Pituitary Tumor and Pituitary Diseases

The pituitary gland is a gland located in the lower part of the brain, weighing about half a kilo, and secreting various hormones. The pituitary gland acts as the master gland, regulating the central control of hormones in the body. A disease called 'hypopituitarism' occurs when this gland secretes insufficient amounts of hormones. This disease may occur due to a tumor in the gland or as a result of head trauma, or it may develop without an obvious underlying cause.

What are Pituitary Gland Diseases?

Some of the common pituitary diseases are growth hormone deficiency, pituitary adenoma, pituitary tumor (cancer), pituitary apoplexy, acromegaly, diabetes insipidus and Cushing's disease.
Hypopituitarism (Growth Hormone Deficiency)
In children, slowing growth and sexual development causes problems such as hypoglycemia (low blood sugar). The most important point for diagnosis is the slowing or stopping of growth and development. The child's height and weight values ​​can be easily determined as they are made during routine controls.

What are the Causes?

Growth hormone deficiency can occur congenitally, at the time of birth or after birth. In cases that may cause damage to the brain, sufficient hormones may not be secreted from the pituitary gland. These conditions are:

• Twin pregnancy,
• Severe head injuries,
• Radiation therapy,
• Any tumor in the body,
• It is the presence of diseases such as meningitis.

However, the cause of growth hormone deficiency is often unknown. This condition is also called idiopathic growth hormone deficiency.

What are the Symptoms?

• Pause or slowdown in height increase,
• Small face for their age,
• Low weight,
• late puberty, symptoms should suggest growth hormone deficiency.

What are the Risk Factors?

Heredity: Children with short parents are generally short.
Inbreeding: As a result of consanguineous marriage, the probability of developing a disease called skeletal dysplasia increases and this disease can cause disproportionate short stature.

How to Diagnose?

If the child's pituitary hormones are working in sufficient quantities If not, dwarfism will occur in the child. The hormone levels in the blood and urine of children who are thought to have this disease are checked.

How to Treat?

If there is not enough hormone secretion, treatment should be done according to the degree of the disorder and the type of hormones that cannot be produced. The patient who cannot produce growth hormone is given this hormone as drug therapy. Supplements of adrenal gland, thyroid hormones and adult sex hormones can also be given. Corticosteroid therapy can be applied to balance the decreased cortisol production as a result of the stimulation of the adrenal gland. These can be given to the person in cases where estrogen, testosterone or thyroid hormones are missing or insufficient.
As other hormones secreted from the pituitary gland decrease in patients with growth hormone deficiency, these hormones may also be deficient. Other hormones are also investigated and, if necessary, treated as replacements in addition to growth hormone therapy.

Pituitary Gland Adenoma What is it?

The pituitary gland acts as the main gland of our body. Pituitary gland adenomas are formed by the uncontrolled proliferation of cells in the gland. It occurs at a rate of 1/1000 in adults. Adenomas are benign. They typically grow slowly, but unlike other benign tumors, they can spread to neighboring tissues. They can also cause cancer, although rarely.
Types of Pituitary Adenoma,

• Microadenoma: They are adenomas smaller than 1 cm in diameter.
• Macroadenoma: They are adenomas larger than 1 cm in diameter.

Some of the tumors that form in the pituitary gland produce hormones while some do not. Hormone imbalance occurs in patients because hormone-producing tumors secrete excessive amounts of active hormones. The type that does not secrete hormones puts pressure on other tissues. Large tumors may prevent the pituitary from performing its normal function by pressing on the pituitary, causing hormone deficiency. The most common type of hormone-secreting pituitary adenomas is prolactin-secreting adenoma and it manifests itself with symptoms such as abortion in women and milk coming from the breasts. ACHTs Adenomas that detect thyroid cause Cushing's disease, and adenomas that affect the formation of thyroid hormones cause hyperthyroidism.

When are Pituitary Tumors Treated?

Endocrinological support is also needed in hormone-secreting tumors.
 Pituitary adenomas;

• If the adenomas are of the hormone-secreting type,
• If the tumor is large,
• If the tumor spreads to neighboring structures

If the general health condition is bad, it is treated.
Adenoma treatment methods include;
Medical Treatment: The treatment of adenomas should be planned together with the endocrinologist. Adenomas that cause prolactin secretion can only be treated with medical treatment. In adenomas that cause acromegaly and Cushing's syndrome (secreting hormones), it is appropriate to perform surgical treatment together with medical treatment. If there is pituitary insufficiency, it should be treated before surgical treatment. Because insufficient cortisol or thyroid levels are vital, it is important to treat them.
Surgery: Pituitary adenomas are usually removed by entering through the nasal cavity using endoscopic and microtechniques. Open surgery can also be applied.
Radiotherapy: The process of giving high doses of radiation to the tumor area and surrounding tissues is called radiotherapy. Radiotherapy may cause the problem of pituitary insufficiency in the future. For this reason, even after years, follow-up should be done and if hormone deficiency occurs, the missing hormones should be replaced. It is a treatment method that can be applied in tumors that cannot be obtained from surgery due to the risk of radiotherapy treatment or in tumors that cannot be controlled by drug therapy.

What is Pituitary Gland Tumor (Cancer)?

Adenoma is benign It is a pituitary gland tumor, but sometimes malignant pituitary gland tumor formation is also possible.

What are the Symptoms of Pituitary Gland Cancer?

• Excess hormone secretion,
• Red face,
• Weakness in muscles and bones,
• Excessive growth of hands and feet,
• High blood pressure, irregular heart rhythm,
• Headache, loss of vision,
• Milk discharge from the breast or cessation of milk while breastfeeding,
• menstrual irregularities,
• Sexual reluctance,
• Shedding of body hair,
• Weight gain,
Anxiety, depression,
• Nausea, vomiting and dizziness.

How is Pituitary Cancer Diagnosed?

• Blood and urine tests,
• MR (Magnetic Resonance),
• CT (Computed Tomography) are the most frequently used methods for diagnosis.

Patients with suspected pituitary gland cancer are first tested by blood and urine, and their hormone levels are checked and evaluated. The diagnosis is then made by MRI or CT imaging.

What Organs Can Pituitary Gland Cancer Spread To?

The most common organs to spread are the brain, spinal cord and meninges (the layer covering the brain and spinal cord) and to the bones near the pituitary gland.

How is Pituitary Gland Cancer Treated?

The type of cancer is determined in the diagnosis. Normally, the treatment process and plan is created according to the stage of the cancer, but since pituitary cancers are very rare, there is no plan for staging. Therefore, the treatment is based on the size and spread of the tumor.
In surgical treatment, the pituitary gland is removed. Radiation therapy is applied to kill the microscopic tumor cells that may remain in the patient after the surgery. Sometimes drug therapy can be used to shrink or destroy the tumor.

What is Pituitary Apoplexy? How Is It Treated?

Pituitary adenomas can suddenly bleed into and increase in size rapidly. This condition is called pituitary apoplexy. The patient has severe headache and loss of vision. The patient must have surgery immediately.

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