Pituitary Adenoma Flashcards
What is a pituitary adenoma?
They are defined as benign tumours of the pituitary gland
What is the most common classification of pituitary tumours?
Pituitary adenoma
What are the two classifications mechanisms of pituatary adenomas?
Pituitary Adenoma Size
Pituitary Adenoma Hormonal Status
What are the two size classifications of pituatary adenomas?
Microadenomas
Macroadenomas
What are microadenomas?
They are defined as pituitary adenomas which are less than 1cm in diameter
What are macroadenomas?
They are defined as pituitary adenomas which are greater than 1cm in diameter
What are the two hormonal status classifications of pituitary adenomas?
Secretory Adenomas
Non-Secretory Adenomas
What is another term for secretory pituitary adenomas?
Functioning pituitary adenomas
What are secretory pituitary adenomas?
They are defined as pituitary adenomas which produce excess of a particular hormone
What is the most common subclassification of secretory pituitary adenomas?
Prolactinomas
How do secretory pituitary adenomas present?
Hyperpituitarism
What is another term for non-secretory pituitary adenomas?
Non-functioning pituitary adenomas
What are non-secretory pituitary adenomas?
They are defined as pituitary adenomas which don’t produce excess of a particular hormone
How do non-secretory pituitary adenomas present?
These tumours lead to compression of the normal functioning pituitary gland, therefore resulting in the presentation of generalised hypopituitarism and pressure effects
What are the nine clinical features of pituitary adenomas?
Headaches
Nausea & Vomiting
Bitemporal Hemianopia
Amenorrhea
Galactorrhoea
Decreased Libido
Cushing’s Syndrome Features
Acromegaly Features
Diabetes Insipidus Features
What are the three investigations used to diagnose pituitary adenomas?
Blood Tests
Visual Field Testing
MRI Scans
What is the first line investigation used to diagnose pituatary adenomas?
Blood Tests
What six blood test results indicate a pituitary adenoma?
Increased/Decreased Growth Hormone Levels
Increased/Decreased ACTH Levels
Increased/Decreased Cortisol Levels
Increased/Decreased Prolactin Levels
Increased/Decreased FH/LSH Levels
Increased/Decreased T3/T4/TSH Levels
Which pituitary adenoma classification results in hormone hypersecretion blood results?
Secretory pituitary adenomas
Which pituitary adenoma classification results in hormone hyposecretion blood results?
Non-secretory pituitary adenoma
What visual field test result indiciates pituitary adenoma?
Bitemporal hemianopia
What MRI scan result indicates pituitary adenoma?
A hyperdense mass within the sellar region
What is the pharmacological management option of pituatary adenomas?
Hormonal Therapy
When is hormonal therapy used to manage pituitary adenomas?
It is the first line management option used to manage secretory pituitary adenomas - prolactinomas
Name a hormonal therapy used to manage prolactinomas
Bromocriptine
What is the surgical management option of pituitary adenomas?
Transsphenoidal Transnasal Hypophysectomy
When is transsphenoidal transnasal hypophysectomy used to manage pituitary adenoma?
It is used to manage non-secretory pituitary adenomas in which the following criteria is obtained…
- Visual Field Defects
- MRI Optic Chiasm Compression
- Pituitary Apoplexy & Visual Disturbances
- Hypersecreting Adenoma Excluding Prolactinomas
What is transsphenoidal transnasal hypophysectomy?
It involves removal of the pituitary adenoma through the sphenoid sinus
When is radiotherapy used to manage pitutary adenomas?
Recurrent pituitary adenomas
In what two ways is radiotherapy used to manage pituitary adenomas?
To control growth rate
To reduce excess hormone secretion
What complication is associated with pituitary adenomas?
Pituitary Apoplexy
What is pituitary apoplexy?
It is defined as a sudden enlargement of a pituitary tumour secondary to haemorrhage/infarction
Which pituitary adenoma classification is most commonly associated with pituitary apoplexy?
Non-secretory macroadenomas
What are the four risk factors associated with pituitary apoplexy?
Trauma
Hypertension
Pregnancy
Anticoagulation
What are the six clinical features associated with pituitary apoplexy?
Sudden Onset Headache
Nausea & Vomiting
Neck Stiffness
Bitemporal Superior Quadrantic Defect
Extraocular Nerve Palsies
Hypotension
What are the three management options of pituitary apoplexy?
IV Hydrocortisone
Fluid Balance
Pituitary Surgical Resection
What is the first line management option of pituitary apoplexy?
IV Hydrocortisone
This should be administered urgently, before diagnostic investigations due to the life-threatening consequences
