Although pituitary cancer is extremely rare, pituitary adenomas are quite common. Discovery with Dr Caroline Apra, neurosurgeon at Pitié-Salpêtrière.
The pituitary gland is a small gland located at the base of the brain which controls the production of hormones such as prolactin, growth hormone, thyroid, oxytocin, sex hormones and even the adrenal glands. A tumor can develop there. This is most often benign tumor called “adenoma”, much more rarely (less than 100 cases per year in France) of a malignant tumor or “cancer”. “Pituitary cancer as such is extremely rare. We can almost say that it doesn’t exist. On the other hand, there are benign tumors of the pituitary glandcalled pituitary adenomas. They are very common and non-cancerous. Most of the time, they evolve slowly and are discovered by chance, during an MRI performed in another context”, says Dr Caroline Apra.
Pituitary adenomas can cause symptoms even if this is not at all systematic:
- Of the hormonal problems, since the pituitary gland is a hormonal gland, such as fatigue, weight gain, painful chest, amenorrhea, fatigue. In men, pituitary adenoma can cause impotence.
- Of the headachedizziness, trouble sleeping, nausea, intense thirst and frequent urge to urinate.
- Of the visual disturbances when the pituitary adenoma is very large: blurred vision, loss of peripheral vision or even blindness when the tumor compresses the optic nerve and if there is no operation.
“The causes of the development of pituitary adenomas are not known, except in very rare genetic diseases,” explains the neurosurgeon.
The diagnosis is generally made incidentally, when the subject has an MRI for another reason (trauma, migraines, dizziness for example). We then discover the presence of a small lump at the level of the pituitary gland. “Among the benign tumors located around the pituitary gland, but more dangerous, there are craniopharyngiomas. Extremely rare, they are not cancerous but can grow more quickly than pituitary adenomas and damage the brain. This therefore requires surgical consultation urgently. On MRI, if we see that the tumor is atypical, we will potentially carry out other examinations and suggest surgery, at least to do a biopsy and determine the type of tumor. If we are sure that it is an adenoma, we will only make sure that there is no associated hormonal or visual problem”comments Dr Caroline Apra.
“When pituitary adenoma is discovered by chance, there is nothing to do, it cannot be treated and it is not serious. In the event of symptoms suggestive of hormonal problems, consultation and follow-up by an endocrinologist are recommended. explains the neurosurgeon. When there are visual symptoms, it means that the optic nerve is affected. Neurosurgical intervention is then indicated to remove the pituitary adenomas.
THE Primary pituitary cancer is extremely rare. It also happens, rarely, that the patient has another cancer and that a metastasis has developed in the pituitary gland. “In that case, the prognosis will depend on the other cancer in question. As for pituitary adenoma, the only two dangers are hormonal and visual. At the hormonal level, the endocrinologist can give treatments to compensate for the effects of the adenoma., specifies Dr Caroline Apra. At the visual level, if there is no surgical intervention, the risk is blindness (loss of vision) because the adenoma presses on the optic nerves. However, this only happens after many years.
Thanks to Dr Caroline Apra, neurosurgeon at Pitié-Salpêtrière.