The pituitary adenoma is a neoplasm of a benign nature. A tumor comes from cells in the anterior pituitary lobe. A neoplasm is localized in the region of the Turkish saddle, at the base of the skull (its wedge-shaped part). As a rule, pituitary adenoma is detected in patients aged 20 to 40 years. Women are more likely to develop tumors. According to statistics, from 22 to 30% of all intracranial neoplasms is a pituitary tumor. Symptoms of the pathology appear depending on the classification.
Benign formations can be hormone-active and hormone-inactive.
The first category includes neoplasms capable of producing tropic hormones. The formation of hormone-active adenomas is indicated by an increased content of these hormones (tropic) in the blood serum and the presence of a clinical syndrome that is quite pronounced. The syndrome is a consequence of increased production of one or another hormone. Hormone-active neoplasms include prolactinomas (producing prolactin), corticotropinomas (producing corticotropin, somatotropins (secreting growth hormone - somatotropic hormone), etc. It should be noted that almost half of the hormone-active adenomas are prolactinomas.
A small part is made up of hormone-inactive neoplasms.
With a formation diameter of less than 10 mm, the pituitary microadenoma takes place .
The reasons for the development of neoplasms have not been studied to date.
According to one concept, there is a primary lesion in the hypothalamus with secondary involvement of tumor tissue in the process. According to another concept, there is a primary lesion, due to which a pituitary adenoma is formed.
Symptoms of hormone-active neoplasms include endocrine-metabolic syndrome, radiological and ophthalmoneurological manifestations.
The severity of manifestations of an endocrine-metabolic nature is a reflection of the concentration of excessively produced hormone and the degree of damage in the tissue that surrounds the neoplasm.
Ophthalmoneurological symptoms indicating pituitary adenoma depend on its suprasellar growth. At the same time, the pressure of the neoplasm on the diaphragm in the Turkish saddle provokes dull headaches. As a rule, pain is not accompanied by nausea, does not depend on the position of the body and is not always eliminated with painkillers.
Damage in the hypothalamic structures provokes an expanding pituitary adenoma. Symptoms during the spread of the neoplasm downward can be manifested by the flow of cerebrospinal fluid from the nasal cavity and a feeling of nasal congestion. The growth of the neoplasm, which provokes compression of the branches of the cranial nerves, is accompanied by ophthalmoplegia (damage to the eye muscles) and diplopia (double vision).
A serious complication, but not fatal, is hemorrhage in a neoplasm. It was established that in this case the pituitary adenoma, the symptoms of which intensify during hemorrhage, can provoke a spontaneous “cure”. As a rule, this phenomenon is more characteristic of prolactin.
During pregnancy, the pituitary adenoma usually increases.
Symptoms detected during X-ray examination are expressed in changes in the size and shape of the Turkish saddle, destruction and thinning of bone structures, etc. With CT, the pituitary adenoma itself can be visualized.
Symptoms of some hormone-active neoplasms are specific. In some cases, prolactinomas in women can manifest as galactorrhea (secretion of milk-like contents from the mammary gland) or menstrual irregularities. Often there is a combined manifestation of these symptoms.