Pituitary tumours

Question 1

Define Microadenoma

Answer 1

Pituitary adenoma

Question 2

Define Macroadenoma

Answer 2

Pituitary adenoma > 1 cm

Question 3

What hormones are commonly secreted by Pituitary adenomas?

Answer 3

50% release prolactin

May produce Growth hormone or ACTH

Question 4

What are the features of a Pituitary adenoma?

Answer 4

Mass effects - Headahce, Bitemporal hemianopia, CN palsies, CSF rhinorrhoea, Diabetes insipidus.
Hormonal effects;
- Prolactin → galactorrhoea, ↓libido, amenorrhoea, ED (↑PRL → ↓GnRH → ↓LH/FSH)
- GH → acromegaly
- ACTH → Cushing’s Disease

Question 5

What investigations can be done for a patient with suspected Pituitary adenoma?

Answer 5

MRI
Visual fields
Suppression tests
Hormones - Prolactin, GH, ACTH, Cortisol, TFTs, LH/FSH

Question 6

What is the management of a Pituitary adenoma?

Answer 6

Medical - Replace any deficient hormones, Treat any hormone excess
Surgical - Trans-sphenoidal excision
Radiotherapy