Pituitary tumour (non functioning)

Question 1

Define Pituitary tumour (non functioning)

Answer 1

Pituitary adenomas that are non-functional
They do not cause a rise in any endocrine hormone levels

refered as clinically non functional Pituitary adenomas (CNFPA)

Question 2

Aetiology and risk factors of Pituitary tumour (non functioning)

Answer 2

Unkown-usually monoclonal suggesting genetic origins
Non functioning are still from an original cellular subtype (e.g. : lactotroph/gonadotroph)
But unclear what causes them to not produce any hormone

Risk factors-
MEN1

Question 3

Epidiemology of Pituitary tumour (non functioning)

Answer 3

Pit adenomas are the most 3rd common intracranial tumour (after meningioma and astrocytoma)-10% of intracranial tumours
around 25 cases in 100 000 in UK

CNFPA account for between 20-55% of pit adenomas (often found incidentally or after death)

Question 4

signs and Sx of Pituitary tumour (non functioning)

Answer 4

Usually presents super late because no hormonal imbalance
all Sx relate to rise in ICP

These are LONG standing and PROGRESSING Sx
The most common sign is headache-care for red flags in any headache

can have double vision, cranial nerve palsy,
new seizures

Bitemporal hemianopia is the most common examination finding
Papilloedema is possible

They can present with hypopituitarism as compresses (late)-gonadotroph and somatotroph most affected
Loss of libido, erectile dysfunction, loss ofmuslce and hair
Ammenorhoea, hot flush, insomnia, dry vagina etc
late present but most common presentation-when pt know

Hypothyroidism
Adrenal insufficency

Question 5

Investigations of Pituitary tumour (non functioning)

Answer 5

Pit hormones
any can be low, or normal -with low suggesting compression

any stimulation test (ACTH) point to a secondary cause (cranial/central)

FBC-normal
MRI-sellar mass
Or CT