Hypophysis microadenoma

The hypophysis is located in the deepening of a wedge-shaped bone of a skull called by the Turkish saddle. The hypophysis is the main central hemaden which produces a number of the hormones regulating function of peripheral closed glands. Besides the hypophysis stimulates growth of a body and formation of breast milk. In a hypophysis allocate two shares – a lobby (adenohypophysis) and back (neurohypophysis). Cells of an adenohypophysis produce thyritropic hormone (stimulates a thyroid gland), adrenocorticotropic hormone (stimulates adrenal glands), gonadotropic hormones (influence gonads at men and women), and also prolactin (stimulates a lactation) and somatotropic hormone (stimulates growth). The neurohypophysis accumulates and cosecretes vasopressin (reduces urine volume) and oxytocin in blood (increases a tone of muscle fibers of a uterus). Diseases of a hypophysis can be shown by decrease or increase in its hormonal activity, emergence of new growths is also possible. Tumors of a hypophysis can produce hormones or to be inactive in this respect.

New growths of gipotalamo-pituitary area

The main new growths in the field of the Turkish saddle are macro - and microadenomas of a hypophysis, a cranyopharyngioma, a meningioma. Adenomas of a hypophysis make about 15% of all intracranial new growths. Difficulties of diagnosis are possible because of the small sizes of new growths of a hypophysis. Hormonal inactive formations of a hypophysis often prove late when symptoms of a prelum of surrounding fabrics appear. Adenomas are classified by hormonal activity and the sizes. On secretory activity prolaktinoma, somatotropinoma and kortikotropinoma prevail. Sometimes hormonal activity has the mixed character. A quarter of all adenomas does not produce hormones. On the basis of the sizes and invasive properties of a tumor of a hypophysis are divided into 2 stages: microadenomas, macroadenomas. It is less than 10 mm of microadenoma in the diameter, do not change structure of the Turkish saddle and do not cause symptoms of a prelum of surrounding fabrics. Larger tumors are called macroadenomas.

Hypophysis microadenoma symptoms

Hypophysis microadenoma often is an accidental find. It is connected with high distribution of the visualizing diagnosis techniques now, including a computer and magnetic and resonant tomography of a brain. Such research is frequent the neuropathologist appoints. And sometimes the patient independently makes the decision to pass a brain tomography for some reason. X-ray of a skull is not informative concerning hypophysis microadenomas.

Symptoms of microadenoma of a hypophysis depend only on its hormonal activity. Microadenoma does not squeeze surrounding fabrics therefore disturbances of fields of vision and a headache usually do not happen. As it was specified earlier, 25% of all new growths of a hypophysis have no hormonal activity. Microadenomas are even more often not cosecreting. In this case the new growth does not cause any complaints and is not the reason of the request for medical care.

Gormonalnoaktivny microadenomas most often are prolaktinoma. These tumors are eurysynusic among women. Prolactin suppresses an ovulation, stimulates a lactation, promotes a body weight increase. Usually women see a doctor with complaints to disturbance of a menstrual cycle and infertility. Less often at very high level of prolactin allocations from mammary glands (spontaneous are possible or when pressing). If the prolaktinoma arises at the man, then impotence and allocations from chest glands are possible. Excess of prolactin in blood is shown by increase in body weight at a usual day regimen, food.

Somatotropinoma develop a growth hormone. Such microadenomas are shown at adults and children on a miscellaneous. At children of a somatotropinoma are shown first of all by excess increase in length of a body. At adults of region of growth of bones are closed therefore increase in length of a body is impossible. Surplus of a growth hormone causes an acromegalia. Clinically the disease is shown by increase in brushes and feet, thickness of fingers, growth of superciliary arches, a posterization of features. The voice becomes lower. The acromegalia causes a secondary diabetes mellitus, arterial hypertension, increases risk of an oncopathology.

Kortikotropinoma produce adrenocorticotropic hormone. This hormone stimulates development of cortisol in adrenal glands. At patients Itsenko-Cushing's disease develops. First of all appearance of the patient changes. Extremities become thinner at the expense of an atrophy of muscles and redistribution of fatty tissue, the excess hypodermic fatty tissue is postponed preferential in a stomach. On skin of a front abdominal wall bright extensions more than 1 cm in thickness (striya) appear. The person becomes crescent-shaped, at cheeks there is always a flush. At patients the secondary diabetes mellitus and arterial hypertension develops. Often changes of mental reactions and behavior meet.

Hypophysis microadenoma reasons

Several factors can become the reason of microadenoma of a hypophysis at once. In this area genetic predisposition, a female is the cornerstone of formation of tumors, functional overloads of a hypophysis also have values. It is possible to refer pregnancies, childbirth, abortions, breastfeeding, hormonal contraception to such overloads. Except the listed factors, infectious process in the central nervous system, craniocereberal injuries can become the reason of microadenoma of a hypophysis.

Treatment of microadenoma of a hypophysis

Treatment of microadenoma of a hypophysis depends on its hormonal activity. If education does not emit hormones, then observation has to be the only tactics in its relation.

Prolaktinoma successfully treat conservatively. The endocrinologist appoints каберголин or бромкрептин to long term under control of a monthly hormonal research and a regular magnetic and resonant tomography. Often prolaktinoma decrease in sizes and within 2 years lose hormonal activity. In case of lack of effect of conservative therapy, the patient goes for operation. Radiation therapy is used seldom.

Surgical treatment is the basic for corticotropin and Somatotropinum. Radiation therapy of these new growths is sometimes carried out. There are drugs for suppression of activity of these microadenomas of a hypophysis. Somatotropinoma decrease in sizes and lose activity at use of artificial analogs of somatostatin (Lanreotid and Oktreotid). Kortikotropinoma react to a course of treatment hloditany (inhibitor of biosynthesis of hormones in bark of adrenal glands) in a combination with purpose of Reserpinum, Parlodelum, dipheninum, Peritolum. More often drugs use for preparation for radical treatment and in the postoperative period. In case of impossibility of surgical treatment and radiation therapy, only conservative treatment is applied.