The pituitary gland is a vital endocrine gland located at the base of the brain in a small bony cavity called the "sella turcica" (Turkish saddle) and is widely known as the body's "conductor of the orchestra." Pituitary tumors are masses that arise from the abnormal and uncontrolled growth of cells within this gland. The vast majority of these tumors are benign (adenomas) and do not tend to be cancerous. However, they are classified into two primary groups based on whether they secrete hormones: "Functional tumors" disrupt the body's hormonal balance by producing excessive hormones, while "non-functional tumors" do not secrete hormones but cause issues by exerting pressure on surrounding tissues as they enlarge.
Symptoms vary across a wide spectrum depending on the type and size of the tumor. If the tumor is functional, systemic symptoms such as excessive weight gain, growth disorders (acromegaly), menstrual irregularities, sexual dysfunction, or elevated cortisol levels (Cushing’s syndrome) may occur, depending on the specific hormone being secreted. In the case of large non-secreting masses, the primary complaint is the "mass effect." Specifically, pressure on the optic nerves located just above the pituitary gland can lead to a narrowing of the visual field (tunnel vision), blurred vision, and severe headaches as the most typical symptoms.
The diagnostic process is conducted through the multidisciplinary collaboration of endocrinology and neurosurgery specialists, guided by the patient's symptoms. The functional status of the gland is evaluated by measuring hormone levels through blood and urine tests. For imaging, the gold standard is high-resolution brain MRI (Magnetic Resonance Imaging), which allows for the precise determination of the tumor's millimetric size and its relationship with surrounding tissues. For patients with suspected vision loss, visual field tests are mandatory to assess the extent of the damage.
The treatment plan is individualized based on the tumor's size and its impact on the patient's quality of life. For certain types of tumors (such as prolactinomas), it may be possible to shrink the tumor and regulate hormone levels using only medication. However, in cases where there is pressure on the optic nerve or when medication is ineffective, surgical intervention is the primary option. Today, these surgeries are typically performed through the nostrils using "endoscopic transsphenoidal surgery," which allows for the removal of the tumor without opening the skull. When necessary, radiotherapy may be added to the treatment plan to ensure long-term recovery.
Wishing you healthy days.
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