What is the Pituitary?

The pituitary is a small gland that “hangs” from the underside of the brain, in close relationship with the hypothalamus and is responsible for the secretion of most of the hormones produced by the body (thyroid, estrogens, prolactin, cortisol, etc.).

What pathologies can it suffer from?

Pituitary tumors are benign (adenomas), with a good prognosis and are produced by the disordered growth of some cells. They are classified according to the type of hormones they secrete in: producing adenomas (which can be of Growth Hormone -GH-, Cortisol -ACTH-, Prolactin etc…) and non-producing adenomas (which do not produce hormones and are always diagnosed later, so they are usually larger in size).

What are the symptoms of pituitary tumors?

The symptoms will depend on the type of hormone whose secretion they favor:

Thus, growth hormone producers cause the patient to experience physical changes characterized by the growth of hands and feet, which leads the patient to change shoe size or to not being able to wear a ring and other body changes that we call Acromegaly.

Those that produce an increase of cortisol (one of the main “alarm” hormones of the organism) cause the patient to have stretch marks in the abdomen or a change in the distribution of body fat, as well as hypertension and hyperglycemia among other manifestations. We call all this Cushing’s disease, in honor of the first neurosurgeon who described it.

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Non-producers, when they reach a larger size, usually produce headaches or visual affectation when they contact the nearby optic chiasm.

How is it diagnosed?

Diagnosis is based on clinical suspicion on the part of the physician, which is confirmed by blood tests and finally by magnetic resonance imaging.

What is the treatment?

Treatment can be medical in some cases (such as prolactinomas) but in most cases requires surgery.

The good news is that it is a relatively simple surgery, which requires no visible incision, since it is performed through the nostril (with microscope or endoscope), making it one of the first minimally invasive surgeries described (at the beginning of the 20th century).

The patient may be getting up the same afternoon of the surgery with a nasal packing that we usually leave for 24h and usually go home after 48h. Analytical and imaging control is performed to confirm healing.

In some rare cases, in which total resection cannot be performed and/or regrowth is confirmed during follow-up, complementary treatment with radiosurgery and/or medical treatment may be required. This is a situation that should be discussed with your endocrinologist and neurosurgeon.