Pituitary adenoma. Symptoms, classification

Adenoma of the pituitary gland is a neoplasm of benign nature. A tumor is produced from the cells in the anterior pituitary lobe. The new formation in the region of the Turkish saddle, at the base of the skull (its wedge-shaped part) is localized. Typically, the adenoma of the pituitary gland is detected in patients aged 20 to 40 years. Women are more likely to develop cancer. According to statistics, from 22 to 30% of all intracranial neoplasms is pituitary tumor. Symptoms of the pathology manifest themselves depending on the classification.

Benign forms can be hormone-active and hormone-inactive.

The first category includes neoplasms capable of producing tropic hormones. The formation of hormonal-active adenomas is indicated by the elevated serum levels of these hormones (tropic) and the presence of a clinical syndrome, quite pronounced. The syndrome is a consequence of increased production of this or that hormone. The hormonal-active neoplasms include prolactinomas (producing prolactin), corticotropinomas (producing corticotropin, somatotropins (secreting growth hormone-growth hormone), etc. It should be noted that almost half of the hormonal-active adenomas are prolactinomas.

An insignificant part is formed by hormonal-inactive neoplasms.

With a diameter of less than 10 mm, there is a pituitary microadenoma.

The reasons for the development of neoplasms have not been studied sufficiently to date.

According to one of the concepts, primary damage occurs in the hypothalamus with secondary involvement of the tumor tissue in the process. According to another concept, there is a primary lesion, which leads to the formation of an adenoma of the pituitary gland.

Symptoms of hormonal-active neoplasms include endocrine-exchange syndrome, radiologic and ophthalmo-neurological manifestations.

The severity of manifestations of the endocrine-metabolic nature is a reflection of the concentration of the overproduced hormone and the degree of damage in the tissue that surrounds the neoplasm.

Ophthalmo-neurological symptoms, indicative of pituitary adenoma, depend on its suprasellar growth. At the same time, the pressure of the neoplasm on the diaphragm in the Turkish saddle provokes headaches of a dull character. As a rule, soreness is not accompanied by nausea, does not depend on the position of the trunk and is not always eliminated with pain medication.

Damage in the hypothalamic structures provokes the growing pituitary adenoma. Symptoms when spreading the neoplasm down can be manifested by the flow from the nasal cavity of the cerebrospinal fluid and the sense of nasal congestion. The growth of the neoplasm, provoking the compression of the branches of the cranial nerves, is accompanied by ophthalmoplegia (defeat of the eye muscles) and diplopia (double vision).

Complication of severe, but not fatal, is considered a hemorrhage in the neoplasm. It is established that in this case, the adenoma of the pituitary gland, the symptoms of which increase with a hemorrhage, can provoke a spontaneous "cure". As a rule, this phenomenon is more typical for prolactin.

During pregnancy, the adenoma of the pituitary gland usually increases.

Symptoms detected during X-ray examination are expressed in changes in the size and shape of the Turkish saddle, destruction and thinning of bone structures, etc. At CT, the adenoma of the pituitary gland can be visualized.

Symptoms of some hormonal-active tumors have a specific character. In some cases, prolactinomas in women may manifest as galactorrhea (the release of milk-like contents from the breast) or a menstrual cycle. Often there is a combined manifestation of these symptoms.

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