PAN ARAB NEUROSURGICAL SOCIETY

Although it is only the size of a pea, the pituitary gland, sometimes called the “master gland”, produces and secretes nine important hormones. The hormones associated with the pituitary gland are involved in such functions as:

 

• Growth

• Blood pressure

• Certain aspects of pregnancy and childbirth and production of breast milk

• Thyroid function

• Metabolism (converting food into energy)

• Sexual functions in both men and women

• Regulation of water in the body

• Temperature regulation

• Skin pigmentation

 

There are many possible disorders of the pituitary gland which often occur when a tumor or growth forms on or near the pituitary gland.

 

Causes

 

Pituitary disorders are most frequently caused by a tumour. As the tumour grows, it may affect the ability of the pituitary to produce hormones. A pituitary tumour may cause the gland to produce too much of one or more hormones or it may impair the ability of the gland to produce enough of one or more hormones. In some cases, the formation of a pituitary tumour may be associated with genetic factors.

 

Terminology

 

The pituitary gland or hypophysis extends outward from the bottom of the hypothalamus at the base of the brain. It is located in the stella turcica, a bony cavity, and is protected by the covering of the dural folds (diaphragma sellae). The pituitary gland is connected to the hypothalamus by means of the infundibular stem or pituitary stalk, a small tube-like connection. The gland itself is divided into three main lobes: theanterior pituitary (adenohypophysis), the posterior pituitary (neurohypophysis), and the intermediate lobe. A pituitary tumor is typically benign (non-cancerous) and is known as a pituitary adenoma. A tumor that decreases the pituitary’s hormone production causes hypopituitarism.

 

Symptoms

 

Symptoms of a pituitary disorder associated with a tumour vary based on what hormone(s) the tumour affects. A pituitary disorder may result in:

 

• Nipple discharge

• Changes in women’s monthly cycles

• Gigantism, acromegaly

• Cushing syndrome (causing weight gain and associated with high levels of cortisol in the blood)

• Overactive thyroid (hyperthyroidism) which may cause rapid heart rate, shakiness, weight loss, and insomnia

• Loss of body hair

 

In some cases, the tumour may put pressure on the pituitary gland, producing symptoms such as:

 

• Headache

• Visual impairment, visual field defect, decrease of visual activity, including but not limited to double vision – oculomotor disturbances

• Fatigue, lethargy

• Easy bruising

• Nausea and vomiting

• Nasal drainage

• Impaired sense of smell

• Drooping eyelids

• Excessive sweating

• Snoring

• Confusion

• Seizures

 

Treatment

 

Most pituitary tumours are not cancerous, and if that is the case, there is no risk the tumor will spread throughout the body. However, as the tumour grows, it will put increasing pressure on the pituitary gland and nearby structures and have more and more effect on hormonal production. Most pituitary tumours can be surgically removed. Advanced surgical procedures, such as those available at the Neuro Spinal Hospital, may be able to remove such tumours in certain patients using minimally invasive techniques. In some patients, drug therapy may be needed to help control symptoms until the tumour can be removed.

 

Prognosis

 

Advanced treatment options, such as minimally invasive surgical tumour excision (removal), have greatly improved the prognosis for patients with pituitary tumours. The Neuro Spinal Hospital offers expert diagnosis and the latest treatments for pituitary tumours. Not all tumours can be effectively removed by surgery, and, if that is the case, the team at the Neuro Spinal Hospital can provide state-of-the-art alternative treatments, including radiation and drug therapy. Although rare, it is possible for a pituitary tumour to grow back even after surgical removal.

 

Risk Factors

 

Genetics or family history of pituitary tumours may be a risk factor.

 

Conclusion

 

There are many pituitary disorders, most of which are associated with the growth of a pituitary tumour. Although pituitary tumours are not usually cancerous, they should be removed because their growth can affect hormonal output into the body (causing symptoms, sometimes severe) and put pressure on nearby structures (producing more symptoms). Since the pituitary gland secretes nine major hormones, symptoms may vary depending on which hormones are affected by the tumour. Neuro Spinal Hospital offers expert care of pituitary disorders, including minimally invasive surgical options which may be curative in certain patients.