Pituitary adenoma natural history, complications, and prognosis: Difference between revisions
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{{CMG}} {{AE}} {{AAM}} | {{CMG}} {{AE}} {{AAM}} | ||
==Overview== | ==Overview== | ||
Patients with pituitary adenoma may progress to develop [[lethargy]], [[headache]], [[nausea]], and [[vomiting]]. Common [[complications]] of pituitary adenoma include [[bitemporal hemianopia]] , [[anosmia]], [[acromegaly]], [[gigantism]] and [[Cushing's syndrome]]. | |||
[[Prognosis]] is generally good, and approximately 18% of patients with macroadenoma require further treatment. | |||
==Complications== | ==Natural history, complications, and prognosis== | ||
Complications associated with pituitary adenoma | |||
*[[Gigantism]] | ===Natural history=== | ||
*[[Acromegaly]] | *Pituitary adenomas are generally [[benign]]. | ||
*[[Cushing's syndrome]] | *Patients with micoradenoma usually [[asymptomatic]] and diagnosed incidentally. At later stage they may show signs and [[symptoms]] of [[hormonal]] disturbances. | ||
*[[Hyperpituitarism]] | *Patients with macroadenoma usually present with [[Visual field defect|visual field deficits]] and [[hormonal]] disturbances. Macroadenoma grows slowly and invades surrounding structure such as [[optic chiasm]] and [[olfactory tract]]. | ||
*[[Pituitary apoplexy]] | *Females tend to develop symptoms at an earlier stage than males due to [[Menstrual cycle|menstrual]] irregularities associated with the disease. | ||
*[[Central diabetes insipidus]] | |||
*[[Bitemporal hemianopia]] | ===Complications=== | ||
*Invasion into the [[cavernous sinus]] with occasional compression of the: | *[[Complications]] associated with pituitary adenoma generally arise from either the mass itself or from prolonged [[hormonal]] imbalance. [[Complications]] may include:<ref name="Wikipaedia"> Pituitary adenoma https://en.wikipedia.org/wiki/Pituitary_adenoma. 9 29 2015</ref><ref name="Acro"> Gigantism http://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/pituitary-gland-disorders/acromegaly-and-gigantism</ref><ref name="Cushing"> http://www.niddk.nih.gov/health-information/health-topics/endocrine/cushings-syndrome/Pages/fact-sheet.aspx#1</ref> | ||
:*[[Oculomotor nerve]] (CN III) | :*[[Gigantism]] | ||
:*[[Abducens nerve]] (CN VI) | :*[[Acromegaly]] | ||
*[[Hydrocephalus]] (seen in large adenoma) | :*[[Cushing's syndrome]] | ||
:*[[Hyperpituitarism]] | |||
:*[[Pituitary apoplexy]] | |||
:*[[Pituitary insufficiency]] | |||
:*[[Central diabetes insipidus]] | |||
:*[[Bitemporal hemianopia]] | |||
:*[[anopsia|Bilateral anopsia]] | |||
:*[[Anosmia]] | |||
:*Invasion into the [[cavernous sinus]] with occasional compression of the: | |||
::*[[Oculomotor nerve]] (CN III) | |||
::*[[Abducens nerve]] (CN VI) | |||
:*[[Hydrocephalus]] (seen in large adenoma) | |||
===Prognosis=== | ===Prognosis=== | ||
*The prognosis of pituitary adenoma is generally good. However, | *The [[prognosis]] of pituitary adenoma is generally good. However, recurrent [[symptoms]] require further intervention. | ||
*Approximately 18% of patients with macroadenoma require further treatment.<ref name=Radiopaedia> Dr Amir Rezaee and Dr Yuranga Weerakkody http://radiopaedia.org/articles/pituitary-adenoma 2015. URL accessed on 9 30 2015</ref> | *Approximately 18% of patients with macroadenoma require further treatment.<ref name="Radiopaedia"> Dr Amir Rezaee and Dr Yuranga Weerakkody http://radiopaedia.org/articles/pituitary-adenoma 2015. URL accessed on 9 30 2015</ref> | ||
==References== | ==References== |
Latest revision as of 19:39, 2 October 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]
Overview
Patients with pituitary adenoma may progress to develop lethargy, headache, nausea, and vomiting. Common complications of pituitary adenoma include bitemporal hemianopia , anosmia, acromegaly, gigantism and Cushing's syndrome. Prognosis is generally good, and approximately 18% of patients with macroadenoma require further treatment.
Natural history, complications, and prognosis
Natural history
- Pituitary adenomas are generally benign.
- Patients with micoradenoma usually asymptomatic and diagnosed incidentally. At later stage they may show signs and symptoms of hormonal disturbances.
- Patients with macroadenoma usually present with visual field deficits and hormonal disturbances. Macroadenoma grows slowly and invades surrounding structure such as optic chiasm and olfactory tract.
- Females tend to develop symptoms at an earlier stage than males due to menstrual irregularities associated with the disease.
Complications
- Complications associated with pituitary adenoma generally arise from either the mass itself or from prolonged hormonal imbalance. Complications may include:[1][2][3]
- Gigantism
- Acromegaly
- Cushing's syndrome
- Hyperpituitarism
- Pituitary apoplexy
- Pituitary insufficiency
- Central diabetes insipidus
- Bitemporal hemianopia
- Bilateral anopsia
- Anosmia
- Invasion into the cavernous sinus with occasional compression of the:
- Oculomotor nerve (CN III)
- Abducens nerve (CN VI)
- Hydrocephalus (seen in large adenoma)
Prognosis
- The prognosis of pituitary adenoma is generally good. However, recurrent symptoms require further intervention.
- Approximately 18% of patients with macroadenoma require further treatment.[4]
References
- ↑ Pituitary adenoma https://en.wikipedia.org/wiki/Pituitary_adenoma. 9 29 2015
- ↑ Gigantism http://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/pituitary-gland-disorders/acromegaly-and-gigantism
- ↑ http://www.niddk.nih.gov/health-information/health-topics/endocrine/cushings-syndrome/Pages/fact-sheet.aspx#1
- ↑ Dr Amir Rezaee and Dr Yuranga Weerakkody http://radiopaedia.org/articles/pituitary-adenoma 2015. URL accessed on 9 30 2015