A little gland in the brain is called the pituitary. It is situated close to the brain and behind the bridge of the nose. It is a component of the endocrine system, which controls hormone production in the body. The pituitary gland is frequently referred to as the "master endocrine gland" because it produces hormones that regulate other glands in the body and have an impact on numerous bodily functions. An unnatural growth in the pituitary gland is known as a pituitary tumor. Pituitary tumors are prevalent tumors that are thought to impact 16.7% of the population, however, they can often go unnoticed.
Headaches are a common complaint among patients with pituitary tumors. Pituitary tumors can directly cause headaches by eroding into the cavernous sinus, affecting the sella's dural lining or diaphragma sella, or by inducing sinusitis, especially after transsphenoidal surgery. In these circumstances, headache pain is often characterised by a constant, bifrontal, or unilateral throbbing in the front. An individual with pituitary tumor apoplexy typically experiences an onset, severe headache in the front of the head.
Patients who have subacute pituitary apoplexy endure terrible headaches for weeks to months. Pituitary tumors indirect consequences, which are brought on by decreased hormone secretion, appear as an increase in "vascular" headaches. The main exception to this rule concerns the possibility that acromegalic patients could experience headaches as a result of cervical osteoarthritis.
The term "pituitary gland tumor" refers to a collection of abnormal cells that develop uncontrollably in your pituitary gland. Tumors that grow on the pituitary gland may be cancerous or benign. A cancerous tumor's capacity to grow and spread to various body parts is referred to be malignant. If a tumor is benign, it can grow but will not spread. Pituitary tumors are frequently classified as brain tumor, accounting for 12 to 19% of all primary brain tumors.
A pituitary tumor can also affect vision if it puts pressure on nearby tissues, such as the optic nerves of the eye. Both benign and malignant tumors in the pituitary gland have the potential to result in serious health consequences because they interfere with the gland's regular endocrine function. The most frequent kind of pituitary gland tumor is benign growth called pituitary adenomas. Pituitary adenomas impact 1 out of every 10 people during the course of their lives.
The early symptoms of a pituitary tumor are frequently determined by whether the tumor is functional or non-functional.
A functional adenoma often produces an excessive amount of a single pituitary hormone. Non-functional adenomas, which don't produce extra hormones, frequently grow large (macroadenomas) before being identified. These tumors don't show symptoms until they put pressure on surrounding nerves, brain tissue, or other pituitary organs.
People who have a pituitary gland tumor may suffer the following symptoms or signs.
The term "macroadenomas" refers to large pituitary tumors that are one centimeter or larger.
The symptoms of functional adenomas differ depending on the hormone they produce.
When a pituitary tumor oversecretes thyroid-stimulating hormone, your thyroid gland generates too much thyroxine.
These tumors overproduce growth hormone (acromegaly), which may result in:
Young women and older males are more likely to have prolactinomas. The following are the symptoms of Prolactin-secreting adenomas.
Adrenocorticotropin is a hormone that is produced by ACTH tumors. The adrenal glands produce steroid hormones like cortisol in response to elevated ACTH levels. The overproduction of cortisol by your adrenal glands leads to Cushing syndrome. Cushing syndrome can show any of the following symptoms:
Pituitary tumors can be treated in several ways, such as by surgically removing the tumor, using drugs to slow its growth, or removing the tumor altogether.
Pituitary tumors that are pushing on the optic nerves or that are overproducing particular hormones typically need to be surgically removed. How successfully the surgery goes depends on the nature, location, size, and degree of the tumor's infiltration into the surrounding tissues. Pituitary tumors are most commonly treated surgically using two basic methods:
This is the most commonly used method for removing pituitary tumors. Transsphenoidal surgery is performed on the sphenoid sinus, a hollow in the skull that is situated below the brain and below the nasal passages.
Large tumors could be challenging to remove in this manner, especially if they have spread to surrounding nerves or brain tissue. The transsphenoidal method offers many benefits, including that no part of the brain is contacted during surgery, minimising the risk of brain damage.
For exceptionally big and invasive tumors that cannot be safely removed via the transsphenoidal route, the transcranial procedure, also known as a craniotomy, is employed. A scalp incision is used to remove the tumor from the top of your skull. With this technique, it is simpler to access larger or more difficult tumors.
Radiation therapy kills tumor cells by using high-energy x-rays or particle waves. An expert in this field of medicine is referred to as a radiation oncologist. An external source of radiation is aimed toward the tumor. If a tumor persists or reappears after surgery and creates signs and symptoms that drugs are unable to treat, radiation therapy can be helpful.
This sort of therapy gives the tumor area a significant, targeted radiation dose in a single treatment. Despite the name "radiosurgery," there is no cutting or actual surgery taking place.
This therapy can be administered in fewer sessions and appears to cause less harm to tissues close to the pituitary. Radiosurgery treats the tumor more accurately than regular radiation therapy.
Instead of using x-rays to destroy cancer cells, this type of treatment uses a beam of protons. Proton beams release their energy inside their target and then stop, unlike X-rays.
The use of the beams on tumors poses a lower risk to healthy tissues due to their fine controllability. It has the advantage of more accurately targeting the radiation on the pituitary tumor, similar to stereotactic radiation.
The doctor can shape the beams and encircle the tumor from a variety of angles using a computer in this particular form of radiation therapy. Additionally, the beams' intensity can be restricted, which will reduce the amount of radiation that reaches nearby tissues.
Radiation known as photons is used in conventional external beam radiotherapy. By using a linear accelerator, these photons are produced. Although this treatment is frequently successful, it could take years to completely stop the production of hormones and tumor growth.
Your doctor might begin treating you with medications depending on the type of tumor you may have. If your tumor generates prolactin, medication could be able to reduce this production and cause the tumor to shrink. Acromegaly, Cushing's syndrome, and tumors that release growth hormone can also be treated with medications.
Dopamine agonist medications help reduce prolactinomas by preventing them from overproducing prolactin. Cabergoline and bromocriptine are the most widely utilised medications.
Both medications are effective. However, cabergoline appears to be more effective and lasts longer in the body than bromocriptine so it can be used once or twice a week as opposed to daily.
These medications may have drowsiness, dizziness, nausea, vomiting, diarrhoea or constipation, headaches, and other side effects.
Ketoconazole and metyrapone are medications used to treat excessive cortisol production in the adrenal gland. People with Cushing syndrome who also have type 2 diabetes or glucose intolerance are permitted to use mifepristone. Although mifepristone does not reduce cortisol production, it does prevent cortisol from having an adverse effect on your tissues.
Fatigue, nausea, vomiting, headaches, muscle aches, high blood pressure, low potassium, and swelling are possible side effects.
These kinds of pituitary tumors can be treated with two different types of medications, which are especially helpful if surgery hasn't been able to restore normal growth hormone production.
Drugs like octreotide and lanreotide are examples of somatostatin analogs, a type of medication that lowers the production of growth hormones and may result in tumor reduction.
These are administered through injection, often every four weeks. Pegvisomant, a second type of medication, prevents the body's response to excessive growth hormone.
Some of the negative effects of these medications include a slowing heart rate, nausea, vomiting, diarrhoea, gas, stomach discomfort, disorientation, headaches, and pain at the injection site.
It is still unclear what causes the uncontrollable cell growth in pituitary glands. Scientists have made considerable progress in recent years in understanding how specific mutations in a person's DNA might cause cells in the pituitary to develop tumors.
DNA mutations cause uncontrolled cell growth and division in the pituitary gland, which leads to the development of pituitary microadenomas. The exact reason for these genetic abnormalities is unclear to experts.
The chance of getting pituitary tumors is considerably increased in those people who inherit genetic abnormalities from their parents. Pituitary tumors are more likely to occur in people with a family history of certain hereditary conditions, such as multiple endocrine neoplasia, type 1 (MEN 1).
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