Pituitary tumours Flashcards
Pituitary adenoma
Benign tumour of the pituitary gland
Microadenoma <1cm and macroadenoma >1cm
Secretory/functioning vs non-secretory/functioning
Prolactinomas
Most common type
Produce excess of prolactin
Most common
Prolactinoma
Then non-secreting adenomas
Then GH secreting and ACTH secreting adenomas
Symptoms if excess hormones
Cushing’s due to excess ACTH
Acromegaly due to excess GH
Amenorrhoea and galactorrhoea due to excess prolactin
Symptoms due to depletion of hormones
Due to compression of the normal functioning pituitary gland
Present with generalised hypopituitarism
Symptoms due to stretching of dura within/around pituitary
Headaches
Symptoms due to compression of optic chiasm
Bitemporal hemianopia
Investigations
Pituitary blood profile (GH, prolactin, ACTH, LSH, TFTs)
Formal visual field testing
MRI brain with contrast
Differential diagnosis for pituitary adenoma
Pituitary hyperplasia
Craniopharyngioma
Meningioma
Brain metastases
Lymphoma
Hypophysitis
Vascular malformation (aneurysm)
Treatment
Hormonal therapy
Surgery (transphenoidal transnasal hypophysectomy)
Radiotherapy
First line treatment in prolactinomas
Bromocriptine
Hypopituitarism features
Depends on which hormones are deficienct
Low ACTH- tiredness, postural hypotension
Low FSH/LH- amenorrhoea, infertility, loss of libido
Low TSH- feeling cold, constipation
Low GH- if in childhood short stature
Low prolactin- problems with lactation
