Pituitary, Neuroendocrine Tumors

Acromegaly

Acromegaly is a condition caused by the presence of excess growth hormone (GH) in your blood. The high levels of the hormone will eventually cause your bodily tissues to grow larger and change the facial aesthetics.
Most commonly caused by a benign tumor of the pituitary gland. In children these tumors present as gigantism, which is caused by an excess of growth hormone.
Acromegaly can only occur after your bones and other organs have stopped growing, usually around 18 years for women and slightly older for men.

Treatments for Acromegaly

Microsurgery
A operating microscope to help your surgeon remove the tumor by magnifying tumor and surrounding structures, to save normal pituitary gland.

Endoscopic surgery
Uses small tubes and a tiny camera to help your surgeon remove your tumor in small pieces.

Radiosurgery
Gamma Knife radiosurgery is a highly advanced form of radiotherapy that is used to achieve similar results to the surgical techniques. However, with Gamma Knife it can take several years for growth hormone (GH) levels to return to normal, rather than days or weeks as with traditional surgery.

Pharmacological Treatment and Hormone Therapy
Treatment with medical agents is possible if surgery does not cure your acromegaly or if surgery is contraindicated for you. Medicines are sometimes prescribed before surgery to improve the likelihood of a good outcome.

Symptoms of Acromegaly

  • Enlargement of your face, hand and feet
  • Tingling and numbness in hands
  • Joint pain and swelling due to arthritis
  • Tiredness, fatigue, and depression
  • Impotence, loss of libido
  • Interrupted menstrual cycle
  • Heart disease and heart enlargement
  • Hypertension
  • Diabetes mellitus
  • Sleep apnea
  • Visual deterioration
  • Headaches

How are Acromegaly diagnosed?

  • GH and IGF-I measurement
  • Growth hormone suppression test
  • MRI scan

Pituitary, Neuroendocrine Tumors

Cushing’s Disease

Cushing’s disease refers specifically to excessive ACTH secretion caused by a type of benign pituitary tumor.
Cushing’s disease is a serious endocrine disorder that is the result of excessive production of cortisol, a steroid hormone produced by the adrenal glands.
These high levels of cortisol in the blood can be caused by tumors of the pituitary gland, adrenal glands, or cancer arising elsewhere in the body (adrenocorticotropic hormone or ACTH-producing tumors).

Treatments for Cushing’s Disease

Microsurgery
A powerful operating microscope to distinguish between tiny structures in and around your pituitary gland.

Endoscopic
Surgery uses a small endoscope and a tiny camera to help your surgeon remove your tumor.

Radiosurgery
Gamma Knife radiosurgery is a highly advanced form of radiotherapy that is used to achieve similar results to the surgical techniques described above. Gamma Knife is an outpatient procedure, does not involve any incisions, and requires only brief sedation under general anesthetic.

Symptoms of Cushing’s Disease

  • Excessive Weight gain
  • High blood pressure
  • Excess hair growth in women
  • Acne, Extra fat around neck
  • Insomnia, Easy Fatigue
  • Poor concentration and irritability
  • Menstrual irregularity
  • Recurrent infection
  • Thin skin and stretch marks
  • Weak bones, Easy bruising
  • Balding in women
  • Hip and shoulder weakness
  • Swelling of feet, legs
  • Diabetes mellitus

How are Cushing’s Disease diagnosed?

  • Hormonal diagnosis/li>
  • Inferior petrosal sinus sampling
  • MRI scan

Pituitary, Neuroendocrine Tumors

Gigantism

Gigantism is accelerated growth during childhood due to the production of excess growth hormone. By definition, gigantism occurs during childhood before the growth plates in the long bones of the body have closed.
In adults, the condition is called acromegaly. Gigantism is most often caused by a benign tumor on the pituitary gland called a pituitary adenoma. However, it can also be caused by the various other disorders.

Treatments for Gigantism

Microsurgery
Uses an advanced operating microscope to help distinguish between tiny structures in and around the pituitary gland.

Endoscopic
Surgery uses small tubes and a tiny camera to help your surgeon remove the tumor in small pieces.

Pharmacological Treatment and Hormone Therapy
Octreotide or lanreotide are synthetic forms of the hormone somatostatin and stop the release of growth hormone, but they can only be administered by injection every two to four weeks.

Gamma Knife Radiosurgery
Radiation therapy is used to achieve similar results to the surgical techniques. However, with Gamma Knife it can take several years for growth hormone levels to return to normal.

Symptoms of Gigantism

  • Abnormally tall stature
  • Abnormal growth of the face, hands and feet
  • Thickened facial features
  • Irregular menstrual cycle in females
  • Excessive perspiration with slight activity
  • Delayed puberty
  • Double vision
  • Deafness
  • Headache

How are Gigantism diagnosed?

  • GH and IGF-I measurement
  • Growth hormone suppression test
  • MRI scan

Pituitary, Neuroendocrine Tumors

Macroadenoma

A macroadenoma is a benign tumor composed of glandular tissue growth larger than 10 mm (those under 10 mm are called microadenomas). They usually form in the adrenal and pituitary glands.

Treatments for Macroadenoma

Microsurgery
Uses an advanced operating microscope to help distinguish between tiny structures in and around the pituitary gland.

Endoscopic
Surgery uses small tubes and a tiny camera to help your surgeon remove the tumor in small pieces.

Gamma Knife Radiosurgery
Radiation therapy is used to achieve similar results to the surgical techniques. However, with Gamma Knife it can take several years for growth hormone levels to return to normal.

Symptoms of Macroadenoma

  • Headache
  • Problems with eyesight
  • Dizziness
  • Nausea
  • Unexplained hair growth or loss
  • Weight changes
  • Menstrual or breast changes
  • Erectile dysfunction

How are Macroadenoma diagnosed?

  • Blood tests, Urine tests
  • Visual field tests
  • Computed tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Inferior petrosal sinus sampling (IPSS)

Pituitary, Neuroendocrine Tumors

Prolactinoma

Prolactinoma is a noncancerous tumor of the pituitary gland. This tumor causes the pituitary to make too much of a hormone called prolactin. The major effect of prolactinoma is decreased levels of some sex hormones — estrogen in women and testosterone in men.

Treatments for Prolactinoma

Microsurgery
Uses an advanced operating microscope to help distinguish between tiny structures in and around the pituitary gland.

Endoscopic
Surgery uses small tubes and a tiny camera to help your surgeon remove the tumor in small pieces.

Gamma Knife Radiosurgery
Radiation therapy is used to achieve similar results to the surgical techniques. However, with Gamma Knife it can take several years for growth hormone levels to return to normal.

Symptoms of Prolactinoma

  • Low bone density
  • Reduction of other hormone production by the pituitary gland as a result of tumor pressure
  • Loss of interest in sexual activity
  • Headaches
  • Visual disturbances
  • Infertility

How are Prolactinoma diagnosed?

  • Blood tests, Urine tests
  • Computed tomography (CT)
  • Magnetic resonance imaging (MRI)

Pituitary, Neuroendocrine Tumors

Rathke Cleft Cyst

Rathke cleft cysts are benign formations and not true tumors. Rather, they take the form of a fluid-filled pouch known as a cyst.
Rathke cleft cysts are thought to form during embryological development from a developmental precursor of the pituitary gland called the Rathke’s pouch. As development proceeds in the womb, the hollow center of the Rathke’s pouch shrinks to a narrow trough called a cleft.
Normally, this cleft continues to regress and then disappears, forming the anterior, or front, part of the pituitary gland.
If the Rathke’s pouch does not close completely, a Rathke cleft cyst can form. The exterior of the cyst is a thin clear membrane while the interior is filled with fluid.

Treatments for Rathke Cleft Cyst

Microsurgery
Uses an advanced operating microscope to help distinguish between tiny structures in and around the pituitary gland.

Endoscopic
Surgery uses small tubes and a tiny camera to help your surgeon remove the tumor in small pieces.

Gamma Knife Radiosurgery
Radiation therapy is used to achieve similar results to the surgical techniques. However, with Gamma Knife it can take several years for growth hormone levels to return to normal.

Symptoms of Rathke Cleft Cyst

  • Visual disturbances (about 47 percent of symptomatic cases)
  • Diabetes insipidus (more common in women)
  • Milky discharge from the breasts
  • Headaches

How are Rathke Cleft Cyst diagnosed?

  • Computed tomography (CT)
  • Magnetic resonance imaging (MRI)

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