What types of pituitary tumors are there?
The majority of tumors that arise in this area are pituitary adenomas and they account for approximately 10% of all intracranial tumors. An "adenoma" is a benign epithelial tumor with a glandular structure. Adenomas of the pituitary gland
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occur in patients of all ages and both sexes. Although they are benign, their growth rate may vary considerably and they can become quite large and invade surrounding tissues at the base of the brain.
Classically, tumors have been divided on the basis of their appearance after standard histologic staining: chromophobic, acidophilic, and basophilic adenomas. This system is now largely replaced by categories based on tumor cell types and their hormonal function. Tumor size is also used to classify tumors. Microadenomas are tumors measuring less than 10 mm in diameter and those of greater size are macroadenomas. Functional (secreting) tumors are those tumors which produce sufficient hormone for clinical symptoms to arise. Often these are microadenomas and they can be difficult to document radiographically. On the other hand, most macroadenomas are non-functioning (non-secreting or secreting clinically insufficient levels of hormones) tumors.
A pituitary tumor is classified as belonging to one of four main types, based on whether it overproduces pituitary hormones and the specific type of hormone produced:
ACTH-producing tumor is called a basophilic adrenocorticotrophic hormone-secreting adenoma, overproduces adrenocorticotrophic hormone (ACTH). ACTH is the pituitary hormone that regulates hormone production by the adrenal gland. When this type of pituitary tumor releases excess amounts of ACTH into the bloodstream, the excess ACTH overstimulates the adrenal glands to pour out high levels of adrenal glucocorticoids (adrenal hormones) and androgens (male hormones) into the blood. In most cases, an ACTH-producing tumor is small and doesn't enlarge beyond the sella turcica.
Prolactin-producing tumor is called a prolactin-secreting adenoma, overproduces the hormone prolactin, which stimulates the breasts to make milk. Prolactin-producing pituitary tumors can develop in both men and women, and they sometimes grow so big that they press on the sella turcica and cause it to enlarge. This enlargement of the sella turcica can be seen on skull X-rays or diagnostic scans and often is an important clue that a pituitary tumor exists.
Growth hormone-producing tumor is called an eosinophilic growth hormone-secreting adenoma, secretes abnormally large amounts of growth hormone. This overproduction of growth hormone causes giantism (excessive growth, especially in height) in children and teenagers and acromegaly (abnormal enlargement of the skull, jaw, hands and feet and other symptoms of abnormal growth) in adults. Growth hormone-producing tumors can enlarge beyond the sella turcica.
Non-functioning pituitary tumor is called a hormonally inactive adenoma, does not produce pituitary hormones and is slow to produce symptoms. For this reason, this type of tumor tends to grow large before it is discovered. In many cases, a nonfunctioning pituitary adenoma is diagnosed only when it already has enlarged beyond the sella turcica and has begun to cause problems related to pressure on the optic nerves or brain. |
