Pituitary adenoma – what is the reason for late diagnosis? What methods can be used to cure or remove the formation?

Pituitary adenoma is a tumor (most often benign) of the glandular tissue of the pituitary gland, developing in the anterior and middle (intermediate) lobe - the adenohypophysis. It is localized in the area of ​​the sella turcica, located in the sphenoid bone at the base of the skull. The peak incidence occurs in the age range from 30 to 50 years. Due to the asymptomatic (most often) course in the early stages, detection is extremely low: per 100 thousand people - only 2 people. As it progresses, it manifests itself as endocrine, neurological and neuro-ophthalmological disorders. It makes up 1/6 of all brain tumors.

Reasons for development

The exact reasons for the formation of pituitary adenoma have not yet been established in neurology. However, there are hypotheses that prove the appearance of a tumor due to infectious phenomena in the nervous system, traumatic brain injuries and the negative impact of various factors on the fetus. The most dangerous neuroinfections that can lead to tumor formation include neurosyphilis, tuberculosis, brucellosis, encephalitis, polio, brain abscess, meningitis, and cerebral malaria.

Currently, neuroscience research is being conducted to establish a connection between the formation of pituitary adenoma and women’s use of oral contraceptives. Scientists are also exploring a hypothesis that proves that a tumor may appear due to increased hypothalamic stimulation of the pituitary gland. This mechanism of tumor occurrence is often observed in patients with primary hypogonadism or hypothyroidism.

Surgery

The lack of results of conservative treatment leads to the appointment of surgery. The procedure for eliminating an adenoma is dangerous; the tumor is located close to the brain. Access to the tumor is difficult. The choice of the course of procedures remains with the neurosurgeon. Therapy is prescribed after a thorough examination of the patient and receipt of MRI results.

Recent medical developments offer minimally invasive and non-invasive options for the removal of pituitary adenomas. They involve minimal surgical intervention. The risk of injury and complications is reduced. This is typical for endoscopy, radiosurgery and the use of cyberknife. The clinic in Israel has a good reputation among specialists. This is a guarantee of the latest techniques and high-quality treatment.

Endoscopy is performed using the transnasal method. The surgeon passes a probe through the nasal sinus. The process of tumor elimination is reflected on the monitor. The procedure does not require cutting or opening the skull.

The probability of an effective result is 90%. An increase in the size of the adenoma decreases the percentage. Large tumors cannot be removed using this method. The method is effective for sizes up to 3 cm.

Classification

Pituitary adenomas are classified into hormonally active (produce pituitary hormones) and hormonally inactive (do not produce hormones).

Depending on which hormone is produced in excess, hormonally active pituitary adenomas are divided into:

• prolactinomas (prolactinomas) – develop from prolactotrophs and are manifested by increased production of prolactin;
• gonadotropic (gonadotropinomas) – develop from gonadotrophs, manifested by increased production of luteinizing and follicle-stimulating hormones;
• somatotropic (somatotropinomas) – develop from somatotrophs, manifested by increased production of somatotropin;
• corticotropic (corticotropinomas) – develop from corticotrophs, manifested by increased production of adrenocorticotropic hormone;
• thyroid-stimulating (thyrotropinomas) – develop from thyrotrophs and are manifested by increased production of thyroid-stimulating hormone.

If a hormonally active pituitary adenoma secretes two or more hormones, it is classified as mixed.

Hormonally inactive pituitary adenomas are divided into oncocytomas and chromophobe adenomas.

Depending on size:

• picoadenoma (diameter less than 3 mm);
• microadenoma (diameter no more than 10 mm);
• macroadenoma (diameter more than 10 mm);
• giant adenoma (40 mm or more).

Depending on the direction of growth (relative to the sella turcica), pituitary adenomas can be:

• endosellar (growth of a neoplasm in the cavity of the sella turcica);
• infrasellar (distribution of the neoplasm below, reaching the sphenoid sinus);
• suprasellar (tumor spreads upward);
• retrosellar (growth of the tumor posteriorly);
• lateral (spread of the tumor to the sides);
• antesellar (tumor growth anterior).

When a tumor spreads in several directions, it is named according to the directions in which the tumor grows.

Causes of pituitary microadenoma

The causes of pituitary microadenoma have not been clearly revealed; research is ongoing, but the most likely factors leading to increased proliferation of organ cells are:

• Dysregulation of the functioning of the pituitary gland by the hypothalamus;
• A decrease in the hormonal function of the peripheral glands, which has a stimulating effect on the pituitary gland, resulting in compensatory hyperplasia of its cells and subsequent growth of microadenoma;
• Genetic predisposition;
• Female gender and the associated increased load on the organ (pregnancy, childbirth, frequent abortions, uncontrolled and long-term use of hormonal contraceptives);
• Damages of the central nervous system due to infections and injuries.

Depending on the structure, the tumor can be homogeneous or cystic microadenoma. The latter is a consequence of small hemorrhages into the neoplasm tissue, which should be considered solely as a sign of degenerative changes that do not affect the course of the disease and prognosis.

Symptoms

Signs that a pituitary adenoma may present vary depending on the type of tumor.

A hormonally active microadenoma manifests itself as endocrine disorders, while an inactive microadenoma can exist for several years until it reaches a significant size or is accidentally detected during examination for other diseases. 12% of people have asymptomatic microadenomas.

Macroadenoma is manifested not only by endocrine, but also by neurological disorders caused by compression of surrounding nerves and tissues.

Prolactinoma

The most common pituitary tumor occurs in 30-40% of all adenomas. As a rule, the size of prolactinoma does not exceed 2–3 mm. It occurs more often in women than in men. Manifested by such signs as:

• menstrual irregularities in women - irregular cycles, prolongation of the cycle for more than 40 days, anovulatory cycles, absence of menstruation
• galactorrhea - constant or periodic release of breast milk (colostrum) from the mammary glands, not associated with the postpartum period
• inability to get pregnant due to lack of ovulation
• In men, prolactinoma is manifested by decreased potency, enlarged mammary glands, erectile dysfunction, and impaired sperm formation, leading to infertility.

Somatotropinoma

Accounts for 20–25% of the total number of pituitary adenomas. In children, it ranks third in frequency of occurrence after prolactinoma and corticotropinoma. Characterized by increased levels of growth hormone in the blood. Signs of somatotropinoma:

• in children it manifests itself with symptoms of gigantism. The child quickly gains weight and height, which is due to the uniform growth of bones in length and width, as well as the growth of cartilage and soft tissue. Typically, gigantism begins in the prepubertal period, some time before the onset of puberty, and can progress until the end of skeletal formation (up to about 25 years of age). Gigantism is considered to be an increase in the height of an adult by more than 2 – 2.05 m.
• if somatotropinoma occurs in adulthood, it is manifested by symptoms of acromegaly - enlargement of the hands, feet, ears, nose, tongue, changes and coarsening of facial features, the appearance of increased hair growth, beards and mustaches in women, menstrual irregularities. Enlargement of internal organs leads to disruption of their functions.

Corticotropinoma

Occurs in 7 - 10% of cases of pituitary adenoma. Characterized by excess production of adrenal hormones (glucocorticoids), this is called Itsenko-Cushing disease.

Signs of corticotropinoma:

• “Cushingoid” type of obesity – there is a redistribution of the fat layer and fat deposition in the shoulder girdle, on the neck, in the supraclavicular areas. The face takes on a “moon-shaped”, round shape. The limbs become thinner due to atrophic processes in the subcutaneous tissue and muscles.
• skin disorders - pink-purple stretch marks (striae) on the skin of the abdomen, chest, thighs; increased pigmentation of the skin of the elbows, knees, armpits; increased dryness and flaking of facial skin
• arterial hypertension
• Women may have menstrual irregularities and hirsutism - increased skin hair growth, beard and mustache growth
• Men often experience a decrease in potency

Gonadotropinoma

Rarely found among pituitary adenomas. It manifests itself as menstrual irregularities, more often the absence of menstruation, decreased reproductive function in men and women, against the background of reduced or absent external and internal genital organs.

Thyrotropinoma

It is also very rare, occurring in only 2–3% of pituitary adenomas. Its manifestations depend on whether the tumor is primary or secondary.

• Primary thyretropinoma is characterized by symptoms of hyperthyroidism - weight loss, trembling of the limbs and the whole body, bulging eyes, poor sleep, increased appetite, increased sweating, high blood pressure, tachycardia.
• For secondary thyrotropinoma, that is, arising from long-term decreased function of the thyroid gland, hypothyroidism is characteristic - swelling on the face, slow speech, weight gain, constipation, bradycardia, dry, flaky skin, hoarse voice, depression.

Neurological manifestations of pituitary adenoma

• visual impairment - double vision, strabismus, decreased visual acuity in one or both eyes, limited visual fields. Significant sizes of adenoma can lead to complete atrophy of the optic nerve and blindness
• headache that is not accompanied by nausea, does not change with changes in body position, and is often not relieved by taking painkillers
• nasal congestion caused by germination of the sella turcica into the bottom

Symptoms of pituitary insufficiency

Pituitary insufficiency may develop due to compression of normal pituitary tissue. Symptoms:

• hypothyroidism
• adrenal insufficiency – increased fatigue, low blood pressure, fainting, irritability, muscle and joint pain, impaired electrolyte metabolism (sodium and potassium), low blood glucose levels
• decreased levels of sex hormones (estrogens in women and testosterone in men) – infertility, decreased libido and impotence, decreased facial hair in men
• in children, lack of growth hormone leads to slow growth and development

Psychiatric symptoms

These symptoms of pituitary adenoma are caused by changes in hormonal levels in the body. Irritability, emotional instability, tearfulness, depression, aggressiveness, and apathy may be observed.

Special cases

Age characteristics

It is most often diagnosed in adults aged 30 to 50 years. The risk group primarily includes people with antisocial behavior who lead an overly “active” but incorrect lifestyle. Participation in fights often leads to TBI. Communicating with sick people living on the street increases the risk of dangerous infections. Poor nutrition, unsanitary conditions - all these factors indirectly cause the development of pituitary adenoma.

It is extremely rare in children. In most cases, it is explained by pregnancy pathologies, when the intrauterine formation of the baby’s brain and central nervous system was accompanied by the woman’s smoking or taking drugs. The second reason for such a diagnosis in newborns is complicated childbirth, when brain damage occurs.

Gender characteristics

It occurs with equal frequency in women and men.

Recently, doctors have increasingly associated pituitary adenoma in women with taking oral contraceptives on an ongoing basis. In this case, the most common symptoms are male body hair and various menstrual irregularities.

In men, the most common cause is traumatic brain injury. Pronounced symptoms include female pattern obesity, breast swelling and impotence.

During pregnancy

Pregnancy complicated by an adenoma is quite dangerous. During this period, the pituitary gland already increases in size by almost 2 times. In the presence of a tumor, this leads to compression of areas of the brain located nearby. The consequences are severe headaches and blindness. If it is prolactinoma, it can cause contractions at any time, which can cause miscarriage or premature birth.

Diagnostics

Despite such a variety of clinical manifestations, we can say that diagnosing a pituitary adenoma is a rather difficult undertaking.

This is primarily due to the non-specificity of many complaints. In addition, the symptoms of pituitary adenoma force patients to consult various specialists (ophthalmologist, gynecologist, therapist, pediatrician, urologist, sex therapist and even psychiatrist). And not always a specialist can suspect this disease. That is why patients with such nonspecific and versatile complaints should be examined by several specialists. In addition, a blood test for hormone levels helps diagnose pituitary adenoma. A decrease or increase in a number of them in combination with existing complaints helps the doctor determine the diagnosis.

Previously, radiography of the sella turcica was widely used in the diagnosis of pituitary adenoma. The identified osteoporosis and destruction of the back of the sella turcica, the double contour of its bottom served and serve to this day as reliable signs of adenoma. However, these are already late symptoms of pituitary adenoma, that is, they appear after a significant period of existence of the adenoma.

A modern, more accurate and earlier method of instrumental diagnosis, compared to radiography, is magnetic resonance imaging of the brain. This method allows you to see the adenoma, and the more powerful the device, the higher its diagnostic capabilities. Some pituitary microadenomas, due to their small size, may remain unrecognized even with magnetic resonance imaging. It is especially difficult to diagnose non-hormonal slowly growing microadenomas, which may not show any symptoms at all.

What triggers development

Despite the high level of development of medicine in the world, doctors still cannot say for sure what activates the pathogenesis of such a neoplasm, but a number of reasons that provoke it have already been precisely established:

1. A failure in the central nervous system, most often caused by an infection.
2. Damage to a child during pregnancy by toxins, medications, and ion radiation.
3. Mechanical injury to brain cells.
4. Brain hemorrhage.
5. A long-term inflammatory or autoimmune disease in which the thyroid gland cannot function normally.
6. Long-term use of contraceptives without medical supervision.
7. Problems in the formation of the testicles or ovaries, which led to their underdevelopment.
8. The genitals have been damaged by radiation or an autoimmune process in the body.
9. Transmission of the disease at the genetic level.

The last point causes heated debate among doctors, because many do not agree with this. Even a series of studies launched by private laboratories did not convince them. But even those doctors who claim the opposite agree that treatment and detection of brain adenoma must be timely in order for it to be successful, otherwise the consequences of the disease may be irreversible.

Treatment of pituitary adenoma

To treat adenoma, various techniques are used, the choice of which depends on the size of the tumor and the nature of hormonal activity. Today the following approaches are used:

1. Observation. For pituitary tumors that are small and hormonally inactive, doctors choose a wait-and-see approach. If the formation increases, then appropriate treatment is prescribed. If the adenoma does not affect the patient’s condition, then observation continues.
2. Drug therapy. Prescribing medications to a patient with a pituitary tumor is indicated to eliminate the symptoms of the disease and improve health. For this purpose, the doctor prescribes general health-improving drugs and vitamin complexes. Conservative treatment is indicated for small tumors. The selection of medications also depends on the type of tumor. For somatotropinomas, somatostatin agonists (somatulin and sandostatin) are prescribed, for prolactinomas - dopamine agonists and ergoline drugs, for corticotropinoma - steroidogenesis blockers (nizoral, mammomit, orimethene).
3. Radiosurgical treatment. This is a modern and highly effective method of radiation therapy, based on the destruction of the tumor by radiation, without surgical manipulation.
4. Operation. Surgical removal of a pituitary adenoma is the most effective, but at the same time traumatic method of therapy. Specialists have two access options: through the nasal passages and by opening the cranial cavity. The first approach is more preferable, but is used only for small adenomas.

Often, for the treatment of pituitary adenoma, it is necessary to combine several of these techniques to achieve the desired result.

Conservative treatment

The use of medications is effective in the initial stages when microadenoma is present. After surgery, it may resolve on its own. Cancer cells can disappear. Before prescribing medications, the doctor thoroughly examines the patient. In some cases, conservative treatment will not show the expected result. The only way to eliminate an adenoma is surgery or radiation therapy.

Taking medications is justified in the absence of visual impairment. It is carried out before surgery to maintain the positive condition of patients with large tumors. Prolactin therapy shows good results. The hormone prolactin is produced in excess.

You can do without surgery using dopaminomimetics. Effective remedies: Parlodel and Cabergoline. The development of cabergoline made it possible to reduce the secretion of prolactin and reduce the size of the adenoma. The product stabilizes the functioning of the genital organs and sperm count in men. Conservative treatment will not have a negative effect on pregnancy.

The formation of somatotropic tumors requires the use of somatostatin analogues. Treatment of thyrotoxicosis is carried out with thyreostatics. A pituitary adenoma of the brain provokes the development of Itsenko-Cushing's disease (a basophilic type of growth). Drugs from the aminoglutethimide group are effective against it.

Forecast for life

Pituitary adenoma is a benign neoplasm, but as its size increases, it, like other brain tumors, takes on a malignant course due to compression of the anatomical formations surrounding it. The size of the tumor also determines the possibility of its complete removal. A pituitary adenoma with a diameter of more than 2 cm is associated with the likelihood of postoperative relapse, which can occur within 5 years after removal.

The prognosis of adenoma also depends on its type. Thus, with microcorticotropinomas, 85% of patients experience complete restoration of endocrine function after surgical treatment. In patients with somatotropinoma and prolactinoma, this figure is much lower - 20-25%. According to some data, on average, after surgical treatment, recovery is observed in 67% of patients, and the number of relapses is about 12%.

In some cases, when hemorrhage into the adenoma occurs, self-healing occurs, which is most often observed with prolactinomas.
Prostate adenoma - what is it? Symptoms and treatment Acromegaly Prolactinoma of the pituitary gland Prevention of prostate adenoma Itsenko-Cushing disease Amenorrhea

Consequences and prevention

The prognosis is often positive: mortality from this disease is low. The tumor rarely becomes malignant. After surgery, complete recovery is observed in 67% of cases.

In 12% of situations, the pathology recurs. Life expectancy with a brain tumor with timely initiation of therapy differs little from that observed in healthy people.

Undesirable consequences are possible in the absence of treatment: hormonal imbalances lead to infertility, the functioning of internal organs is disrupted, general well-being worsens, compression of brain tissue can cause various neurological abnormalities and severe pain.

There are no specific methods of prevention.

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Many features of the hormones produced by the pituitary gland are not fully understood. The pituitary gland, and indeed the entire endocrine system, is so unique and complex that it still raises a lot of questions among specialists. But still, some hormones produced by the pituitary gland are, to a greater or lesser extent, known to us. Let's look at them:

1. Thyroid-stimulating hormone – regulates the functioning of the thyroid gland;
2. Adrenocorticotropic – responsible for the endocrine function of the adrenal glands;
3. Follicle-stimulating hormone is a hormone that is responsible for the maturation of follicles in women, and therefore the ability to bear children;
4. Luteinizing hormone - ensures the proper functioning of both male and female gonads. The production of the female hormone progesterone and the male hormone testosterone is also dependent on luteinizing hormone;
5. Somatotropic – also called growth hormone;
6. Prolactin is the main function of breast milk production. But besides this, this hormone has a number of other functions, such as the formation of secondary reproductive organs, suppression of ovulation during breastfeeding, etc.;
7. Oxytocin is a hormone responsible for stimulating the muscles of the uterus during labor.

This list of functions of the pituitary gland is not final, but one thing is clear - the role of the pituitary gland is great and any deviation in its work leads to bad consequences for human health.

One of such deviations is a disease such as pituitary microadenoma.

Dangerous consequences

If pathology is identified, there is a chance of avoiding complications. The disease cannot be ignored, since microadenoma of the pituitary gland of the head tends to increase in size. As it grows, major changes occur in hormonal activity. Large tumors put pressure on surrounding tissues, negatively affecting the processes occurring in the central nervous system.

Hormonally active tumors can provoke irreversible processes. Excessive production of hormones causes diabetes and cardiovascular disorders. The seal poses a threat not only to the health, but also to the life of the patient if left untreated.

Over time, vision becomes impaired and brain tissue may be damaged. In addition, the pathology causes infertility due to hormonal imbalance.

How is it diagnosed?

This type of adenoma is difficult to identify unless it belongs to the hormonally active variety. In this case, there are no symptoms; the small size of the thickening will not allow it to be diagnosed during a routine examination. If the patient suspects that he has a benign tumor, he consults a doctor for a diagnosis.

Based on complaints, the doctor will prescribe the following types of examinations:

Magnetic resonance imaging.

• Magnetic resonance or computed tomography are the most effective diagnostic methods. They allow you to get the full picture. The pituitary gland is visualized and any changes that occur in its parts are noted. During the study, the dimensions of the capsule are specified. Ultrasound and x-ray are ineffective in the case of microadenoma;
• biochemical examination of blood and urine. The level of hormones is determined, their deficiency or excess is monitored. The advantage of the analysis is that it allows you to identify disorders at an early stage of tumor development;
• undergo an examination by an ophthalmologist to determine visual impairment.

Causes and provoking factors

The reasons why pituitary microadenomas develop remain unknown, but some provoking factors can be identified that increase the likelihood of pathology occurring. They can be divided into external and internal factors.

External factors:

• skull or brain injuries;
• infectious brain damage;
• disorders during embryogenesis caused by the effect on the fetus of medicinal, toxic substances, ionizing radiation; they are important for congenital microadenomas;
• a woman's prolonged use of combined oral contraceptives over many menstrual cycles reduces the production of ovarian hormones, in response to this the pituitary gland produces more luteinizing and follicle-stimulating hormones, and a microadenoma of the corresponding area of ​​the pituitary gland may occur;
• In women, the likelihood of developing a tumor increases with many pregnancies and abortions

Internal factors:

• decreased thyroid function due to long-term diseases;
• disruption of the adrenal glands;
• decreased production of hormones of the reproductive system;
• with multiple adenomatosis syndrome, which is a hereditary disease, tumors of other glands are observed, the likelihood of developing pituitary microadenoma is higher

The pituitary gland reacts to insufficient production of hormones by increasing its work - it is necessary to normalize the hormonal balance.

Pregnancy

Pituitary microadenoma and pregnancy can be compatible only during hormonally inactive microadenoma. In order for the pregnancy to be successful, a woman with an inactive adenoma must monitor the level of hormones in the body throughout the nine months, and also periodically undergo magnetic resonance imaging. This diagnostic method allows you to detect in time if the adenoma begins to grow.

It is better for women with hormonally active adenoma not to plan a pregnancy, and if it occurs, to have an abortion, since pregnancy often provokes accelerated growth of the tumor and can contribute to its malignancy.

You can become pregnant approximately one year after successful treatment. After therapy, a pregnant woman needs to monitor her hormonal levels every three months and consult an endocrinologist and an ophthalmologist. Lactation for adenoma of any type is on the list of contraindications.

What is microadenoma

Everyone, faced with a diagnosis, wants to know what a pituitary microadenoma is, what it is, what causes it, and why this cystic tumor in the head is dangerous. Pituitary gland microadenoma is a benign neoplasm in the brain. Microscopic tumors of the pituitary gland are up to one centimeter in size. If the size increases beyond this figure, we can talk about macroadenoma.

Such adenomas are common among women of reproductive age, which is associated with effects on the pituitary gland during pregnancy, childbirth and breastfeeding. During menopause, women may also experience this disease. Microadenoma is slightly less common in males and children. Children are susceptible to this pathology during puberty.

Most often, tumor cells do not contribute to the production or suppression of hormones, so there are no signs, but sometimes the formation of a tumor leads to a deficiency or excess of a hormone. That is why it is necessary to undergo examination by a doctor for any dysfunction of the endocrine system.

Pituitary

The pituitary gland, despite its small size, plays a huge role in the proper functioning of such a complex system - the human body. The pituitary gland is located in the brain, in the so-called fossa - the sella turcica. This anatomical feature allows you to protect the pituitary tissue from any external damage. The main function of the cerebral appendage is the secretion of hormones that regulate the function of certain organs of the endocrine system. The hormone is produced by the cells of the adenohypophysis (anterior part) and the neurohypophysis (posterior part).

Manifestations of the disease

Symptoms of pituitary microadenoma can be nonspecific and specific. The first group includes conditions caused by tissue compression:

• persistent headache on one or both sides;
• vision problems, in particular strabismus and diplopia;
• dizziness.

The second group includes signs that vary depending on the type of tumor.

Prolactinoma

Prolactinoma in women manifests itself in the following symptoms: menstrual irregularities, lack of ovulation, infertility, fluid discharge from the breasts, a decrease in the amount of female hormones, bone fragility, hair growth above the lip, on the back and in the abdomen, underdevelopment of female organs, obesity.

In men, prolactinoma can be diagnosed by the development of impotence, infertility, gynecomastia, and emotional instability.

Somatotropinoma

This microadenoma is characterized by enlargement of internal organs, parts of the face, feet and hands. When it appears, diabetes mellitus and deforming osteoarthritis develop, and blood pressure rises.

Prevention

At the moment, there are no specific measures to avoid the development of pituitary microadenoma. However, there is a set of measures, following which, you can significantly reduce the risk of pathology:

• if there are hormonal changes, they need to be corrected;
• If you have symptoms, consult a doctor immediately;
• promptly treat infectious diseases of the brain and follow measures to prevent them;
• If you have an established diagnosis, follow all doctor’s recommendations

It has been proven that with early detection and treatment of the disease at the initial stage of development, microadenoma can disappear on its own.

Prevention after treatment

After treatment of pituitary microadenoma, the prognosis is usually positive; the patient just needs to follow the doctor’s recommendations. Of course, there is a small risk of complications, but the vast majority of patients are successfully treated with proper diagnosis and professional treatment. Microadenomas usually do not cause serious damage to the body and are not prone to recurrence.

In a situation with large adenomas, residual symptoms are likely to appear, representing the consequences of a former tumor. They may indicate a relapse; if they occur, doctors should be consulted. Compensatory treatment may also be required.

Treatment of microadenoma

The disease can be cured. Especially if the tumor is small. Can it disappear on its own? No. She still needs to be treated. And treatment must be comprehensive.

When pituitary microadenoma appears, 3 types of therapy are performed:

1. medicinal (conservative);
2. surgical intervention;
3. radiosurgery.

Each of them has its own characteristics.

Drug therapy

The main purpose of using medications is to normalize hormonal levels. The doctor prescribes medications depending on the type of tumor. These can be dopamine agonists (prolactinoma), somatostatin analogs (for somatotropinoma), derivatives of ketoconazole and aminoglutethimide (Cushing's syndrome). To normalize the level of thyroid hormones, you need to take thyreostatics.

The dosage of medications and the duration of treatment are determined by the doctor. Self-medication is prohibited. Self-medication is dangerous to health.

Surgery

Surgery is indicated in cases where drug therapy is ineffective and the microadenoma increases in size.

The operation is performed through the nasal passage. Craniotomy is not needed here. Thanks to this, the procedure does not require a long recovery period and has virtually no complications. After 3 days the patient can go home.

Radiosurgical methods

Radiosurgery is a minimally invasive treatment method. The microadenoma is exposed to a beam of radioactive waves. The doctor monitors the process using CT or MRI.