Pituitary Adenoma

What visual field defect can pituitary adenomas cause and why?

Bitemporal hemianopia due to compression of the optic chiasm

What are the second most common adenomas?

Non-secreting

What are the two ways that pituitary adenomas can be classified?

1. Size 2. Hormonal status

What three ways will pituitary adenomas be investigated?

1. A pituitary blood profile (including GH, Prolactin, ACTH, FH, LSH and TFTs) 2. Formal visual field testing 3. MRI brain with contrast

Give some examples of excess hormone effects from pituitary adenomas? (3)

1. Cushing's disease from excess ACTH 2. Acromegaly from excess GH 3. Amenorrhoea/galactorrhoea from excess prolactin

What do some differential diagnoses of pituitary adenoma include? (7)

1. Pituitary hyperplasia 2. Craniopharyngioma 3. Meningioma 4. Brain metastases 5. Lymphoma 6. Hypophysitis 7. Vascular malformation

What proportion of adult brain tumours do adenomas account for?

10%

What makes a pituitary adenoma a microadenoma?

<1cm

What makes a pituitary adenoma a macroadenoma?

>1cm

What are the two types of adenoma based on hormonal status?

A secretory/functioning adenoma and a non-secretory/functioning adenoma

What is the fourth most common type of pituitary adenoma?

ACTH secreting

What proportion of people will have a pituitary adenoma?

Around 10% but most will never be symptomatic

What is the first line treatment for prolactinomas?

Bromocriptine

What are the third most common pituitary adenoma?

Gh secreting

What is the indication for pituitary adenoma surgery?

Progression in size

What are the most common type of pituitary adenoma?

Prolactinomas

How do pituitary adenomas cause headaches?

Stretching of the dura within/around the pituitary fossa

What is a pituitary adenoma?

This is a benign tumour of the pituitary gland

What is the main surgical technique used for pituitary adenomas?

Transsphenoidal transnasal hypophysectomy