Pituitary tumors

Pituitary tumors

Constituting 10% of intracranial neoplasms, pituitary tumors typically originate in the anterior pituitary (adenohypophysis). They occur in adults of both sexes, usually during the third and fourth decades of life. The three tissue types of pituitary tumors are chromophobe adenoma (90%), basophil adenoma, and eosinophil adenoma.

The prognosis is fair to good, depending on the extent to which the tumor spreads beyond the sella turcica.


Although the exact cause is unknown, a predisposition to pituitary tumors may be inherited through an autosomal dominant trait. Some are part of a hereditary disorder called multiple endocrine neoplasia 1. Pituitary tumors aren’t malignant in the strict sense; however, because their growth is invasive, they’re considered a neoplastic disease.

Chromophobe adenoma may be associated with the production of corticotropin, melanocyte-stimulating hormone, growth hormone, and prolactin; basophil adenoma, with evidence of excess corticotropin production and, consequently, with signs of Cushing’s syndrome; and eosinophil adenoma, with excessive growth hormone.

Signs and symptoms

As pituitary adenomas grow, they replace normal glandular tissue and enlarge the sella turcica, which houses the pituitary gland. The resulting pressure on adjacent intracranial structures produces typical clinical features.

Neurologic features

  • Frontal headache

  • Visual symptoms, beginning with blurring and progressing to field cuts (hemianopias) and then unilateral blindness

  • Cranial nerve involvement (III, IV, VI) from lateral extension of the tumor, resulting in strabismus; double vision, with compensating head tilting and dizziness; conjugate deviation of gaze; nystagmus; lid ptosis; and limited eye movements

  • Increased intracranial pressure (secondary hydrocephalus)

  • Personality changes or dementia, if the tumor breaks through to the frontal lobes

  • Seizures

  • Rhinorrhea, if the tumor erodes the base of the skull

  • Pituitary apoplexy secondary to hemorrhagic infarction of the adenoma.
    Such hemorrhage may lead to both cardiovascular and adrenocortical collapse.

Jun 16, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Pituitary tumors

Full access? Get Clinical Tree

Get Clinical Tree app for offline access