Frequently Asked Questions About Pituitary Adenoma

It means a type of tumor. These tumors are defined as benign tumors.

Pituitary adenomas smaller than 10 mm are called microadenomas, and those 10 mm and larger are called macroadenomas.

The pressure the adenoma places on surrounding tissues due to its mass effect. Accordingly, headache, visual disturbance, or decreased production of pituitary hormones. Uncontrolled excessive hormone production by the adenoma.

The visual impairment caused by pituitary adenomas usually appears as the inability to see certain areas of the surroundings when looking with one eye closed. It may not be noticed when both eyes are open.

Yes, there may be pituitary adenomas with no symptoms at all. These types of adenomas are currently among the most commonly seen pituitary adenomas. They are detected incidentally on scans such as brain MRI taken for other purposes. The adenomas may not produce hormones, or compression symptoms may not have developed because they are small.

Treatment for pituitary adenoma varies. The treatment changes according to the compression findings of the adenoma, whether it produces hormones, and the MRI appearance. As treatment options, there are cases requiring surgery as well as a fairly large group that can be treated with medication. There are even pituitary adenomas that require no treatment at all and are only followed up.

In this type of pituitary adenoma, treatment is always surgical; in addition, Radiotherapy is applied to shrink the remaining unreachable mass.

The primary treatment is dopamine antagonists (bromocriptine, cabergoline). These agents (medications) lower prolactin levels and improve sexual function in a very large group of patients. In very elderly patients or patients with heart problems who cannot use dopamine antagonists, surgical treatment should be performed. In addition, if the adenoma has started to put pressure on the optic nerve and medical treatment has remained insufficient, surgical treatment should again be chosen.

The primary treatment is surgery. If this treatment is not effective and is insufficient, octreotide and bromocriptine treatment should be used. This treatment does not shrink the tumor structure; it has a suppressive effect on hormone levels.

The primary treatment is surgery.

Especially in pituitary adenomas where excessive hormone production cannot be suppressed with drug treatment, the adenoma should be removed by surgery. In addition, surgery should also be preferred in cases that gradually spread to surrounding tissues and create pressure.

Although it is a surgery involving the lower part of the brain, it is not considered brain surgery. This is because the pituitary region at the base of the brain is reached through the nasal root and nasal sinuses. The brain is usually not affected during the operation. The hospital stay after the operation is generally a few days.

There is a possibility that the tissue may grow again after surgery. Therefore, despite other treatments during patient follow-up, a new operation may be required in recurrent adenomas.

Excess milk hormone is seen most frequently in pituitary adenomas. In pituitary adenomas causing excess milk hormone (prolactinoma), treatment is generally medication. With medication, the hormone excess can be normalized and it is also possible to shrink the adenoma. Drug treatment may also be applied in some other pituitary adenomas. Hormone replacement treatments for patients with hormone deficiency are drug treatments that absolutely need to continue lifelong.

Prolactinoma, the most commonly seen pituitary adenoma, is most frequently seen in women of reproductive age and constitutes approximately 30-40% of all pituitary tumors. This tumor secretes prolactin, a hormone that controls sexual function. As a result of this excessive prolactin secretion, cessation of monthly menstrual bleeding and/or milk production in the breasts (galactorrhea) may be seen in women. These tumors, which can also be seen in men around the ages of 40-50, may cause symptoms such as headache, loss of vision, impotence, or decreased sexual desire in this group.

Growth hormone-secreting pituitary tumors, which are seen more often in men, make up approximately 20% of all pituitary tumors. These tumors, which are generally macroadenomas, cause gigantism in children or adolescents, while they may cause acromegaly in adults who have completed their growth. Acromegaly is the enlargement of the hands, feet, and jaw. In addition, excessive growth hormone secretion may also worsen high blood pressure, heart disease, and diabetes.

ACTH-secreting pituitary adenomas are more common in women. The ACTH hormone stimulates the adrenal glands to release the body’s natural steroids, namely glucocorticoids. Excessive secretion of glucocorticoids causes Cushing’s disease. Symptoms of this disease are weight gain, diabetes, irregular menstruation, excessive body hair, easy bruising of the skin, and high blood pressure.

These tumors, which make up approximately 25% of all pituitary adenomas, generally reach large sizes without causing symptoms. This growth may cause vision loss and headache. The pressure caused by the tumor may also prevent the secretion of hormones normally released from the pituitary gland. This may cause symptoms such as lack of interest, weakness, fatigue, and paleness of the skin.

MRI and hormone tests are used for follow-up after treatment. These are important for monitoring the success of the treatment and whether the tumor recurs.