According to abbreviationfinder, PT stands for pituitary tumor. A pituitary tumor is a predominantly benign growth of the pituitary gland that accounts for about 30 to 40 percent of brain tumors. Pituitary tumors are usually easy to treat thanks to modern microsurgical techniques.
What is a pituitary tumor?
Schematic representation of the location of a brain tumor in the brain.
A pituitary tumor is a diseased, usually benign (non-cancerous) neoplasm of the pituitary gland (pituitary gland). A distinction is made between the more frequently diagnosed pituitary adenomas, which account for a total of 15 percent of brain tumors and arise from cell tissue of the anterior lobe of the pituitary gland (adenohypophysis), and the extremely rare tumors of the posterior pituitary lobe (e.g. granular cell tumors of the neurohypophysis).
The pituitary gland is a bean-sized endocrine gland that acts as the interface between the brain and the endocrine system and is instrumental in the hormonal regulatory system. Since a pituitary tumor arises from tissue cells of the pituitary gland, it can take over its hormone-producing properties.
Therefore, a distinction is also made between hormone-inactive and hormone-active pituitary tumors. The predominantly occurring hormone-active pituitary tumors produce hormones and impair the hormonal regulatory system of the pituitary gland as a result of a hormone excess. The most common pituitary tumor is the prolactinoma (about 40 percent of pituitary tumors), which produces prolactin as a hormone-active tumor.
Causes
The causes of a pituitary tumor have not yet been clearly clarified. A pituitary tumor is thought to arise from a single abnormal pituitary tissue cell that divides, multiplies, and forms a tumor, with no specific cells particularly at risk of degenerating.
The triggers for this degeneration process are also unknown and a correlation between environmental factors affecting the genome and the development of a tumor has not yet been demonstrated. In individual specific cases, a pituitary tumor is based on genetic factors. There is an increased risk of pituitary tumors in patients with multiple endocrine neoplasia (MEN-1 syndrome).
Typical Symptoms & Signs
- visual disturbances
- visual field defects
- Increase in pituitary hormones
Diagnosis & History
Diagnostic imaging methods such as MRI, CT and X-rays are primarily used to diagnose a pituitary tumor. For example, an MRI (magnetic resonance imaging) of the head can be used to locate a pituitary tumor and determine its size.
A hormone determination of the blood provides information about the hormone activity and the type of pituitary tumor as part of a differential diagnosis. In the case of a prolactinoma, the prolactin value is increased. Elevated levels of growth hormone (above 5 ng/mm) indicate a growth hormone-producing pituitary tumor.
In addition, an ACTH-producing (adrenocorticotropic hormone) pituitary tumor can be detected by a dexamethasone test. Since there is a visual impairment in about 30 percent of cases of a pituitary tumor, a precise eye examination is indicated.
Generally, a pituitary tumor is not fatal or life-threatening, and the prognosis is good, although there is a high risk of recurrence (recurrence). Left untreated, as the size of a pituitary tumor increases, it can affect adjacent organs (optic nerves, blood vessels) and is fatal in the majority of cases.
Complications
In most cases, a pituitary tumor can be treated and removed relatively well, so there are no particular complications and discomfort for the patient. However, without treatment, the tumor in the brain can spread to other regions of the head and body and cause symptoms in those regions. In most cases, the pituitary tumor causes visual disturbances.
This can reduce the eyesight and the patient suffers from double vision or what is known as blurred vision. Paralysis and failures in the various areas of the visual field can also occur, so that the affected person can no longer move or control certain regions. This paralysis severely restricts the patient’s everyday life and leads to a significant loss of quality of life.
The pituitary tumor is usually treated with radiation therapy because surgical removal is not possible. There are no particular complications and the tumor can usually be removed relatively easily. Furthermore, medication is used and the affected person has to be examined again and again in the following years. If removed successfully, life expectancy is not affected.
When should you go to the doctor?
Depending on its size and location, a pituitary tumor can cause very different symptoms. A doctor’s visit is advisable as soon as there are signs of a hormonal imbalance such as increasing fat deposits on the abdomen with simultaneous loss of muscle mass or an unexplained enlargement of the hands and feet (acromegaly). Children should be seen by the pediatrician when they fail to develop normal growth spurts and are significantly below their peers in height.
Menstrual cycle disorders and the loss of sexual desire in women can indicate a tumor-related lack of female sex hormones. In this case, a visit to the gynecologist is recommended, who can rule out gynecological causes and, if necessary, arrange for further specialist clarification. In men, a pituitary tumor occasionally triggers erectile dysfunction and a loss of libido. The urologist is a suitable first point of contact here.
Other warning signs that make you think of a tumor of the pituitary gland can be an increased sensitivity to cold, a slow pulse, low blood pressure, tiredness, loss of performance, striking pale skin, headaches, blurred vision and a tendency to hypoglycaemia. Each of these signs can also be caused by other, far more harmless diseases – a visit to the family doctor is advisable if some symptoms occur at the same time, the symptoms persist for a long time or become progressively worse. If the suspicion is confirmed, further examinations by an endocrinologist or by imaging methods are useful.
Treatment & Therapy
The standard therapy for a pituitary tumor is microsurgery, with a prolactinoma being an exception and being treated with medication. Due to the location of the pituitary gland, access to the tumor is in most cases through the nostril and opening of the skull is only necessary for particularly large pituitary tumors.
If the pituitary tumor proves to be inoperable or only partially removable, radiation therapy is also used. In some cases, however, a radical removal of the residual tumor is not possible due to the problematic position of the pituitary gland, so that its development can be monitored using imaging methods (MRI) and another surgical intervention may be necessary.
As a hormone-active pituitary tumor, prolactinoma is treated medicinally with dopamine agonists, which inhibit the increased release of prolactin and gradually lead to a minimization of the pituitary tumor. Microsurgical tumor removal is only an option for those affected who cannot tolerate long-term drug therapy and if the tumor does not respond to the drug.
In not uncommon cases, the consequence of a microsurgical and radical removal of the pituitary tumor is hypofunction of the pituitary gland, which entails a hormone deficiency. This is compensated for with medication as part of a substitution therapy.
Prevention
Since neither the exact causes nor the triggers for the assumed cell degeneration are known, a pituitary tumor cannot be prevented. It is generally recommended to avoid carcinogenic substances such as chemicals, unnecessary radiation, alcohol and nicotine. A healthy diet and physical activity support the immune system and minimize the risk of disease in general and especially with regard to pituitary tumors.
Aftercare
Following a pituitary tumor, there is often a hormone deficiency, triggered by the hypofunction of the pituitary gland. For this purpose, the doctor prescribes the appropriate medication. Patients should strictly follow the instructions for this substitution therapy in order to rule out any problems. In the phase after the treatment, it is important to avoid harmful stimulants such as alcohol and nicotine.
Healthy food and sufficient exercise help those affected to reduce the risk of disease and strengthen the immune system. With this improvement in their state of health, patients feel armed against illness and relapse. In addition to a healthy diet, you can limit caffeine consumption and follow a diet if you are overweight.
Patients of normal weight feel much better because their cardiovascular system is not overloaded. A doctor-recommended weight loss also has a positive effect on the blood values and ensures more fitness. That’s why it’s worth including sports and exercise in the aftercare program.
The activities and the subsequent relaxation phases also reduce everyday stress. This is another important point for health. With autogenic training and/or yoga, those affected also train their mindfulness and thus improve their quality of life.
You can do that yourself
The pituitary tumor is a serious disease that the patient should under no circumstances treat independently or ignore. It is very important that the therapy is determined in consultation with the doctor treating you and that it is carried out consistently. The patient can actively participate in this process. The person concerned can follow the therapy plan consistently, attend check-ups and actively report to the doctor about changes, abnormalities or any new symptoms that may arise.
Parallel to the tumor therapy, the patient can try to achieve an immune system that is as stable as possible and a good general physical condition. A first step is to avoid harmful substances such as nicotine and alcohol. Caffeine consumption can also be reduced to one or two cups a day.
If the patient is overweight, they should try to achieve a normal weight. This takes the strain off your cardiovascular system and puts you in a fitter, healthier state. A change in diet can usually lead to rapid weight loss, and blood values and the overall physical condition improve. An appropriate sports or exercise program supports these measures. In this way, the patient can ensure that he or she can cope better with the strenuous stress of the therapy with a healthier body.
Stress and pressure in everyday life can be avoided or reduced in many cases. Autogenic training or yoga can contribute to relaxation.
