The pituitary gland is a part of the brain which is located at the base of the brain. The pituitary gland has different cell types that can produce different types of hormones. A pituitary adenoma is known as an abnormal growth in the pituitary gland. When an adenoma secretes many hormones, it can lead to symptoms and signs specific to that hormone oversecretion. When the pituitary adenoma doesn’t secrete any hormone, it is called a non-functioning pituitary tumor.
Adenoma arising from pituitary gland will be usually benign in nature. It can have symptoms due to local pressure or effects of the hormone if it’s secreting a tumor. Mostly, it is expected to not spread to the other parts.
Pituitary adenoma happens due to a mutation in the pituitary cells, leading to abnormal growth and multiplication. It can also happen as a part of some genetic syndromes like multiple endocrine neoplasia.
Small pituitary adenomas may not cause any symptoms. Large adenomas can lead to pressure symptoms like headaches and vision changes. Adenoma can affect other pituitary cells, leading to less secretion of those hormones. Patients can have symptoms like irregular or absent menstrual periods in women, erectile dysfunction in males, low energy, low blood pressure, and height problems in children.
Untreated non-functioning pituitary tumors can lead to vision loss and hypopituitarism (deficiency of multiple pituitary hormones).
A non-functioning pituitary tumor is diagnosed by CT scan or MRI imaging. Patients may also require hormone investigation and vision testing to assess the impact of the tumor.
Pituitary adenoma is relatively common. They make up 10 to 15% of all the tumors that develop within the skull.
Small adenomas may not lead to any symptoms or signs. Sometimes an incidentally discovered macroadenoma (larger than 10 mm) has no effect. They can be followed up on periodically. If the patient is symptomatic or has vision changes, they will require surgery. With this approach, hormone deficiency can be replaced from outside and a patient can lead a near-normal life.
Incidentally diagnosed, non-functional pituitary adenoma causing no symptoms does not usually require treatment. But regular follow-up is required to monitor the growth of the tumor. A large pituitary adenoma or a pituitary tumor that causes symptoms usually needs treatment. They are treated mainly with endoscopic surgery via the nasal route. Radiation therapy may be required for recurrent tumors. After surgery, patients may require hormonal treatment if they are deficient in certain hormones.