Understanding Pituitary Adenoma and Prolactinoma
The pituitary gland, also known as the “master gland,” is located at the base of the brain. This gland plays a crucial role in regulating vital bodily functions by producing hormones that influence growth, metabolism, and reproduction.
Pituitary Adenomas
Pituitary adenomas are benign (non-cancerous) tumours that occur on the pituitary gland. Although the pituitary gland is part of the endocrine system and not technically a part of the brain, it is attached to the brain. Therefore, doctors often classify pituitary adenomas as brain tumours due to their location and effects on brain function.
These tumours can be classified based on their size and hormone activity:
- Microadenomas: Small adenomas less than 10 millimeters.
- Macroadenomas: Larger tumours greater than 10 millimeters.
Pituitary adenomas can also be categorised as functioning if they are producing excess hormones or non-functioning if they are not affecting the pituitary hormone levels:
- Functioning Adenomas: These tumours secrete one or more pituitary hormones in excess, leading to various hormonal disorders depending on the type of hormone produced.
- Non-functioning Adenomas: These do not produce hormones and are usually diagnosed when they cause symptoms by pressing on surrounding tissues.
Prolactinoma
Prolactinoma is a specific type of functioning pituitary adenoma that produces excessive amounts of prolactin, a hormone that stimulates milk production in women when they are pregnant. This hormone also regulates the menstrual cycle. Excess of prolactin levels can cause absent menstrual cycles. Hyperprolactinemia (excess of prolactin levels) can cause infertility both in men and women. galactorrhoea, milky discharge from the breast when a woman is not pregnant, and gynaecomastia, enlargement of the male breast, are seen in chronic untreated conditions due to prolong excess of prolactin levels. It is the most common type of hormone-producing pituitary tumour. This is a tumor that can be treated with medication and does not require surgery.
Symptoms of Pituitary Adenomas
Symptoms can vary widely based on hormone levels and pressure on surrounding structures, including headaches, vision problems, and hormonal imbalances. The symptoms of pituitary adenomas generally depend on whether the tumour is functioning or non-functioning:
- Functioning Adenomas: Symptoms are typically related to the excess hormones the tumour produces. For example, Cushing’s disease from excess cortisol, acromegaly from excess growth hormone, and prolactinoma symptoms are described above.
- Non-Functioning Adenomas: These tumours may grow large enough to press on nearby nerves or parts of the brain, causing headaches, vision problems, or other neurological symptoms before they are diagnosed.
Specifically, prolactinoma (which is a type of pituitary adenoma) alone might not cause any signs or symptoms. Nonetheless, excessive prolactin in the blood can cause a variety of symptoms, including:
Symptoms in Women
Symptoms in Men
Seeking early help from an Endocrinologist (a medical doctor specialising in hormonal disorders) for pituitary adenomas is crucial because these tumours can cause hormone imbalances that affect multiple body functions. Early detection facilitates more effective management of symptoms such as vision problems, headaches, or hormonal dysfunctions. An Endocrinologist can provide timely diagnosis, initiate treatment to regulate hormone production and prevent further complications like tumour growth or permanent damage to surrounding tissues, such as the optic nerve. Importantly, early intervention from a specialist increases the chances of successful treatment.
Diagnosis of Pituitary Adenomas
At Harmony Thyroid, Endocrinology and Diabetes Centre, our experienced Endocrinologist in Singapore, Dr Vikram Sonawane, will conduct a detailed assessment of your condition, which typically involves:
- Blood Tests: These tests check for high blood levels of hormones, such as prolactin, growth hormone, and adrenocorticotropic hormone.
- Imaging Tests: MRI or CT Scans can help visualise the size and location of the pituitary gland tumour.
- Vision Tests: These are conducted to determine if a tumour impacts the optic nerves.
Treatment Options for Pituitary Adenomas
The recommended treatment plan differs according to the type of tumour, its size, whether it is producing excess hormones and the patient’s overall health. Dr Vikram will advise accordingly based on his assessment of your condition:
- Medication: Drug treatments are often the first-line therapy for prolactinomas. These medications, such as cabergoline and bromocriptine, reduce prolactin production and may shrink the tumour.
- Radiation Therapy: This may be used following surgery or alone if surgery is not viable. Radiation aims to shrink the tumour and prevent growth.
If you or your loved ones are suffering from symptoms of pituitary adenoma or prolactinoma, please schedule an appointment with our Senior Consultant Endocrinologist, Dr Vikram, from Harmony Thyroid, Endocrinology, and Diabetes Centre.
