Types of Pituitary Tumors
- Pituitary Microadenoma – smaller than 1 cm
- Pituitary Macroadenoma – bigger than 1 cm
- Symptomatic pituitary tumor – these patients visit the physician with presenting symptoms.
- Asymptomatic pituitary tumor is usually found incidentally on imaging and do not require any aggressive treatment except for serial imaging.
- Functional Pituitary tumors – causing abnormal hormone production, these hormones control metabolism, growth, sexual and other bodily functions.
- Non -functional Pituitary tumors – generally diagnosed when they get large in size and press surrounding structures.
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Symptoms of Pituitary Tumor
Many times Pituitary tumors are asymptomatic and seen in scans done for some other disease condition.
Symptoms when present mostly is:
- Hormonal problems due to over or underproduction of hormones
Symptoms due to Overproduction of hormones
- Prolactin-excess production stimulates lactation leading to discharge from nipple, oligomenorrhoea or amenorrhoea absence of menses, there may be fertility problems
- Increased growth hormone production leading to Gigantism in kids and Acromegaly in adults
- ACTH producing tumors producing excess cortisol leading to Cushing’s syndrome with weight gain, stretch marks around the abdomen , high blood sugar, high blood pressure, hirsuitism
- Increased TSH –leading to nervousness, irritability, fast heart rate, weight loss, increased sweating
Symptoms due to underproduction of hormones
- Less production of growth hormone –causes late growth in children, poor strength of bones and muscles
- Low TSH causes fatigue, lethargy, cold extremities, weight gain There may be lack of energy, general low feeling
- Changes in vision or Visual loss- when the tumor grows upwards and presses optic nerves, there will be visual changes, the patient will be able to see central and not peripheral, or double vision, etc
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Tests and Diagnosis for Pituitary Tumor
Many times asymptomatic and only seen on imaging
Occasionally Pituitary tumors are diagnosed when the patient presents with symptoms which make the physician suspect and refer for :
- Complete medical history and physical examination, visual field study when tumor pressing on the optic nerve
- Blood tests to check for hormone levels.
- Imaging tests –X rays, MRI scans to check the extent the tumor has grown, CT scans
Treatment for Pituitary Tumor
Pituitary tumors are usually curable, mostly these are benign tumors so no metastasis
Treatment plan selected jointly by a team of the neurosurgeon, endocrinologists, physicians, an oncologist in consultation with the patient.
The treatment goal is providing relief of presenting symptoms
- Few cases require only monitoring and regular endocrine screening,
- Few cases can be treated by medication only,
- Few may require surgery, radiation, chemotherapy or a combination of the above.
Surgery, when required, can be:
- Traditional surgery (craniotomy) – cutting open the skull, lifting the brain and taking out the tumor, surgery requires hospitalization for about 2 weeks and a long recovery period. The risks are high in this type of surgery and is usually avoided.
- Trans sphenoid surgery approach – endoscopic surgery performed with the help of fibro optic scope introduced through the nose and sphenoid sinus into the brain, tumor broken and scooped out through suction. This procedure is usually performed as is less risky and has faster recovery with only 2 days of hospitalization required.
Aftercare or Follow up Treatment :
Blood tests and hormone markers, as well as MRI scans, are done a few days after surgery to check whether the treatment was successful. Screening of the cases needs to be maintained after surgery at regular intervals to evaluate and modify the treatment plan.
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Factors Affecting the Cost Pituitary Macro Adenoma Treatment
- The hospital patient is opting for.
- Room –Standard single room, deluxe room, super deluxe room for the number of nights specified (including nursing fee, meals, room rate and room service).
- Operating room, ICU
- Fee for the team of doctors (Surgeons, Anesthesist, Physiotherapist, Dietician)
- Standard test and diagnostic procedures
- Depend on the treatment options :
- Radiation therapy