Disease

management of
Pituitary gland
non-malignant
disorders
Introduction
Pituitary gland is the “master gland” found at the base of brain
which is responsible for the production of many major hormones.

Pituitary gland non-malignant disorders

99% of pituitary gland tumors are non malignant & is characterized
by the abnormal growth of cells in the pituitary gland which are
benign , results in the
1. too high level of the hormones

2. too low level of the hormones

Pathophysiology
Pituitary gland is surrounded by
the sphenoid bone in a basketlike
structure called the sella turcica
and superiorly by the optic
chiasm. The sella turcica forces
an expanding adenoma
superiorly leading to the
compression of the optic nerve
and headaches from mass effect.
 Sign & symptoms

 Growing large enough to press on the nearby optic nerves

or on the parts of the brain itself.
 Headache due to the mass effects.
 Vision problem due to pressure on optic nerves.
 Sexual dysfuction
 Weightloss or gain
 Weakness
 Changes in monthly periods (women)
 Nausea & vomiting.
Having too much hormones can lead to certain
disorders

 Gigantism
 Cushing syndrome
 Hyperthyroidism
 Acromegaly
Classification

On the basis of
size

Macroadenoma Microadenoma
(Diameter < 1cm) (Diameter 1cm)
 ON THE BASIS
OF CELL OF
ORIGIN

Lactotroph Gonadotroph Somatotroph Corticotroph Thyrotroph

 ON THE BASIS OF
SPECIFIC
HORMONE

Growth
Prolactinoma
ACTH tumor hormone Non funtiong
tumor
tumor
 Diagnosis
 Detailed history and complete physical examination is done along
with some tests

1. Blood & urine test: These test can determine whether you have an

overproduction or deficiency of hormones.

2. Brain imaging : A CT scan or MRI scan of brain can help to judge

location and size of pituitary tumor.

3. Vision testing : This can determine if a pituitary tumor has

impaired your sight or peripheral vision.

Management
 Goals ;

1. Removing the tumor

2. Controlling it’s growth

3. Managing hormone level with medication

Surgery
 Endoscopic endonasal approach is the preferred surgical
treatment

 This innovative , minimally invasive technique removes the

tumor by using nose & nasal cavities as natural corridores to
access tumor.
Radiation therapy
 Destroys the tumor with high energy x rays.

 It’s helpful when surgery can’t remove the whole tumor

or if the tumor returns and medicine does’t improve
symptoms.