Pituitary Macroadenoma
Definition
A pituitary macroadenoma is a benign growth larger than 10 mm. Macroadenomas come from glandular tissue, and can form in many organs. The most common macroadenomas are in the adrenal and pituitary glands. They also can form in the colon, thyroid, and kidneys. They do not spread to other parts of the body.
Causes
It’s unknown why macroadenomas form.
Risk Factors
A family history of multiple endocrine neoplasia type 1 (MEN1) – a hereditary condition – can increase the chances of developing a pituitary macroadenoma or other types of macroadenomas in the endocrine system.
Symptoms
The symptoms of macroadenomas can vary base on whether they are secreting hormones. Symptoms may be caused by other health problems, and don’t always indicate that there is a macroadenoma.
Pituitary macroadenomas can cause Cushing’s syndrome, acromegaly, hyperthyroidism, and rarely symptoms related to decreased secretion from the pituitary gland.
Symptoms may include:
- headache
- problems with eyesight
- dizziness
- nausea
- unexplained hair growth or loss
- weight changes
- menstrual or breast changes
- erectile dysfunction
Diagnosis
Tests you may have done will vary based on the suspected location of the macroadenoma. Possible testing includes:
Treatment
There are various ways to treat macroadenomas, and many of the treatments may be used together.
Treatment options include:
Surgery
The most common and effective treatment for a macroadenoma is removal. An exception to this is with a prolactin-producing tumor; that macroadenoma is better treated with medication. Macroadenomas may be removed using the expanded endoscopic approach (EEA).
The EEA uses a specially designed endoscope, which is a tubular device inserted through the nose that provides optical fiber light and a lens for seeing and transmitting images. Finely-crafted drills and other instruments are used with the endoscope for dissection and tumor removal.
This procedure gives surgeons access to the central brain, base of the skull, and the top of the spinal cord. Patients usually stay in the hospital for one or two days after surgery.
Medication
Medications that block hormone secretion can control symptoms. It can possibly shrink some specific types of macroadenoma, such as the ones producing prolactin.
Radiation therapy
This treatment uses radiation to kill the macroadenoma’s cells. Radiation therapy generally is only used when surgery was unable to remove the entire adenoma and patients have persistent symptoms.
Prevention
Because the causes of pituitary macroadenomas are largely unknown, there aren’t guidelines for preventing them.