Patient's question:
What should I do if the pituitary gland is enlarged?Doctor's answer:
Hello: The pituitary gland is an important endocrine organ containing several types of endocrine cells that secrete various endocrine hormones. If a pituitary cell develops an adenoma, it can lead to specific clinical manifestations. The possibilities include:(1) Growth Hormone Cell Adenoma: In the early stages, the tumor is only a few millimeters in size and primarily manifests as excessive secretion of growth hormone. In pediatric patients, it can cause accelerated growth, even leading to gigantism. In adults, it results in acromegaly, characterized by facial changes, enlarged forehead, prominent jaw, large nose, thick lips, thickened fingers, tightness when wearing shoes and hats, requiring multiple size changes, and even the need for custom-made items. Some patients may also experience increased appetite, rough hair and skin, hyperpigmentation, and finger numbness. Severe cases may lead to general fatigue, headaches, joint pain, decreased sexual function, amenorrhea, infertility, and even diabetes.
(2) Prolactin Cell Adenoma: The main manifestations include amenorrhea, galactorrhea, and infertility. Severe cases may cause loss of axillary hair, pale and smooth skin, increased subcutaneous fat, and symptoms such as fatigue, easy exhaustion, drowsiness, headaches, and decreased sexual function. In males, it may lead to decreased libido, impotence, gynecomastia, and sparse facial hair. Severe cases may cause atrophy of the genital organs, reduced sperm count, and infertility. Cases of male-to-female transformation are relatively rare.
(3) Adrenocorticotropic Hormone Cell Adenoma: Clinical manifestations include central obesity, moon face, buffalo hump, erythema, and striae on the abdomen and thighs, as well as increased body hair. Severe cases may cause amenorrhea, decreased libido, general fatigue, and even bedridden status. Some patients may also develop hypertension and diabetes.
(4) Thyrotropin Cell Tumor: Rare, as excessive secretion of pituitary thyrotropin causes hyperthyroidism symptoms. These symptoms disappear after pituitary tumor removal. Additionally, hypothyroidism feedback can lead to focal hyperplasia of the pituitary gland, which gradually develops into a pituitary adenoma. As the tumor grows, it can also cause expansion of the sella turcica and compression of surrounding tissues.
(5) Follicle-Stimulating Hormone Cell Adenoma: Very rare, with only isolated reports of clinical manifestations such as decreased sexual function, amenorrhea, infertility, and reduced sperm count.
(6) Melanocyte-Stimulating Hormone Cell Adenoma: Very rare, with only isolated reports of patients experiencing hyperpigmentation without cortisol excess.
(7) Endocrine-Inactive Adenoma: Early-stage patients may not feel any tumor growth, but it can compress the pituitary gland, leading to clinical manifestations of pituitary dysfunction.
(8) Malignant Pituitary Tumor: Characterized by a short history and rapid progression. It not only compresses pituitary tissue but also invades surrounding areas, causing destruction of the sella turcica bone or infiltration into the cavernous sinus, leading to paralysis of the oculomotor nerve or abducens nerve. Sometimes, the tumor may break through the sella turcica and grow into the sphenoid sinus, with transiently neurological symptoms. Therefore, it is recommended that you visit a hospital for a CT scan to confirm the diagnosis.