Pituitary Adenomas and Tumors
A pituitary adenoma is a rare, noncancerous tumor of the pituitary gland. This small gland is located at the base of the brain and plays a crucial role in regulating the body’s hormonal balance. Adenomas account for about 15% of all brain tumors. This condition can develop at any stage of life but is most commonly diagnosed between ages 35 and 45.
The pituitary gland is located in the sella turcica, at the base of the brain. This is a depression in the central part of the middle cranial fossa. Adenomas are neoplasms that originate from the cells of the pituitary gland. The optic nerves run in close proximity to the hypothalamus, the controlling neuroendocrine organ. If a pituitary tumor causes symptoms, it is usually due to compression of neighboring brain structures.
Types of Pituitary Adenomas
The pituitary gland produces hormones through various glandular cells that regulate metabolism, reproductive function, and growth. Pituitary adenomas can originate from any glandular tissue type in the pituitary gland and may lead to an increased production of the corresponding hormone.
- In 60% of cases, we are dealing with hormonally active pituitary tumors.
- In 30% of cases, there is increased prolactin secretion. This type of tumor is called a prolactinoma.
- Less frequently, about 20% of cases involve tumors that cause increased growth hormone production.
- In approximately 5% of patients, there is excessive adrenocorticotropic hormone (ACTH) secretion.
- Very rarely, a pituitary adenoma affects thyroid and sex hormone production.
Along with hormone-active tumors, there are tumors that do not affect hormone production. Hormone-inactive pituitary adenomas occur in 40% of patients.
Symptoms of a Pituitary Adenoma
The first symptoms of a pituitary adenoma usually appear years after the tumor develops. This is due to the tumor’s slow growth. Although an adenoma is benign, it can lead to serious complications.
When the optic nerves are compressed, vision worsens. In the early stages, peripheral vision becomes blurred. Some patients experience double or blurred vision.
If tumor cells secrete hormones uncontrollably, severe endocrine disorders such as Cushing’s disease, acromegaly, or gigantism can result.
Treatment of Pituitary Adenoma
If the tumor does not cause any symptoms, it is recommended that its growth be monitored. To do this, MRI scans are performed at regular intervals. If the tumor grows, a treatment method will be decided upon.
How is a pituitary adenoma treated?
Removal of a pituitary tumor through the nose
Surgery is the primary treatment for a pituitary adenoma. Modern surgical methods include minimally invasive procedures, such as transnasal removal of a pituitary adenoma, in which the tumor is removed through the nasal sinuses. This is possible because the pituitary gland is located at approximately the level of the bridge of the nose. During the procedure, the surgeon uses an endoscope or an operating microscope. Removing a pituitary tumor through the nose has several advantages over the transcranial approach. With transnasal removal, the risk of damaging adjacent brain tissue is minimal.
Ninety percent of pituitary tumors are removed through the nasal passages.
The smaller the tumor, the easier it is to remove. For tumors smaller than one centimeter (microadenomas), there is an 80% chance of a full recovery. The probability of complete removal for tumors larger than one centimeter (macroadenomas) is 45%. After surgery, radiation and/or drug therapy are prescribed to destroy any remaining tumor tissue.
Transcranial Removal of Pituitary Adenomas
Some large pituitary adenomas that extend deep into the skull and brain are removed by opening the skull, a procedure known as transcranial surgery.
Other types of tumors located above the pituitary gland and in the pituitary stalk region can also be removed via transcranial access. These include craniopharyngiomas and meningiomas, for example.
Where is pituitary adenoma treatment performed in Germany?
Endoscopic removal of pituitary tumors requires the coordinated efforts of an experienced neurosurgeon and a team of qualified specialists, including intensivists, neuroradiologists, pathologists, neuro-ophthalmologists, and neurologists. Additionally, a full set of specialized equipment is required for transnasal surgeries. Therefore, it is recommended that pituitary adenoma treatment be conducted at specialized neurosurgical centers.
One such center is the Duisburg Neurosurgery Clinic, led by Professor Martin Scholz. Effective collaboration among the clinic’s physicians ensures that patients receive qualified medical care during hospitalization and the postoperative period.
The University Hospital of Tübingen successfully performs microsurgical and endoscopic removal of pituitary adenomas. Here, microsurgical techniques are preferred.
At the Charité University Hospital, Professor Peter Vajkoczy, the head of the neurosurgery clinic, performs the removal of pituitary adenomas.
How much does surgery to remove a pituitary adenoma cost?
The cost depends on the extent of the procedure and the technique used. On average, the surgery costs 22,000 euros.
For questions regarding arranging treatment at certified neurosurgery clinics in Germany, please contact our consultants at the phone numbers listed on the website or fill out the online application form.
