By Dr. Ravindra Patil
The pituitary gland is a tiny pea-sized organ located at the base of the brain. Barely a cubic centimetre in volume, it produces and stores so many hormones of our body that it is known as the ‘master gland’. These pituitary hormones control the activity of other hormones in the body.
The pituitary gland has 2 parts: the anterior (front) and the posterior (back) parts, each producing a different set of hormones. Each of these hormones acts on different parts of the body and controls their proper functioning. The pituitary hormones are:
Function of pituitary hormones are vital for human survival. The deficiency or overproduction of each and every of the above hormones results in major medical disorders. For example, a shortage of growth hormone during childhood leads to reduced growth. The child does not grow like a normal adult but remains a dwarf. Conversely, excess of growth hormone leads to gigantism, a condition where the person keeps on growing abnormally.
Hormones are the body’s chemical messengers, sending signals into the bloodstream and tissues. Hormones work slowly, over time, and affect many different processes, including growth and development, blood sugar, sexual functions, reproduction, urine output, managing stress and mood. Hormone diseases occur when the level of any hormone is reduced or increased because of any reason. The Pituitary Gland produces many hormones and any pituitary gland problems lead to major illnesses.
Apart from a deficiency or excess production of the above hormones, disorders of pituitary gland are as follows:
Anterior pituitary disorders occur as a result of overproduction or underproduction of hormones secreted by the anterior lobes.
Disorders caused by over-production of anterior pituitary hormones
Disorders caused by under-secretion of anterior pituitary hormones
Posterior pituitary disorders are caused by either under-production or overproduction of the ADH hormone. ADH helps the kidneys to prevent excess water loss through urine. Imbalance in ADH production can lead to the following disorders:
Hypopituitarism is a condition that results in a partial or complete loss of the anterior pituitary gland functions. Panhypopituitarism is a condition, characterized by damage to the entire pituitary gland. In such cases, the production of all pituitary hormones stops.
Pituitary tumours are abnormal growths in the pituitary glands. They may cause overproduction or low levels of pituitary hormones. Most pituitary tumours are noncancerous growth and remain confined within the pituitary gland. These are known as an adenomas.
When the tumour size is less than one cm, it is called a Microadenoma. Most pituitary adenomas are microadenomas. When the tumour is greater than one cm in size, it is called a Macroadenoma.
Malignant Pituitary tumours (cancers) are rare and mostly affects old aged persons. Pituitary carcinomas can spread to the brain, spinal cord or the bone surrounding the pituitary glands. In some patients, the pituitary adenoma can turn cancerous and spread to other parts of the body.
A pituitary adenoma is the third largest cause of brain tumours, accounting for 10% of all cases. The global prevalence of pituitary adenomas is approximately 17%. Studies have reported the risk of pituitary tumours to increase with age, with maximum cases being diagnosed between 30 and 60 years.
The cause of pituitary adenoma remains unknown. Genetic alteration is thought to play an important role in adenoma development. Studies have shown that people with certain genetic factors such as multiple endocrine neoplasia, type 1 (MEN 1) are at increased risk of pituitary tumours.
If diagnosed early, pituitary tumours can be managed well. However, if left undiagnosed and untreated for a long period, such tumours can become large and affect the functioning of several organs of the body, causing blindness, hypertension, diabetes, osteoporosis, heart disease and death.
Evidence suggests the 5-year survival rate of pituitary gland tumours be about 82%.
Survival rate also depends upon factors like:
Not all pituitary tumours require treatment. Treatment depends upon the following:
The treatment is usually given by a brain surgeon (neurosurgeon), endocrine system specialist (endocrinologist) and a radiation oncologist. Doctors use a combination of surgery, radiation therapy and medications to normalize hormone levels.
Surgery is needed when the tumour presses on the optic nerve or leads to the overproduction of hormones. The Endoscopic transnasal transsphenoidal approach involves removing the tumour through the nose without making an incision. This is usually done when the tumour is small in size and no other part of the brain is affected by it. The Transcranial approach (craniotomy) is used for removing large tumours by making an incision in the scalp.
This technique uses high-energy radiation to destroy tumour cells. It can be used alone or in combination with surgery.
They help to limit excess hormone production and shrink certain types of pituitary tumours.
Hormone replacement therapy is done in patients with reduced hormone production after surgery.
Watchful waiting: Many patients do not exhibit any symptoms and function normally without any treatment. In such cases, patients are advised only regular tests to keep a check on the tumour growth.
To summarise, a disease of pituitary gland can be very harmful. It must be diagnosed and treated as soon as possible. Such complex disease treatment is available in Samarth Neuro and Superspeciality Hospital in Miraj, Maharashtra. Dr. Ravindra Patil, the chief neurosurgeon there, is an expert in performing such operations.
Samarth Neuro and Superspeciality Hospital has 100+ beds & specializes in emergency surgery for neurological issues/disorders & diagnostics.
Samarth Neuro and Superspeciality Hospital
