Question

PM is a 15-year-old young woman who had her menstrual period at age 11. Recently, she has been experiencing double vision, headaches, and amenorrhea. A skull MRI indicates a pituitary adenoma. Blood tests indicate low estrogen, progesterone, and TSH levels.

2.     Explain why this benign tumor must be surgically removed.

Answer 1

Pituitary adenomas are tumors that occur in the pituitary gland.

Surgical removal of a pituitary tumor usually is necessary if the tumor is pressing on the optic nerves or if the tumor is overproducing certain hormones. The success of surgery depends on the tumor type, its location, its size and whether the tumor has invaded surrounding tissues.

Diagnosis

Pituitary tumors often go undiagnosed because their symptoms resemble those of other conditions. And some pituitary tumors are found because of medical tests for other conditions.

To diagnose a pituitary tumor, your doctor will likely take a detailed history and perform a physical exam. She might order:

• Blood and urine tests. These tests can determine whether you have an overproduction or deficiency of hormones.
• Brain imaging. A CT scan or MRI scan of your brain can help your doctor judge the location and size of a pituitary tumor.
• Vision testing.This can determine if a pituitary tumor has impaired your sight or peripheral vision.

Surgery

Endoscopic transnasal transsphenoidal surgeryOpen pop-up dialog box

Surgical removal of a pituitary tumor usually is necessary if the tumor is pressing on the optic nerves or if the tumor is overproducing certain hormones. The success of surgery depends on the tumor type, its location, its size and whether the tumor has invaded surrounding tissues. The two main surgical techniques for treating pituitary tumors are:

• Endoscopic transnasal transsphenoidal approach. This usually enables your doctor to remove the tumor through your nose and sinuses without an external incision. No other part of your brain is affected, and there's no visible scar. Large tumors may be difficult to remove this way, especially if a tumor has invaded nearby nerves or brain tissue.
• Transcranial approach (craniotomy). The tumor is removed through the upper part of your skull via an incision in your scalp. It's easier to reach large or more-complicated tumors using this procedure.

Replacement of pituitary hormones

If a pituitary tumor or surgery to remove it decreases hormone production, you'll likely need to take replacement hormones to maintain normal hormone levels. Some people who have radiation treatment also need pituitary hormone replacement.