Pituitary tumours Flashcards
What is a pituitary adenoma?
A pituitary adenoma is a benign tumour of the pituitary gland
What visual field defect is most common with a pituitary tumour?
Bitemporal hemianopia
What is the most common type of pituitary tumour?
Pituitary adenoma
What is the typical presentation of a pituitary adenoma?
Headache
Visual field defects - bitemporal hemianopia
What is the cause of a bitemporal hemianopia that affects predominantly the upper quadrants?
An inferior chiasmal compression (pituitary tumour)
What is the cause of a bitemporal hemianopia that predominantly affects the inferior quadrants?
Superior chiasmal compression - commonly a craniopharyngioma
What investigations are used in the diagnosis of a pituitary adenoma?
Brain MRI - diagnostic
Visual field defect screening
Hormone tests - if tumour is suspected of being a functioning adenoma
What is the primary management of a pituitary adenoma?
Transphenoidal resection of the pituitary adenoma
What additional treatments may be used in the management of pituitary adenoma?
Radiotherapy
What is the most common hormone secreting pituitary tumour?
Prolactinoma
What are microadenomas and macroadenomas?
Microadenoma = <10mm
Macroadenoma = >10mm
What is the presentation of prolactinoma in women?
Oligomenorrhoea or amenorrhoea
Galactorrhoea
Vaginal dryness
Headaches
Visual field defects
What is the presentation of prolactinoma in men?
Erectile dysfunction
Reduced facial hair growth
Headaches
Visual field defects
What investigations are used in the diagnosis of prolactinoma?
MRI brain
Serum prolactin
What is the medical management of prolactinoma?
Dopamine agonists e.g cabergoline
HRT
What is the definitive management of prolactinoma?
Trans-sphenoidal resection of the tumour (when medical treatment fails to manage the tumour)
