From the Guidelines
Pituitary adenomas can cause a range of symptoms, including headaches, vision problems, fatigue, and nausea, and may lead to hormone imbalances, vision loss, or other complications if left untreated. The symptoms of pituitary adenomas depend on their size and hormone production, with common symptoms including:
- Headaches
- Vision problems, particularly peripheral vision loss
- Fatigue
- Nausea If the tumor produces excess hormones, specific syndromes may develop, such as:
- Prolactin-secreting tumors causing irregular menstruation, breast milk production in non-pregnant women, and erectile dysfunction in men
- Growth hormone-producing tumors leading to acromegaly with enlarged hands, feet, and facial features
- ACTH-producing tumors causing Cushing's disease with weight gain, muscle weakness, and easy bruising
- TSH-producing tumors resulting in hyperthyroidism symptoms like anxiety, weight loss, and rapid heartbeat Non-functioning adenomas typically cause symptoms through pressure on surrounding structures as they grow 1. Diagnosis typically involves blood tests to measure hormone levels, MRI imaging, and visual field testing. Treatment options include medication, surgery (usually transsphenoidal approach), radiation therapy, or a combination of these approaches 1. Early detection is important as untreated pituitary adenomas can lead to permanent hormone imbalances, vision loss, or other complications. According to the most recent guidelines, transsphenoidal surgery is the recommended treatment for pituitary adenomas, even in patients with incompletely pneumatized sphenoid sinuses 1. Additionally, radiotherapy may be considered for symptomatic, growing, or resistant tumors 1.
From the Research
Pituitary Adenoma Symptoms
- Pituitary adenomas can cause a variety of symptoms, including endocrine dysfunction, neurologic symptoms, and mass effect symptoms 2, 3
- Common symptoms of pituitary adenomas include:
- Headache
- Visual field defects
- Hypopituitarism
- Hyperprolactinemia (from oversecretion of prolactin)
- Acromegaly (from excess growth hormone)
- Cushing disease (from overproduction of adrenocorticotropic hormone)
- Functioning tumors, such as prolactinomas, somatotropinomas, corticotropinomas, and thyrotropinomas, can cause specific symptoms related to the excess hormone secretion 2, 4
- Nonfunctioning adenomas, which do not produce hormones, can cause mass effect symptoms, such as visual field defects and headache 2, 3
Classification of Pituitary Adenomas
- Pituitary adenomas can be classified as either macroadenomas (≥10 mm) or microadenomas (<10 mm) 2
- Macroadenomas are more likely to cause mass effect symptoms, such as visual field defects and hypopituitarism 2
- Microadenomas are more likely to be functioning tumors, such as prolactinomas, and can cause specific symptoms related to the excess hormone secretion 2, 4
Diagnosis and Treatment
- Diagnosis of pituitary adenomas typically involves endocrine evaluation for hormone hypersecretion and imaging studies, such as MRI or CT scans 2, 3
- Treatment of pituitary adenomas depends on the specific type of tumor and can include surgery, medical therapy, and radiation therapy 2, 5
- First-line therapy for prolactinomas is usually medical therapy, such as dopamine agonists, while first-line therapy for other pituitary adenomas is usually transsphenoidal pituitary surgery 2, 4