Condition- pituitary tumour (non-functioning)

Question 1

Describe the size wise classification of pituitary tumours

Answer 1

Pituitary adenomas can be divided into:

• microadenomas (<1cm)
• macroadenomas (>1cm)

Question 2

Describe the histological classification of non-functioning pituitary tumours….

Answer 2

• Prolactinomas (35%): stain for and secrete prolactin (prolactin and GH are co-secreted by about 7% of pituitary adenomas).
• Somatotroph adenomas (20%): stain for and secrete GH (prolactin and GH are co-secreted by about 7% of pituitary adenomas).
• Corticotroph adenomas (10% to 12%): stain for and secrete ACTH.
• Gonadotroph adenomas (20%): stain for and secrete follicle-stimulating hormone, luteinising hormone, alpha subunit, beta subunits.
• Null cell adenomas (10%): stain for and secrete no hormones.
• Thyrotroph adenomas (1% to 2%): stain for and produce thyroid-stimulating hormone.

Question 3

Which syndrome may pituitary tumours be associated with?

Answer 3

MEN 1 (PPP)

Question 4

List some of the presenting symptoms of pituitary tumours…

Answer 4

• Insidious onset due to lack of hormonal derangements
• Headaches
• Pressure on surronding structures:
  
  • Optic chiasm- bitemporal hemianopia
  • Cavernour sinus- palsy of CN III,IV, VI
  • Normal pituitary gland- panhypopituitarism

Question 5

Which investigations could you order to identify the presence of a non-functioning pituitary tumour?

Answer 5

• MRI
• CT
• Bloods- check hormone levels
• Visual fields testing