August 22, 2024 Author : Gonçalo Guerreiro The pituitary is an endocrine gland. It is located at the base of the brain, in a small chamber called the sella turcica; It is approximately the size of a pea; It is divided into two main parts – anterior and posterior – and has different types of cells that are responsible for the production of different hormones; Pituitary hormones control several body functions, including the function of other glands; The pituitary gland is mainly controlled by the hypothalamus. What are pituitary hormones? The pituitary gland is responsible for the production of several hormones . Hormones of the anterior pituitary or adenohypophysis Growth hormone (GH) , which controls growth and development; Adrenocorticotropic hormone (ACTH) , which stimulates the adrenal glands to produce cortisol and other hormones; Gonadotropic hormones, which are two, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) , which stimulate: The production of sperm by the testicles; The production of eggs by the ovaries and ovulation; The production of sex hormones (testosterone and estrogens) by the testicles and ovaries Prolactin , which stimulates milk production; Thyroid-stimulating hormone (TSH) , which stimulates the thyroid to produce hormones; Beta-melanocyte stimulating hormone , which darkens the skin; Enkephalins and endorphins , which interfere with the sensation of pain; Hormones of the posterior pituitary or neurohypophysis Vasopressin or antidiuretic hormone (ADH) , which regulates the amount of water eliminated in the urine, regulating blood pressure and the amount of sodium; Oxytocin , which stimulates the contraction of the uterus during childbirth and the ducts that carry milk into the breast during lactation. Pituitary tumors Pituitary tumors are abnormal developments of pituitary cells . The most common are pituitary adenomas , which originate from cells in the anterior pituitary and are benign (which means they are not cancer). There are several types of pituitary adenomas, which depend on the cells that gave rise to them. Its effects can be : Change the production (increase or decrease) of hormones by the cells that caused the tumor; Compress structures close to the pituitary gland , like nerves, altering their functions. A frequently affected nerve is the optic nerve, which causes vision disorders; Exerting pressure on other cells and thus also interfering with the hormones that these cells produce. Symptoms of pituitary tumors Symptoms of a pituitary adenoma depend on: Type of adenoma; Tumor size; Structures affected. Depending on the hormones involved, symptoms can be, for example : Sexual dysfunction, for example, decreased sexual desire and erectile dysfunction; Menstrual disorders, for example absence or irregularity of menstruation; Infertility; Growth disorders, for example gigantism in children or acromegaly (disproportionate growth of regions such as hands, feet or jaws); Excessive weight gain, high blood pressure, weakness of muscles and bones; Fatigue, tremors. When a pituitary adenoma compresses neighboring structures, headaches and changes in vision are common symptoms. Diagnosis and treatment of pituitary tumors The suspicion of a pituitary adenoma can be raised by the symptoms and history reported by the patient and the examination performed by the doctor. To confirm the diagnosis, diagnostic tests are requested, such as, for example, hormonal analysis, imaging tests (brain magnetic resonance) and ophthalmological examinations. Treatment of these tumors depends on their type and size. It may involve medicines, surgery, radiation therapy, or a combination of these modalities . Surgical approach of pituitary tumors is performed by neurosurgeons . It does not involve open cranial surgery or brain manipulation. Access is done through the nostrils , which reduces surgical risks and is associated with a shorter hospital stay and faster recovery. After treatment, regular follow-up is maintained to ensure that there is no new growth or, if it does occur, the necessary intervention is carried out in a timely manner. There are also pituitary adenomas that are diagnosed accidentally, for example, in a brain MRI carried out for another reason, and which due to their size do not cause any symptoms. In these cases, tumors generally do not require treatment and are kept under supervision with regular surveillance. Meet the nerosurgery clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
