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