The pituitary microadenoma is a volumetric formation, which is considered benign. Typically, the size of such a formation is small and does not exceed one centimeter. Specialists also call this process hyperplasia of the pituitary gland. The pituitary microadenoma (the ICD ascribes code D35-2 to it) is considered the intrasellar type of ordinary adenoma. With the endosellar form, the tumor goes beyond the limits of the pituitary gland, strongly compressing the nearby areas. The cystic type is able to transform into a malignant form.
Types of microadenomas and its symptoms
Microadenoma, even in spite of its small size, and at the same time its benign quality, can suppress or, conversely, stimulate the significant production of pituitary hormones. Two such conditions in medicine are called hormonal-active or inactive pituitary microadenoma.
Hormone-active microadenomas produce several types of hormones at once. Prolactinomas are often found among them, which occurs in thirty percent of cases. Somatotropinomas or corticotropinomas can be observed a little less often.
There are usually no obvious symptoms of pituitary microadenoma in women that would indicate a disease until the neoplasm goes beyond the pituitary gland and degenerates into another type of adenoma. Indirect symptoms of the disease due to its similarity with the signs of other diseases do not always serve as the basis for this diagnosis.
Due to the physiological features of the pituitary microadenoma, early diagnosis was impossible for many years. The reason for this was that x-ray studies were the only diagnostic method. But x-ray images never showed the presence of the disease. Only when the tumor grew in size, provoking the asymmetry of the pituitary gland, was it possible to detect it. Subsequently, the detection of the tumor after it was already transformed into the macroadenoma of the pituitary gland and the symptoms had already manifested itself, greatly complicating the treatment.
Tumor growth outside the pituitary gland, especially its vertical growth, can damage the hypothalamic structure. Thanks to the latest technologies like magnetic resonance imaging , early diagnosis of microadenomas has become possible. People, feeling certain deviations in their bodies, can go to the doctor. Most often, doctors refer patients to MRI. Conducting timely diagnosis can prevent the further development of the disease along with the occurrence of complications. Treatment is most often carried out conservatively.
Prolactinoma as a female type of tumor and its symptoms
The severity of symptoms directly depends on the type of pituitary microadenoma. In twenty-five percent of cases, the neoplasm is hormone-inactive. With this form, the symptoms of the disease are practically absent. But in cases of a hormonal-active nature, a number of atypical structural changes in the body can be observed. Let's consider them further. So, one of these structural changes in microadenomas is prolactinoma.
Most often, prolactinoma occurs in women. Prolactin is a hormone that stimulates milk production and suppresses ovulation. Symptoms of pituitary microadenoma in women are such that, against the background of a high level of prolactin, fluid may be released from the mammary gland. This is an alarming factor requiring immediate medical attention. A change in the amount of prolactin also leads to irregularities in the cycle of menstruation and, as a result, leads to infertility.
Symptoms of the pituitary microadenoma are important to recognize in a timely manner.
In the event that a high level of prolactin was detected during pregnancy, the patient should be constantly under the supervision of her doctor. Breast feeding immediately after birth in most situations will be contraindicated. The fact is that, due to the need for medication, lactation can harm a child. In addition, a woman should be alerted by an unreasonable increase in body weight. As for men, they have a high level of prolactin is the reason for the development of impotence.
What is dangerous pituitary microadenoma, consider in more detail below.
Somatotropinoma and its symptoms
In the presence of growth hormones in the body in excessive quantities, growth hormone is produced, which leads to acromegaly. Due to certain physiological characteristics in adults and children, the symptoms are different. In adolescents and children, this disease will be manifested by excessive growth in body length. Adults suffer from enlarged feet and hands, their fingers thicken, and facial features can become rough and puffy. This is because the growth zone is already closed, so soft tissue undergoes a pathological change.
Acromegaly can also lead to secondary diabetes, and in addition, arterial hypertension. The growths that form on the bones are subsequently able to transform into a malignant tumor. In addition to muscle and bone changes, pathological processes in the internal organs also occur. Such patients often suffer from diseases of the respiratory tract, digestive system and genitals.
Symptoms of Corticotropinomas
Corticotropinoma causes Cushing's disease in people, which can be triggered by excessive production of adrenacorticotropic hormones, which are produced by the adrenal glands. The patient may suffer from muscle atrophy. This leads to weakness of the limbs, which become thin. Against the background of pathology, fat is distributed unevenly in the body and is mainly deposited in the abdomen. Human skin is not ready for such a tension, which leads to stretch marks with a thickness of more than one centimeter. A person's face can take on a moon shape, while the cheeks turn red. Often in such patients arterial hypertension occurs along with diabetes mellitus. Mental abnormalities are also possible.
Gonadotropinoma and its symptoms
This type of pituitary microadenoma affects the reproductive functions of the body, regardless of the gender of the person, which often leads to female infertility due to the cessation of menstrual cycles. Among men, this type of microadenoma also causes infertility due to a decrease in sperm count and deterioration of its quality; moreover, in the stronger sex, the size of the testicles decreases in this disease.
Symptoms of thyrotropinomas
In the presence of thyrotropinomas, the thyroid gland intensely releases thyrotropic hormones, which leads to nodular goiter, and in addition to thyrotoxicosis, which is the cause of rapid weight loss, tachycardia and other disorders of the heart. In general, against the background of this disease, people endocrine and metabolic processes are violated.
Hormone-active forms of microadenomas are now being treated quite successfully, subject to timely detection. But if treatment is neglected, such a tumor can actively grow and degenerate into a cancerous tumor, leading to irreversible processes, such as, for example, loss of vision.
Before talking about the treatment of symptoms of pituitary microadenoma in women, consider its diagnosis.
Diagnostics
In the presence of symptoms indicating the presence of microadenomas in the patient, the doctor prescribes an additional examination, which refutes or, conversely, confirms the diagnosis. In the case of confirmation of the diagnosis, it is first necessary to determine the type along with the degree of development of the neoplasm through the following types of diagnostics:
- Testing that determines the hormonal state of the patient.
- Carrying out magnetic resonance and computed tomography. These are the most effective diagnostic methods to date, which give a complete picture of the disease, and in addition, about any changes in the structure of the pituitary gland. For example, a diffuse and heterogeneous structure indicates the presence of a disease.
- Performing radiography. Often with small tumor sizes, this diagnostic technique is ineffective. But on the background of the significant size of the tumor, a study such as an x-ray can be very informative.
Treatment of the pituitary microadenoma
Therapy is selected depending on the type of tumor. Hormone-inactive microadenoma most often does not cause any concern. Patients are advised to undergo regular medical examinations in order not to miss the conversion of the tumor to another type. This should also be done because the tumor may increase in size over time. In the presence of a hormone-active tumor, endocrinologists, together with oncologists and surgeons, resort to the following treatment options:
- Conducting conservative treatment through the use of hormone-regulating drugs.
- Surgery to remove microadenomas.
- Conducting radiation therapy.
Conservative treatment of pituitary microadenomas lends itself well in the case of prolactinomas. Conducting drug therapy involves the use of hormonal drugs like Cabergoline, Parlodel, and Dostinex. Regular use of them for a couple of years in most examples eliminates the disease, and prolactin decreases to normal values.
In the presence of somatotropinomas and thyrotropinomas, hormonal preparations, for example, "Somatostatin" or its analogues, are also prescribed. In addition, tereostatics may be prescribed. But very often, the treatment of pituitary microadenomas in women with hormones may not produce a lasting effect, and in this regard, it is often combined with surgery to remove the tumor.
Surgery for pituitary microadenoma patients is required in cases of impossibility of recovery through the use of conservative treatment. True, thanks to modern technology, operations of this kind are carried out with almost minimal pain and trauma. As part of the operation, an endoscopic technique is used, in which a tumor is removed through the nasal passage. Patients then recover quickly, which is a huge advantage of this technique.
It is well known that radiation therapy is one of the main ways of treating oncology. With modern medicine, the method of radiosurgery has increasingly been used to treat pituitary microadenomas. Radiosurgery or radiation surgery makes it possible without a knife through radiation to purposefully act on the tumor and not affect healthy tissue. Immediately after irradiation, the tumor cells die, which leads to a decrease in the size of the neoplasm. This type of treatment is often combined with hormone therapy if the tumor is hormone-active.
We will understand what is dangerous pituitary microadenoma.
What are the implications for women?
Ignoring this problem can lead to the fact that in the end the hormonal background will shift towards the excessive production of one or another hormone. For a woman’s body, such hormonal cascades can be fraught with a number of the following complications:
- The development of infertility.
- The occurrence of an imbalance of hormones, leading to too rapid aging of the skin.
- The presence of persistent menstrual dysfunction.
- The appearance of a woman's obesity.
- Flabbiness and dryness of the skin along with progressive aging.
- The occurrence of epileptic seizures due to compression of the structure adjacent to the pituitary gland.
- The emergence of psychological problems against the background of all of the above factors.
- Against the background of uncontrolled growth and an increase in the pituitary microadenoma, pathologies of vision may appear, and as a result, the onset of complete blindness is not excluded.
We examined the symptoms of treatment of pituitary microadenomas in women.
Forecast
As a rule, the prognosis regarding the cure of microadenoma is optimistic. This disease can be cured today. Whatever method is chosen for the treatment of pituitary microadenomas, the prognosis will depend on the implementation of all medical recommendations, since ignoring therapy often leads patients to irreversible consequences.
Pregnancy
Often there are situations in which the onset of pregnancy due to microadenomas is impossible. This is primarily due to the development of hormonal imbalance and the suppression of ovulation. All of these factors make fertilization impossible.
Another common situation is the circumstance in which the diagnosis of hormone-active neoplasms occurs precisely during the gestation of the child. This deviation occurs due to a serious change in the body and its restructuring due to pregnancy. In addition, increased loads on the pituitary gland can affect the appearance of the pituitary microadenoma of the brain.
During pregnancy planning, consult an endocrinologist. Most often, doctors recommend conception directly a year after the cure in order not to endanger the health of a woman’s life in serious danger. In this case, immediately after treatment, the expectant mother undergoes a thorough examination and becomes pregnant if there are satisfactory results. During the period of gestation, you should regularly visit a doctor in order to monitor the state of the tumor, since relapse is possible. The prognosis of the pituitary microadenoma is already known.
Thus, timely and competent treatment, as a rule, leads to an absolute recovery, with the exception of some rare relapses of the disease. In general, as already noted, the forecast is favorable. But in the event that an irreversible visual defect or any endocrine-metabolic disturbance has already occurred in the body, then patients with pituitary adenoma may have a lifelong disability.
The article presented the symptoms of pituitary microadenoma in women, treatment and prognosis.