Pituitary Tumours (non-functioning)

Question 1

Define Pituitary Tumours (non-functioning)

Answer 1

Clinically non-functional adenomas (CNFPAs), a pituitary tumour with no hypersecretion of hormone

Micro-adenoma = <1cm
Macro-adenoma = ≥1cm

Question 2

Aetiology and risk factors of Pituitary Tumours (non-functioning)

Answer 2

Unknown
Monoclonal in origin
Hypothalamic hormones + other local growth factors may promote growth of already transformed cell clones

RF:
MEN-1
Familial isolate pituitary adenomas (FIPA)
Carney complex (CNC)

Question 3

Symptoms of Pituitary Tumours (non-functioning)

Answer 3

Mass effect: vomiting, drowsiness, vision problems
Headaches (SOL: worse in the morning and leaning forward + vomiting)
Visual loss
Seizures

Hypogonadism
Hypothyroidism 
Adrenal insufficiency 
Diabetes insipidus
Prolactin raised -> galactorrhoea

Question 4

Signs of Pituitary Tumours (non-functioning) on examination

Answer 4

Mass effect:
Visual field defects (bitemporal hemianopia)
Cranial nerve neuropathies
Hydrocephalus
CSF rhinorrhoea

Question 5

Investigations for Pituitary Tumours (non-functioning)

Answer 5

Full pituitary evaluation (Bloods)
GH/IGF-1 | prolactin | TFTs | LH/GH/testosterone/oestradiol | ACTH/cortisol

MRI: micro or macro adenoma

Visual field assessment: normal or unilateral/bitemporal field defect