Pituitary adenoma and endonasal endoscopy
The pituitary adenoma is a benign tumor, which strikes the pituitary gland and in particular its anterior part (adenohypophysis). No specific risk factors have been identified, with the exception of familiarityTo understand the possible consequences, it is worth knowing the role of the pituitary gland in our body.
Pituitary adenoma is usually treated surgically using endoscopic surgery.
What is the pituitary gland for?
The pituitary gland is a endocrine gland Small in size, measuring less than 1 centimeter in diameter. It is located inside the skull and contained within a bony saddle (the "sella turcica"), located behind the nose and between the eyes. It consists of two sections, an anterior (adenohypophysis) and a posterior (neurohypophysis).
Although its structure makes one think of a gland of little importance, the pituitary gland is actually the equivalent of an orchestra conductor: the hormones it secretes in turn stimulate the activity of other glands, thus influencing the regulation of our body's metabolism, growth and reproduction.
For this reason, if one of the pituitary hormone lines is affected by a particular disorder, potentially very serious pathologies can arise. The pituitary gland can be affected by various types of lesions, mostly benign, of which Pituitary adenoma is the most common.
Types of pituitary adenoma
When a pituitary adenoma forms, we see the abnormal development of a part of the pituitary gland and its cells. It can secrete hormones (secreting) or not (non-secreting). Below a diameter of 1 centimeter, we speak of pituitary microadenoma; once the centimeter is exceeded, it is a question of pituitary macroadenoma. Size, location and secretory or non-secretory state determine the possible consequences:
- hypersecretion syndrome: occurs when the adenoma produces too many hormones (TSH, prolactin, ACTH, growth hormone). This causes a significant imbalance in the body, which causes pathologies such as Cushing's disease (which manifests itself with excessive amounts of fat along the entire trunk and on the face), acromegaly (excessive growth of some bone structures), prolactinoma (cancer that negatively affects fertility in both men and women)
- insufficiency syndrome, which sees the adenoma invade the space occupied by the pituitary gland and hinders its normal functioning. This leads to a decrease in the production of hormones (hypopituitarism)
- mass syndrome: the size of the adenoma ends up causing compression of the optic nerves, resulting in loss of visual acuity or reduction of the lateral visual field
Pituitary adenoma and symptoms
It is not a given that a pituitary adenoma will manifest itself with recognizable symptoms: on the contrary, it is possible that it is identified by chance, during diagnostic tests performed for other reasons.
Among the most common symptoms, especially in the case of macroadenoma, are included: headache, blurred vision, visual field alterationIn case of particularly invasive macroadenoma, there may also be disorientation, vomiting, drowsiness, bulimia, and diabetes insipidus (which is not related to sugar metabolism, but to the lack of the hormone vasopressin).
Other symptoms, due to the loss of pituitary gland function, may include menstrual problems and breast discharge in women, changes in the face, hands, and feet, hypertension, decreased libido, infertility in both women and men, sweating, increased hairiness, gigantism in children or adolescents, fragile skin, stretch marks, and osteoporosis.
Key figures for the treatment of a pituitary adenoma
As mentioned, diagnosing pituitary adenoma is not easy. The patient must describe their symptoms as precisely as possible and any family history of similar cases. Based on this information, the doctor may prescribe: blood and urine tests to analyze hormone levels and subsequently a CT scan and an MRI to detect any lesions. If the symptoms also involve the visual field, a vision assessment exam.
Dealing with this pathology is therefore a team play, in which each subject involved is essential:
- the patient, who is always at the center of the whole process with his personal and clinical history
- the doctor which has an important coordinating role
- L 'endocrinologist, contact person for diagnosis, monitoring and treatment of the pathology
- the neuroradiologist, expert in the diagnostic study of the nervous system
- L 'oculist, a reference point for screening, diagnosis and monitoring of eye disorders
- the neurosurgeon, which treats the pathology through surgical removal
Treatment of pituitary adenoma: the surgery
The therapy involves surgery in most cases, with the exception of small adenomas that secrete prolactin or growth hormone, which can be treated with specific drugs. The evolution of technology and skills in this field has made a type of intervention possible minimally invasive very effective: the transnasal transsphenoidal endoscopic surgery.Pituitary adenoma and endonasal endoscopy
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