Pituitary tumors

1. Ratheesh.R
SLMGNC

2.  Pituitary tumors are common neoplasms, and
recognition of their presentation is critical
since a favorable therapeutic outcome is
dependent on early identification of the
lesion.
 Pituitary tumors constitute 10-15% of all
diagnosed intracranial tumors, 90% of which
are adenomas.

3.  Abnormal proliferation of cells on target
tissue or on local structures surrounding
the pituitary gland.

4.  Typically, pituitary tumors are characterized by
size and by what hormones, if any are
secreated.
Size:
 Micro adenoma- less than 10mm wide.
 Macro adenoma- Greater than 10mm wide.
Functionally:
 Hormone secreting- Exaggerated hormone activity
- May secrete multiple hermones.
 Non-Secreting -Diminished hormone activity.

5.  Unknown
 Uncontrolled cell growth in the pituitary
gland, which creates a tumor
 Certain hereditary conditions
 Such as multiple endocrine neoplasia

6.  Headache.
 Some loss of vision.
 Loss of body hair.
 In women, less frequent or no menstrual
periods or no milk from the breasts.
 In men, loss of facial hair, growth of
breast tissue, and impotence.
 In women and men, lower sex drive.
 In children, slowed growth and sexual
development.

7. Too much prolactin may cause:
 Headache.
 Some loss of vision.
 Less frequent or no menstrual periods or
menstrual periods with a very light flow.
 Trouble becoming pregnant or an inability to
become pregnant.
 Lower sex drive.
 Flow of breast milk in a woman who is not
pregnant or breast-feeding.

8. Too much ACTH may cause:
 Headache.
 Some loss of vision.
 Weight gain in the face, neck, and trunk of the body,
and thin arms and legs.
 A lump of fat on the back of the neck.
 Thin skin that may have purple or pink stretch marks
on the chest or abdomen.
 Growth of fine hair on the face, upper back, or arms.
 Bones that break easily.
 Anxiety, irritability, and depression.

9. Too much growth hormone may cause:
 Headache.
 Some loss of vision.
 In adults, acromegaly (growth of the bones in the
face, hands, and feet). In children, the whole body
may grow much taller and larger than normal.
 Tingling or numbness in the hands and fingers.
 Snoring or pauses in breathing during sleep.
 Joint pain.
 Sweating more than usual.
 Dysmorphophobia (extreme dislike of or concern
about one or more parts of the body).

10. Too much thyroid-stimulating hormone may
cause:
 Irregular heartbeat.
 Weight loss.
 Trouble sleeping.
 Frequent bowel movements.
 Sweating.

11. Other general signs and symptoms of
pituitary tumors:
 Nausea and vomiting.
 Confusion.
 Dizziness.
 Seizures.
 Runny or "drippy" nose (cerebrospinal
fluid that surrounds the brain and spinal cord
leaks into the nose).

12.  History collection
 Physical examination
 CT scan
 MRI
 Skull films
 Serum hormone level
 Provocative Testing
 Neurological exam
 Visual field exam
 Twenty-four-hour urine test
 Biopsy

13.  Radiation therapy
 Hormone replacement therapy
 Chemotherapy
 Systematic Treatment

14.  Hypophysectomy- Removal of Pituitary.
 Frontal Craniotomy- Uncommon approach
except where tumor
occupies broad area.
 Transspenoidal Hypophysectomy-
-Directapproach through the sinus and
nasal cavity.

15.  Severe disability
 Death due to stroke, blindness, imbalance of
TSH, ACTH or ADH.
 Transient or permanent Diabetes insipidus.
 Hypo parathyroidism
 Adreno cortical insufficiency.

16.  Disturbed body image related to enlargement of body
parts as manifested by enlarged hands, feet and jaw.
 Disturbed sensory perception related to
enlarged pituitary gland as manifested by protrusion of
eye balls.
 Disturbed sleeping pattern related to soft tissue swelling
as manifested by verbalization of the patient about
insomnia.
 Fluid volume deficit related to polyuria as manifested by
excessive thirst of the patient.
 Anxiety related to change in appearance and treatment
as manifested by verbalization of the patient about body
appearance.