There are two main systems that control the body's functions. The first of these is the "nervous system", which originates from the brain and spinal cord and distributes throughout the body, and the second is the "hormonal system" or "endocrine system", which manages body functions by watching in the blood constantly circulating in the body. These two systems work in conjunction with each other. Hormones are chemical substances secreted by cell communities or glands in the body. There are two glands in the brain that belong to the endocrine system. The first is the pituitary gland, the second is the pineal gland. While tumors involving the pineal gland are very rare, tumors involving the pituitary gland are detected in 5-10% of all brain tumors.
Pituitary gland tumors have harmful effects on the body in two ways. Its first harmful effect occurs when it exceeds its normal size and compresses the surrounding structures. In this case, the optic nerve near the gland is especially affected and the patient experiences decreased vision or loss of vision. If the tumor grows further, loss of function of the nerves that enable eye movements may occur. When the pituitary gland reaches such large sizes, normal pituitary tissue will lose its function, and deficiency of various hormones secreted from the pituitary may also occur. Tumors that cause the first effect are called macroadenomas. The tumor shows its second harmful effect by excessive secretion of some hormones, with or without excessive enlargement of the pituitary gland. If the pituitary gland grows larger than 1 cm, these tumors are called microadenomas. Pituitary gland; It consists of two parts: anterior pituitary and posterior pituitary. Pituitary gland tumors are mainly tumors of the anterior pituitary.
The hormones secreted from the anterior pituitary and their functions are as follows:
Prolactin hormone ensures the secretion of milk from the breast.
Growth hormone; It controls carbohydrate, fat and protein metabolism in the body. It ensures balanced growth of the body, especially during adolescence.
Adrenocorticotrophic hormone; It regulates the vitally important cortisol secretion from the adrenal glands.
Thyroid stimulating hormone; It ensures the secretion of thyroid hormones from the thyroid gland.
Gonadotrophic hormones; reproductive organs They control their functions.
Cell groups in the pituitary gland that secrete one or two of the hormones listed above secrete more hormones than the body needs, causing the functions of that hormone or hormones to increase in the body. In this case, for example; If excessive prolactin is secreted, milk comes from the breast even though the patient is not pregnant. If excessive growth hormone is secreted in adults, shoes may start to become tight as a result of excessive growth of the body. Antidiuretic hormone, which regulates urine output from the body, and a hormone called oxytocin, which causes uterine contraction during birth, are secreted from the posterior pituitary. Tumors of the posterior pituitary are almost never seen.
There are three approaches to the treatment of pituitary tumors:
Medication, surgery and radiation therapy. It is possible to control excessive hormone secretion with drug therapy. However, when the drug is stopped, hormone secretion increases to its previous level in most patients. For example, if the patient wants to become pregnant with a tumor that secretes excessive prolactin, the drug must be discontinued as it will have side effects on the unborn baby. This makes it easier for the tumor to grow back. The patient may need to use the drug throughout his or her life.
The aims of surgical treatment are as follows:
To remove the pressure of the tumor on the surrounding tissues, such as the optic nerves, to shrink the tumor mass and to ensure a better response to drug treatment. Surgical treatment is also necessary for tumors that do not respond to medication. In cases such as macroadenoma or intratumor bleeding that causes sudden vision loss, surgery should be performed without delay. Surgical treatment is performed in two main ways. The first can be summarized as the nasal passage called transsphenoidal, and the second can be summarized as removing the pituitary tumor by opening the skull bone from above.
It may be preferred in pituitary tumors that cannot be controlled with radiation therapy, drug therapy and surgery, or that extend to areas that are risky to reach with surgery.
br />
Read: 0
