Pituitary microadenoma

Microadenoma of the pituitary gland refers to benign tumors and originates from the cells of its anterior lobe. The tumor is localized in the area of the Turkish saddle. Up to 30% of all cases of intracranial tumors is adenoma (microadenoma) of the pituitary gland. In general, it is found in people from twenty to forty years. The cases of its detection in women are observed somewhat more often than in men.

Microadenoma of the pituitary gland may have a significant difference from the macroadenoma. The difference is manifested, first of all, in the amount. Microadenoma of the pituitary gland has a diameter of less than ten millimeters. In addition, the clinical course and the response to different types of therapy are different. The micro-tumor has a less prominent capsule or lack of it.

It should be noted that most tumors do not have morphological signs of malignancy. However, many tend to sprout in the brain (its hard shell) and in the bone structures surrounding the pituitary gland.

Adenoma (microadenoma) of the pituitary gland. Symptoms

Hormonal-inactive tumors do not provoke clear violations of the endocrine-exchange character. The clinical manifestation of hormone-active tumors includes the endocrine-exchange syndrome, ophthalmo-neurological and radiological symptoms. The severity of endocrine-metabolic disturbances reflects the level of damage to the surrounding tumor tissue.

The manifestation of ophthalmic and neurological symptoms is the primary atrophy of the optic nerves, the change in the field of vision. Their intensity depends on the suprasellar growth of the adenoma (microadenomas). The pressure of the tumor on the region of the diaphragm of the Turkish saddle causes a headache, which is localized in the temporal, frontal and foreground regions. As a rule, it is not accompanied by nausea and does not depend on the position of the body. It is not always possible to remove medicines. Subsequent growth of the tumor up leads to damage to the hypothalamic structures. The growth of the tumor towards the bottom of the region of the Turkish saddle and its spread into the sinuses may be manifested by a sensation of nasal congestion and the discharge of cerebrospinal fluid from it .

A sharp increase in pain and ophthalmic and neurological symptoms is usually associated with an increase in the intensity of the development of the tumor (for example, in pregnancy) or with a hemorrhage into the tumor. As practice shows, hemorrhage is a frequent, severe, but not fatal complication. In a number of cases, it leads not only to increased pain, visual impairment, but also to a sudden "cure" of the tumor.

X-ray symptoms are manifested in changes in the size and shape of the Turkish saddle, destruction and thinning of bone structures and other things. In some cases, the visualization of the tumor itself (with computed tomography) is possible.

Adenoma (microadenoma) of the pituitary gland. Treatment

Depending on the type, severity of manifestation, severity and size, complex therapy is prescribed.

In the absence of development of visual disturbances, a hormone-active tumor, such as prolactinoma, is treated conservatively using dopamine receptor agonists. Operative methods are used for drugs that are not susceptible to medication. As a rule, microsurgery is used. Tumors of large size are subjected to neurosurgical intervention. After the operation, radiotherapy is prescribed.

In some cases, young patients with tumors of medium or mild severity with the manifestation of Isenko-Cushing's disease or Nelson 's syndrome are prescribed remote radiation therapy. For small tumors, proton irradiation is more often used.

For hormonal-inactive adenomas, surgical intervention and radiation therapy are used.