2. ο Pituitary tumors are common neoplasms, and
recognition of their presentation is critical
since a favorable therapeutic outcome is
dependent on early identification of the
lesion.
ο Pituitary tumors constitute 10-15% of all
diagnosed intracranial tumors, 90% of which
are adenomas.
3. ο Abnormal proliferation of cells on target
tissue or on local structures surrounding
the pituitary gland.
4. ο Typically, pituitary tumors are characterized by
size and by what hormones, if any are
secreated.
Size:
ο Micro adenoma- less than 10mm wide.
ο Macro adenoma- Greater than 10mm wide.
Functionally:
ο Hormone secreting- Exaggerated hormone activity
- May secrete multiple hermones.
ο Non-Secreting -Diminished hormone activity.
5. ο Unknown
ο Uncontrolled cell growth in the pituitary
gland, which creates a tumor
ο Certain hereditary conditions
ο Such as multiple endocrine neoplasia
6. ο Headache.
ο Some loss of vision.
ο Loss of body hair.
ο In women, less frequent or no menstrual
periods or no milk from the breasts.
ο In men, loss of facial hair, growth of
breast tissue, and impotence.
ο In women and men, lower sex drive.
ο In children, slowed growth and sexual
development.
7. Too much prolactin may cause:
ο Headache.
ο Some loss of vision.
ο Less frequent or no menstrual periods or
menstrual periods with a very light flow.
ο Trouble becoming pregnant or an inability to
become pregnant.
ο Lower sex drive.
ο Flow of breast milk in a woman who is not
pregnant or breast-feeding.
8. Too much ACTH may cause:
ο Headache.
ο Some loss of vision.
ο Weight gain in the face, neck, and trunk of the body,
and thin arms and legs.
ο A lump of fat on the back of the neck.
ο Thin skin that may have purple or pink stretch marks
on the chest or abdomen.
ο Growth of fine hair on the face, upper back, or arms.
ο Bones that break easily.
ο Anxiety, irritability, and depression.
9. Too much growth hormone may cause:
ο Headache.
ο Some loss of vision.
ο In adults, acromegaly (growth of the bones in the
face, hands, and feet). In children, the whole body
may grow much taller and larger than normal.
ο Tingling or numbness in the hands and fingers.
ο Snoring or pauses in breathing during sleep.
ο Joint pain.
ο Sweating more than usual.
ο Dysmorphophobia (extreme dislike of or concern
about one or more parts of the body).
10. Too much thyroid-stimulating hormone may
cause:
ο Irregular heartbeat.
ο Weight loss.
ο Trouble sleeping.
ο Frequent bowel movements.
ο Sweating.
11. Other general signs and symptoms of
pituitary tumors:
ο Nausea and vomiting.
ο Confusion.
ο Dizziness.
ο Seizures.
ο Runny or "drippy" nose (cerebrospinal
fluid that surrounds the brain and spinal cord
leaks into the nose).
12. ο History collection
ο Physical examination
ο CT scan
ο MRI
ο Skull films
ο Serum hormone level
ο Provocative Testing
ο Neurological exam
ο Visual field exam
ο Twenty-four-hour urine test
ο Biopsy
14. ο Hypophysectomy- Removal of Pituitary.
ο Frontal Craniotomy- Uncommon approach
except where tumor
occupies broad area.
ο Transspenoidal Hypophysectomy-
-Directapproach through the sinus and
nasal cavity.
15. ο Severe disability
ο Death due to stroke, blindness, imbalance of
TSH, ACTH or ADH.
ο Transient or permanent Diabetes insipidus.
ο Hypo parathyroidism
ο Adreno cortical insufficiency.
16. ο Disturbed body image related to enlargement of body
parts as manifested by enlarged hands, feet and jaw.
ο Disturbed sensory perception related to
enlarged pituitary gland as manifested by protrusion of
eye balls.
ο Disturbed sleeping pattern related to soft tissue swelling
as manifested by verbalization of the patient about
insomnia.
ο Fluid volume deficit related to polyuria as manifested by
excessive thirst of the patient.
ο Anxiety related to change in appearance and treatment
as manifested by verbalization of the patient about body
appearance.