicobesity (face, chest, abdomen), thinning of the skin, change in nails, susceptibility to fungal diseases, depression.
- The thyroid gland. Thinning, dry hair and nails, weight changes, feeling of a lump in the throat, the thyroid gland, visible or palpation, sweating, feeling of heat, changes (anxiety, nervousness, hysteria, or apathy, depression).
It's only the most characteristic manifestations of pituitary adenomas, in practice, there are a variety of symptoms of this disease.
The hardest to diagnosis of hormone-tolerant adenoma. They are often found accidentally, during a total scan of the brain.
Methods of diagnosis of pituitary adenoma
Pituitary adenoma has a characteristic exclusive to her symptoms, so most people initially turn to specialists (gynaecologists, mammologu, pediatricians and so on). Finding no abnormalities, and the causes of such violations on his part, they recommend to address to the endocrinologist.
These specialists, in turn, know the list of diseases that can be triggered by pituitary tumors, and suggest to consult a neurologist or to undergo examination.
As a rule, to diagnose cases of pituitary adenoma using the following methods:
- A blood test to determine the level characteristic of hormones. You first need to establish that there is a deviation in the concentration of typical hormones produced by the pituitary gland.
- MRI. MRI is the most accurate and important method of diagnosing brain tumors because it allows to determine the presence, location and size of the formation with high precision. This method is safe and highly effective, but the study costs can be quite high and availability is clearly insufficient.
- The x-ray. In some cases an MRI to make x-ray examination, which allows to gather preliminary data.
- Histological examination. Upon detection of tumors is extremely important to determine whether they are benign or malignant. To do this, examine its cellular structure. The main disadvantage is the need to obtain a sample of tissue that is not always possible.
The collected data is sufficient for the choice of strategy of treatment.
Treatment of pituitary adenoma
In modern medicine there are many methods of treatment of pituitary adenomas. They are chosen based on a number of factors, primarily the type of tumor and symptoms. It is conditionally possible to allocate the following directions:
- Wait-and-see strategy. In the case of small tumors that do not affect the hormonal balance andno signs of growth, can be chosen the strategy of waiting with regular monitoring of the size of the tumor and the level characteristic of hormones.
- Hormonal therapy. As a rule, it is necessary to adjust the hormones, to avoid further deterioration of the physical and psychological state.
- The surgical removal. The most effective and radical method of treatment of pituitary tumors is surgical removal. There are several schemes of access: open surgery and minimally invasive removal. In the first case it is necessary to hide the skull, it is easier to access, but may be side effects. Usually try on at adenomas larger size. Small tumors are removed endoscopically. Instruments inserted through the nasal passage. This method of removing pituitary adenomas is less traumatic, has shorter recovery period, but is suitable for small tumors.
- CyberKnife, radiosurgery. The tumor is irradiated with strictly metered pulses of radio waves, destroying its tissues and without affecting the surrounding. The method applies to modern and highly efficient. Its main advantage is the low invasiveness and short recovery period.
- Chemotherapy. Used in the treatment of malignant pituitary adenomas.
Often used combination of these treatment methods, which allows us to achieve the best effect.
In some cases after recovery relapse. The likelihood of this varies in different types of tumors. This occurs most often when adenomas that produce somatropin.