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Pituitary tumor
Symptoms of Pituitary Tumors
For patients with pituitary tumors, they often present with headaches, typically located behind the eye sockets, forehead, and both temporal areas. In the early stages of the disease, the nature of the headache is relatively mild and intermittent, mostly due to direct stimulation by the tumor or due to increased intrasellar pressure causing compression of the pituitary dural sac and the diaphragm sellae. When the tumor breaks through the diaphragm sellae, the intrasellar pressure gradually decreases, and the pain may gradually lessen or disappear. In the later stages of the disease, headaches may occur due to the tumor spreading to the parasellar region, invading the dura and vessels at the skull base, and compressing the trigeminal nerve, causing severe pain. In rare cases, due to a large pituitary adenoma growing upward into the third ventricle, breaking through and causing obstruction of the foramen of Monroe or the cerebral aqueduct, progressive intracranial pressure increases.
How is pituitary tumor surgery performed?
Currently, there are generally two surgical methods for pituitary tumors. One is the transnasal transsphenoidal endoscopic pituitary tumor resection. The other is the craniotomy microsurgery pituitary tumor resection. If the main body of the tumor is located within the sella or even within the sphenoid sinus, it is suitable for transnasal transsphenoidal pituitary tumor resection. If the main body of the tumor is located above the sella, it is suitable for craniotomy microsurgery pituitary tumor resection. Of course, some adjustments should also be made according to the patient's age, physical condition, etc.
How long is the leave for pituitary tumor surgery?
The duration of leave needed after pituitary tumor surgery must be judged based on individual circumstances, as everyone's condition is different. Generally, if the tumor removal uses a minimally invasive method, entering through the nose, then under normal circumstances, if the surgery goes well without any complications or sequelae, the patient often only needs to take one to two weeks off, and can usually return to work or studies afterwards. However, in some cases where open craniotomy is used for the tumor removal and the surgery encounters problems, postoperative complications or sequelae may occur, and the leave required can be around one to two months. If the condition is more critical, the leave period may be extended even further. Therefore, the decision must be based on the specific condition at the time, with most cases likely requiring around one month off.
How long does pituitary tumor surgery take?
Generally, for patients with pituitary tumors, it is usually recommended to choose endonasal transsphenoidal minimally invasive surgery to completely remove the pituitary tumor. If no unexpected circumstances occur during the surgery, the process typically takes about two hours, though this can vary depending on the size of the tumor and how smoothly the surgery proceeds. Patients are given general anesthesia before the surgery, which involves inducing anesthesia and ensuring it is administered successfully. After the surgery, patients are moved to a recovery room to recuperate for a period of time. Once the patient gradually regains consciousness, the tracheal tube is removed, and they are returned to their hospital room. Therefore, the total time involved is approximately three to four hours.
Pituitary tumor complications
For patients with pituitary tumors, it is common to see certain complications, especially post-surgery, such as hematoma in the sellar region, life-threatening nasal hemorrhage, pseudoaneurysm rupture bleeding, cerebrospinal fluid rhinorrhea, meningitis, reduced pituitary function, diabetes insipidus, as well as associated issues with fluid, electrolyte imbalance, and acid-base imbalance. Some patients may also experience rare complications like eye muscle paralysis and nasal septum perforation. Therefore, for patients with pituitary tumors, it is crucial to closely monitor any changes in their condition after surgery. If any abnormalities are found, a prompt re-examination with a head CT should be conducted to observe changes and provide appropriate treatment.
How long should one rest after pituitary tumor surgery?
For patients who have undergone pituitary tumor surgery, it is recommended that they rest for at least about six months. During this initial post-operative period, patients should be placed in an intensive care unit to monitor vital signs, with a focus on consciousness, pupils, awareness, and limb activity, including blood pressure, heart rate, respiratory rate, and blood oxygen saturation. Once the patient's condition stabilizes, they can be transferred to a regular ward for continued treatment. Patients should not engage in early ambulation to prevent complications such as cerebrospinal fluid rhinorrhea. During the recovery period, rest should be prioritized, and strenuous physical activity should be avoided. At the same time, appropriate nutritional support should be strengthened. Generally, with about six months of rest, the body will gradually recover.
Which department should I go to for a pituitary tumor?
Pituitary tumors are a relatively common type of benign intracranial tumor. The main treatment method is surgical intervention, and patients usually see a neurosurgeon for this. The surgical approach can be minimally invasive, performed through the nasal cavity, and typically, complete removal of the tumor is achievable with a generally good prognosis. However, there is a type of pituitary adenoma called prolactinoma, which is sensitive to bromocriptine. It can be treated with bromocriptine without surgery, leading to a significant reduction or even disappearance of the tumor. Nevertheless, medication should be guided by a neurosurgeon, and it is still necessary to visit the neurosurgery department.
How is a pituitary tumor caused?
At present, there is no definitive conclusion on how pituitary tumors are formed and further developed. Clinically, it is mostly believed to be the result of a combination of congenital genetic factors and adverse environmental factors acquired later in life. For patients with pituitary tumors, they are often seen in some special familial genetic diseases. In the family medical history, a tendency for a higher accumulation of family members can be observed. Additionally, some pituitary tumor patients are also found in clear familial genetic endocrine diseases. Moreover, patients who are overworked, fatigued, under stress, and experience endocrine hormone disorders are also affected. Exposure to radioactive contamination and chemical carcinogens can also potentially lead to pituitary tumors.
The difference between pituitary tumors and pituitary adenomas
The difference between a pituitary tumor and a pituitary adenoma mainly lies in the extent of the affected tissue involved. Generally, pituitary tumors may have a broader range than pituitary adenomas, meaning that pituitary tumors include pituitary adenomas. Normally, a pituitary adenoma specifically refers to tumors occurring in the anterior lobe of the pituitary gland, as this lobe primarily consists of glandular tissue. Meanwhile, the posterior lobe of the pituitary is mainly neurohypophysis. Therefore, tumors typically referred to as pituitary adenomas occur in the anterior lobe. If a tumor is in the posterior lobe, it cannot be called a pituitary adenoma, but it still falls under the category of pituitary tumors.
Are pituitary tumors prone to recurrence?
Pituitary tumors in the brain are benign tumors that grow slowly. When the tumor size is relatively small, there are generally no clear symptoms or signs, and most patients can work, live, and study like normal people. It is recommended to treat pituitary tumors with surgical methods. Most pituitary tumors are benign. If they can be completely removed through microscopic surgery, or through the transnasal transsphenoidal approach, minimally invasive surgery can achieve ideal treatment results and generally will not recur. However, for individual patients with pituitary tumors, if the tumor is malignant, it may easily adhere to surrounding tissues in the early stages, making it difficult to completely remove surgically, thus it is prone to recurrence.