What are the symptoms of pituitary tumors

Some friends may not know much about pituitary tumors, but they can bring great pain to patients, and in severe cases, they can even endanger their lives. Therefore, only if we discover related symptoms early can we seek medical treatment in time. Otherwise, delaying the condition will worsen the condition and the consequences will be disastrous. Now let me take you to understand what the symptoms of pituitary tumors are?

Pituitary tumors are a group of tumors that arise from residual cells of the craniopharyngeal epithelium in the anterior and posterior pituitary glands. Pituitary tumors account for about 10% of intracranial tumors, and asymptomatic small tumors are more likely to be found during autopsy. Anterior adenomas account for the majority of this group of tumors, and those from the posterior lobe are rare. A variety of intracranial metastatic cancers can involve the pituitary gland and must be differentiated from primary pituitary tumors.

Symptoms of pituitary tumors include:

Pituitary tumors usually develop slowly and insidiously, with no symptoms in the early stages. Some are asymptomatic and are only discovered during autopsy. The clinical manifestations are mainly the following two major groups:

1. Hormone secretion abnormalities

(I) Hormone Excessive Secretion Syndrome Group Functional pituitary tumor cells can secrete excessive hormones, causing corresponding clinical manifestations. For example, excessive growth hormone causes acromegaly, excessive ACTH causes Cushing's disease with melanin deposition, and excessive prolactin causes galactorrhea-amenorrhea syndrome and impotence.

(II) Hormone secretion deficiency syndrome When the non-functional tumor increases and the normal pituitary tissue is damaged, the secretion of gonadotropin (except for the decrease of dopamine due to the compression of the pituitary portal system, which leads to the increase of prolactin) often decreases. In particular, the decrease of gonadotropin secretion and amenorrhea, infertility or impotence are often the first to occur and are more common. The second is secondary hypothyroidism caused by insufficient secretion of thyroid-stimulating hormone, and secondary adrenocortical insufficiency caused by insufficient secretion of adrenocorticotropic hormone. Clinically, complex syndromes are more common. Sometimes the tumor can invade the pituitary stalk and the pituitary portal system, inhibiting the portal blood supply, weakening the effect of prolactin inhibitory factor (PIF), that is, dopamine, and increasing prolactin. Women often complain of amenorrhea and infertility, and men complain of impotence. About 60-80% of this disease has elevated prolactin, and sexual dysfunction is the first symptom.

2. Symptoms of tumors compressing the tissues surrounding the pituitary gland

(A) Nerve fiber irritation headache is the second most common symptom. It is a persistent headache located in the forehead, bilateral temporal sides, and retroorbital area. It may also be accompanied by swelling and paroxysmal aggravation. It is caused by tumor compression or erosion of the dura mater or sella turcica diaphragm or traction of the nerve fibers in the vascular epithelium.

(ii) Patients with optic nerve, chiasm and optic nerve fascicle compression experience decreased vision, visual field defects and fundus changes

When the tumor develops upward and forward to the sella turcica, patients often experience visual impairment, visual field defects and fundus changes. When the tumor develops upward and forward outside the sella turcica, it often compresses the optic nerve, optic chiasm and (or) optic nerve bundle, causing bitemporal hemianopsia, homonymous hemianopsia or 1/4 visual field loss, etc. Vision is often impaired, and the patient may even be blind with only light perception. Fundus examination may show that the optic nerve disc is pale and atrophied.

(III) Other compression syndromes When the tumor grows upward, it often invades the hypothalamus and causes hypothalamic syndrome, obesity, diabetes insipidus, lethargy, polyphagia, sexual retardation or precocious puberty, etc., especially in craniopharyngioma. When the tumor develops to the sides and back, it can erode the cavernous sinus and cause compression of the III, IV, and VI cranial nerves, cavernous sinus syndrome such as eye movement disorders and exophthalmos; when the Vth nerve is affected, trigeminal neuralgia or facial numbness may occur. If the tumor develops downward and destroys the sellar floor and sphenoid sinus, it is often easy to cause cerebrospinal fluid rhinorrhea and meningitis.

In addition to the above two major symptom groups, sometimes intratumoral bleeding causes severe headaches accompanied by sudden hypofunction of the anterior pituitary gland or acute decrease in vision and visual field, or even blindness, which is clinically called pituitary stroke. Mild cases may resolve on their own after a few days, or even without obvious symptoms, while severe cases must be treated as pituitary crisis.

Other neurological symptoms and signs: If the pituitary tumor grows posteriorly and upwards and compresses the pituitary stalk or hypothalamus, it may cause polydipsia and polyuria; if the tumor grows laterally and invades the cavernous sinus wall, paralysis of the oculomotor nerve or abducens nerve may occur; if the tumor passes through the septum sellae and then grows upwards to the ventral part of the frontal lobe, psychiatric symptoms may sometimes occur; if the tumor grows posteriorly and upwards and blocks the anterior part of the third ventricle and the interventricular foramen, symptoms of increased intracranial pressure such as headache and vomiting may occur; if the tumor grows posteriorly, it may compress the brainstem and cause coma, paralysis, or decerebrate rigidity.

Patients are reminded that the key to the treatment of pituitary tumors is early detection. If symptoms of pituitary tumors appear, they should seek medical attention as soon as possible to avoid delaying the condition and causing other diseases. Therefore, patients must pay attention to it.