Pituitary Tumours

Pituitary Tumours

·        Symptoms caused by local pressure, hormone secretion or hypopituitarism

·        Almost always benign adenomas

·        Histological classification:

o   Chromophobe (70%): half produce PRL, some non-secretary, a few produce ACTH or GH

o   Acidophil (15%): Secrete GH or PRL

o   Basophil (15%): secrete ACTH

·        Effects of pressure: headache (felt anywhere over head, local or general), bilateral hemianopia (initially of superior quadrants), III, IV or VI palsy, CSF rhinorrhoea (erosion through floor of sellae)

·        Tests: as for hypopituitarism.  Water deprivation test if diabetes insipidous is suspected

·        Treatment: surgery (trans-sphenoidal or transfrontal). Hormone replacement. Bromocriptine for PRL secreting tumours. Radiotherapy (but side-effects common)