Nonfunctioning pituitary gland macroadenoma
What are the signs and symptoms?
- Signs and symptoms of nonfunctioning adenomas (most commonly gonadotroph adenomas) may include the following:
- Visual field deficits.
- Pituitary insufficiency, which is due to compression of the pituitary stalk or destruction of normal pituitary tissue by the tumor, and predominantly manifests as secondary hypogonadism.
What is pituitary apopexy?
In addition to cell-type specific presentations, pituitary apoplexy (i.e., pituitary adenoma apoplexy) represents another important clinical presentation of pituitary adenomas. Pituitary apoplexy can result from an acute hemorrhagic or ischemic infarction of the pituitary in patients harboring often unrecognized secreting or nonfunctioning pituitary adenomas.
What are the most common symptoms?
In a series analyzing 40 cases of pituitary apoplexy, the presenting signs and symptoms included:
- headache (63%),
- vomiting (50%),
- visual field defects (61%),
- ocular paresis (40%),
- mental deterioration (13%),
- hyponatremia (13%), and
- syncope (5%)
Can pituitary adenomas be part of familiar cancer syndromes?
The development of pituitary adenomas may also occur as a component of three familial cancer syndromes:
- Multiple endocrine neoplasia.
- Carney complex (e.g., cardiac myxomas, spotty skin pigmentation, and tumors of the adrenal gland and anterior pituitary).
- Isolated familial acromegaly.
What is the differential diagnosis?
- A number of other lesions should be considered in the differential diagnosis of sellar masses.
- Although rare, lymphocytic (i.e., autoimmune) hypophysitis should be considered in the differential diagnosis of any nonsecreting pituitary mass, especially when occurring during pregnancy or postpartum.
- In addition, the clinician should consider craniopharyngioma and Rathke cleft cyst in the differential diagnosis of pituitary tumors.
- Sellar masses may also result from tumors that are metastatic to the pituitary.
- This typically occurs as a part of a generalized metastatic spread and is usually associated with five or more additional metastatic sites, especially osseous; breast cancer and lung cancer are the most common primary neoplasms metastasizing to the pituitary.
How are pituitary adenomas treated?
Treatment depends on the type of tumor, the size of the tumor, whether the tumor has invaded or pressed on surrounding structures, such as the brain and visual pathways, and the individual’s age and overall health.
Three types of treatment are used:
- surgical removal of the tumor; - (transsphenoidal surgery, if possible) to remove the tumor, followed by watchful waiting (closely monitoring a patient’s condition without giving any treatment until signs or symptoms appear or change). Radiation therapy is given if the tumor comes back.
- radiation therapy, in which high-dose x-rays are used to kill the tumor cells; and
- drug therapy to shrink or destroy the tumor.
What is the prognosis?
- If diagnosed early enough, the prognosis is usually excellent.
- If diagnosis is delayed, even a non-functioning tumor can cause problems if it grows large enough to press on the optic nerves, the brain, or the carotid arteries (the vessels that bring blood to the brain).
- Early diagnosis and treatment is the key to a good prognosis.
Can you help answer any of these frequently asked questions on Nonfunctioning pituitary gland macroadenoma?
- How serious is a pituitary Macroadenoma?
- Can pituitary Macroadenoma be treated without surgery?
- How long can you live with a pituitary tumor?
- How long does it take for a pituitary tumor to shrink?
- Is pituitary Macroadenoma curable?
- Do Microadenomas grow?
- How do you get rid of pituitary Macroadenoma?
- What foods to avoid if you have a pituitary tumor?
- How do you shrink a pituitary tumor?
- What is the reason of pituitary Macroadenoma?
- How successful is pituitary surgery?
- Can a pituitary tumor go away on its own?
- Are Microadenomas common?
- Can Microadenoma cause death?
- How do I activate my pituitary gland?
- How big is a pituitary Macroadenoma?
- Do Macroadenomas need to be removed?
- Can stress cause a pituitary tumor?
- Can you live without a pituitary gland?
- Can you live a normal life with a pituitary tumor?
Frequently asked questions