Pituitary tumor

A Pituitary tumor is a predominantly benign tumor of the pituitary gland that makes up around 30 to 40 percent of brain tumors. Pituitary tumors are usually well treatable due to modern microsurgical techniques.

What is a pituitary tumor?

As Pituitary tumor is a pathological, usually benign (benign) neoplasm of the pituitary gland (pituitary gland). A distinction is made between the more frequently diagnosed pituitary adenomas, which make up 15 percent of brain tumors and arise from cell tissue of the anterior lobe of the pituitary gland (adenohypophysis), and the extremely rare tumors of the posterior lobe of the pituitary gland (e.g. granular cell tumors of the neurohypophysis).

The pituitary gland is about the size of a bean, which acts as an interface between the brain and the endocrine system and plays a key role in the hormonal regulatory system. Since a pituitary tumor arises from tissue cells of the pituitary gland, it can take over their hormone-producing properties.

Therefore, a distinction is also made between hormone-inactive and hormone-active pituitary tumors. The predominantly hormone-active pituitary tumors produce hormones and, as a result of a hormone excess, impair the hormonal regulation system of the pituitary gland. The most common pituitary tumor is the prolactinoma (about 40 percent of pituitary tumors), which is a hormonally active tumor that produces prolactin.

causes

The causes of one Pituitary tumor have not yet been clearly clarified. It is assumed that a pituitary tumor arises from a single abnormal tissue cell of the pituitary gland that divides, multiplies and forms a tumor, with no specific cells particularly at risk of degeneration.

The triggers for this degeneration process are also unknown and a correlation between environmental factors affecting the genetic material and the development of a tumor has not yet been proven. In some specific cases, a pituitary tumor is based on genetic factors. With multiple endocrine neoplasia (MEN-1 syndrome) there is an increased risk of pituitary tumors.

Typical symptoms & signs

• Visual disturbances
• Visual field loss
• Increase in pituitary hormones

Diagnosis & course

For diagnosing a Pituitary tumor Diagnostic imaging methods such as MRI, CT and X-rays are used. Using an MRI (magnetic resonance tomography) of the head, for example, a pituitary tumor can be localized and its size determined.

A hormone determination in the blood provides information about the hormone activity and the type of pituitary tumor as part of a differential diagnosis. In a prolactinoma, for example, the prolactin level is increased. An increased level of growth hormones (above 5 ng / mm) indicates a growth hormone-producing pituitary tumor.

In addition, an ACTH-producing (adrenocorticotropic hormone) pituitary tumor can be detected by a dexamethasone test. Since a pituitary tumor is visually impaired in around 30 percent of cases, a detailed eye examination is indicated.

In general, a pituitary tumor is not fatal or life-threatening and the prognosis is favorable, although there is a high risk of recurrence (recurrence). If left untreated, a pituitary tumor that increases in size can affect adjacent organs (optic nerves, blood vessels) and lead to death in the majority of cases.

Complications

In most cases, a pituitary tumor can be treated and removed relatively well, so that the patient does not experience any particular complications or discomfort. Without treatment, however, the tumor in the brain can spread to other regions of the head and body and cause symptoms in these regions. In most cases, the pituitary tumor causes visual disturbances.

The eyesight can decrease and the patient suffers from double vision or what is known as veiled vision. Furthermore, paralysis and failures can occur in the various areas of the field of vision, so that the person affected can no longer move or control certain regions. This paralysis severely restricts the patient's everyday life and leads to a considerable loss of quality of life.

The pituitary tumor is usually treated with radiation therapy, as surgical removal is not possible. There are no particular complications and the tumor can usually be removed relatively easily. Furthermore, medication is used and the person concerned has to be examined again and again in the following years. With successful removal, life expectancy is not affected.

When should you go to the doctor?

Depending on its size and location, a pituitary tumor can cause very different symptoms. A visit to a doctor is advisable as soon as there are signs of a hormonal disorder such as increasing fat deposits on the stomach with simultaneous loss of muscle mass or an inexplicable enlargement of the hands and feet (acromegaly). Children should be presented to the pediatrician if the normal growth spurts fail and their height is significantly below that of their peers.

Menstrual cycle disorders and loss of sexual desire in women can indicate a tumor-related deficiency in female sex hormones. In this case, a visit to the gynecologist is recommended, who can rule out gynecological causes and, if necessary, arrange for a further specialist investigation. In men, a pituitary tumor occasionally triggers erectile dysfunction and a loss of libido; the urologist is the first point of contact here.

Other warning signs that suggest a pituitary gland tumor may include an increased sensation of cold, a slow pulse rate, low blood pressure, tiredness, decreased performance, noticeable pale skin, headache, visual disturbances and a tendency to hypoglycaemia. Each of these signs can also be caused by other, far more harmless diseases - a visit to the family doctor is advisable if some symptoms occur at the same time, the symptoms persist for a long time or become increasingly worse. If the suspicion is confirmed, further examinations by an endocrinologist or by imaging procedures are useful.

Doctors & therapists in your area

Treatment & Therapy

Standard therapy is one Pituitary tumor in a microsurgical procedure, whereby a prolactinoma is an exception and is treated with medication. Due to the position of the pituitary gland, access to the tumor is in most cases via the nasal opening and opening of the skull is only necessary for particularly large pituitary tumors.

If the pituitary tumor proves to be inoperable or only partially removable, radiation therapy is also used. In some cases, however, due to the problematic location of the pituitary gland, radical removal of the residual tumor is not possible, so that its development is monitored using imaging techniques (MRT) and a new surgical intervention may be necessary.

As a hormonally active pituitary tumor, prolactinoma is treated with dopamine agonists that inhibit the increased release of prolactin and gradually lead to a minimization of the pituitary tumor. Microsurgical tumor removal is only an option for those affected who cannot tolerate long-term drug therapy and if the tumor does not respond to the drug.

The result of microsurgical and radical removal of the pituitary tumor is in not uncommon cases hypophyseal function, which results in a hormone deficiency. This is compensated with medication as part of substitution therapy.

prevention

Since neither the exact causes nor the triggers for the assumed cell degeneration are known, one can Pituitary tumor not prevent. In general, it is recommended to avoid carcinogenic substances such as chemicals, unnecessary radiation, alcohol and nicotine. A healthy diet and physical activity support the immune system and minimize the risk of disease in general and especially with regard to pituitary tumors.

Aftercare

After a pituitary tumor, there is often a hormone deficiency, triggered by the hypofunction of the pituitary gland. The doctor prescribes the appropriate medication for this. Patients should strictly adhere to the instructions for this substitution therapy in order to rule out any problems. In the post-treatment phase, it is important to avoid harmful stimulants such as alcohol and nicotine.

Healthy food and sufficient exercise help those affected to lower the risk of the disease and to strengthen the immune system. With this improvement in health, patients feel armed against illness and relapse. In addition to a healthy diet, you can limit your caffeine consumption and maintain a diet if you are overweight.

Patients of normal weight feel much better because their cardiovascular system is not overloaded. Weight loss recommended by a doctor also has a positive effect on blood values ​​and ensures greater fitness. That is why it is worthwhile to include sports and exercise exercises in the aftercare program.

The activities and the subsequent relaxation phases also reduce everyday stress. This is another important point for health. With autogenic training and / or yoga, those affected also train their mindfulness and thus increase their quality of life.

You can do that yourself

The pituitary tumor is a serious disease that the patient should never treat or ignore independently. It is very important that the therapy is determined in consultation with the attending physician and carried out consistently. Active participation by the patient is possible here. The person affected can follow the therapy plan consistently, attend check-ups, and actively report changes, abnormalities or possibly new symptoms to the doctor.

In parallel to tumor therapy, the patient can try to achieve the most stable immune system possible and a good general physical condition. A first step is to avoid harmful substances such as nicotine and alcohol. Caffeine consumption can also be reduced to one or two cups a day.

If the patient is overweight, try to reach a normal weight. This relieves his cardiovascular system and brings himself into a fitter, healthier state. Weight loss can usually be achieved quickly by changing your diet, and your blood values ​​and your overall physical condition also improve. An appropriate sport or exercise program supports these measures. In this way, the patient himself can ensure that the strenuous stress of the therapies can be better processed with a healthier body.

In many cases, stress and pressure in everyday life can be avoided or reduced. Autogenic training or yoga can help relax.