Pituitary adenoma

Pituitary adenoma is a common benign intracranial endocrine tumor. Marie described acromegaly in 1886; Minkowski attributed it to pituitary abnormality in 1887; Benda recognized eosinophil adenoma with acromegaly in 1900 as a true adenohypophyseal tumor.

Common Symptoms

Oculomotor palsy; sella deformity; anovulation; diffuse headache; nasal obstruction; hypopituitarism; amenorrhea

Causes

Pituitary adenomas arise from adenohypophyseal cells. Multihormonal "heterologous" adenomas exist (Zimmerman 1970s showed GH and PRL in same cell). Chromophobe adenomas arise from less-differentiated cells. Mechanism: two-stage theory — initiating mutation then promotive factors. (1) Intrinsic pituitary abnormalities: point mutations in Gsα (gsp oncogene, ~40% of GH tumors), ras (rare), PKCα, PTTG, c-myc/c-fos. Receptor abnormalities: dopamine D2, somatostatin SSTR2/SSTR5, TRH, GnRH, GHRH, CRH. (2) Hypothalamic dysregulation: GHRH/CRH tumors cause pituitary tumors; peripheral target hormone loss promotes growth (Nelson syndrome after adrenalectomy). Clonality studies show most are monoclonal. Autopsy/MRI show ~10% have incidental microadenomas but clinical prevalence is 1/500-1/1000. Gross: normal pituitary is orange-red; adenomas are purple-red, soft, sometimes necrotic/cystic; unencapsulated; cells vary from small lymphocyte-like to large granular/foamy; rare mitoses.

Treatment

Drug therapy; rehabilitation

Prevention

Health education; no effective prevention; early detection and diagnosis are key.

Recommended Department

It is recommended to visit the neurosurgery department; before the visit you may first book an appointment and connect with experts through this platform.

Warm reminder: The above information is provided for health education reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek care at a regular hospital in time.