Pituitary Tumours Flashcards
What is a pituitary adenoma?
A benign tumour of the pituitary gland.
What are non-functioning pituitary tumours?
Tumours that do not produce hormones or only produce very small amounts.
What are the symptoms of non-functioning pituitary tumours?
- Compression of surrounding structures (e.g. optic nerve → vision problems)
- Headaches
- Pituitary hormone deficiency
What is the most common type of pituitary tumour?
Non-functioning pituitary tumours.
What characterizes functioning pituitary tumours?
They produce excess amounts of one or more hormones.
What are the types of functioning pituitary tumours?
- Prolactinomas
- Growth hormone-secreting tumours
- Corticotrophin-secreting tumours
- Thyroid-stimulating hormone secreting tumours (rare)
What are the symptoms of prolactinomas in women?
- Irregular periods
- Infertility
- Milk production outside of pregnancy/breastfeeding
What are the symptoms of prolactinomas in men?
- Decreased libido
- Erectile dysfunction
- Infertility
What do growth hormone-secreting tumours cause in children?
Gigantism.
What do growth hormone-secreting tumours cause in adults?
Acromegaly.
What are the symptoms of growth hormone-secreting tumours?
- Enlarged hands and feet
- Joint pain
- Excess sweating
- Sleep apnoea
- Thickened skin
What do corticotrophin-secreting tumours produce in excess?
ACTH.
What is Cushing’s disease associated with?
Excess cortisol production.
What are the symptoms of Cushing’s disease?
- Weight gain
- Hypertension
- Diabetes
- Skin thinning
- Osteoporosis
What do thyroid-stimulating hormone secreting tumours cause?
Excess production of T4 and T3.
What are the symptoms of hyperthyroidism?
- Weight loss
- Rapid heartbeat
- Tremors
- Nervousness
What investigations are used for pituitary tumours?
- Pituitary blood profile (GH, prolactin, ACTH, FSH, LSH, TFTs)
- Formal visual field testing
- MRI brain with contrast
What is a medical therapy for prolactinomas?
Dopamine agonists - cabergoline, bromocriptine.
What is a medical therapy for GH-secreting tumours?
- Somatostatin analogues - octreotide, lanreotide
- GH receptor antagonists - pegvisomant
What is a medical therapy for ACTH-secreting tumours?
- Cortical synthesis inhibitors - ketoconazole, metyrapone
- Neuromodulators - pasireotide
What type of surgery is often performed for non-functioning, ACTH, and GH tumours?
Trans sphenoidal surgery.
