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Enlarged Pituitary Gland

Abhijit Naik
Of the various health problems associated with the pituitary gland, the development of tumors is perhaps the most common. If the data compiled by the American Brain Tumor Association (ABTA) is to be believed, pituitary tumors account for 9 – 12 percent of all primary brain tumors.
The pituitary gland is an endocrine gland housed in a small bony cavity known as sella turcica at the base of the brain. The hormones secreted by this gland have a crucial role to play in various body functions, including growth, thyroid gland functioning, as well as the regulation of blood pressure and body temperature. Even the tropic hormone, which helps in stimulating other endocrine glands, is secreted by the pituitary gland.
Pituitary gland is one of the most important components of the endocrine system. It is also called the 'master gland' as it controls the functions of other endocrine glands. At times, however, this master gland itself encounters some functional problems. Such problems are usually reflected in form of signs, like enlargement of the gland and unusually high or low secretion of hormones.

What Causes the Pituitary Gland to Enlarge?

In most of the cases, enlarged pituitary gland is associated with the development of tumors, which are known as pituitary adenomas or pituitary tumors. These tumors are either classified on the basis of their size, i.e., microadenomas (measuring less than a cm) and macroadenomas (larger than 1 cm), or their ability to secrete hormones, i.e., functioning or secreting tumors and non-functioning or non-secreting tumors.
Pituitary gland can also enlarge as a result of internal bleeding into the gland, or in response to underlying ailments, like sarcoidosis, which results in the formation of granulomas in various parts of the body, or the Cushing's syndrome, which develops when the pituitary gland secretes adrenocorticotropic hormone (ACTH) in excess.
Slight enlargement of this gland is also associated with thyroid disorder at times. In fact, secondary hypothyroidism is primarily caused when the pituitary gland fails to release thyroid-stimulating hormone (TSH) or thyrotropin-releasing hormone (TRH).

Signs and Symptoms

Even though pituitary tumors are benign, i.e., they don't spread to the surrounding region, they can still pose some problems owing to their proximity to the brain. This is especially the case with macroadenomas, which press into the nerves and blood vessels in the surrounding region as they grow and end up damaging them. In fact, vision problems are relatively common in this case as the pituitary gland tends to press on the optic nerve passing above it as it enlarges. At times, it can even result in loss of vision.
Swelling of the pituitary gland caused as a result of pituitary adenoma may or may not affect hormone production. When it does affect the hormone production, it reflects in the form of obvious symptoms, like headache, lethargy, nausea, vomiting, double vision, drooping eyelids, problems with sense of smell, etc.
In most of cases though, overproduction or underproduction of a particular hormone affects the part of the body to which it caters. Though rare, the chances of posterior pituitary tumor cannot be ruled out; it usually surfaces in the form of symptoms, like excessive thirst, frequent urination, and weak urine stream.

How is the Condition Diagnosed?

Owing to the possible hazards of this condition, including the chances of permanent loss of vision, one has to opt for its treatment as soon as it is diagnosed. Basically, the condition can be diagnosed by imaging tests, like CT scan or MRI scan. The doctor may even recommend an eye test to detect pressure on the optic nerve, which is likely to be the case when it comes to pituitary tumors.
Additionally, the preliminary diagnostic process will also involve physical examination of the symptoms of this condition that we discussed above. The doctor will also take into account the complete medical history of the person to check for risk factors involved. A blood or urine test may also be recommended to measure the levels of hormones produced by the pituitary gland.

Treatment Options

Hormone replacement therapy is quite effective in the treatment of symptoms associated with pituitary disorders. Basically, these symptoms surface as a result of some underlying condition triggered by overproduction or underproduction of certain hormones. As such, it can be cured by correcting the hormonal imbalance and, thus, hormone replacement therapy. In case of prolactin-secreting tumors treatment, the doctor will prescribe medication that blocks the production of prolactin before recommending a surgery.
If it's a tumor, the person might have to undergo radiation therapy or surgery for the same. While radiation therapy will involve delivering doses of high-energy rays to abnormal cells, the surgical procedure will involve removal of tumor. If it is not possible to remove the tumor without leaving behind a part of the pituitary gland, which can be the case at times, then the patient will be prescribed medication to replace the hormones that are secreted by this gland.
It is but obvious that the pituitary gland is one of the most important components of our body, and any problem with it is bound to result in adverse effects on our health. Taking into account the role of this gland in various body functions, pituitary gland problems should not be taken lightly. Pituitary adenomas may not spread to the other parts of the body, but like we said earlier, they can press on the nerves in the surroundings and impair certain body functions.
Disclaimer: This story is purely for the purpose of providing information and should not be used as a substitute for medical advice.