Pituitary adenomas are often discovered incidentally during a brain imaging scan (CT or MRI) performed for another reason. When they cause clinical signs, they can lead to 3 main types of symptoms depending on their secretory nature and size.
1. Symptoms related to excessive hormone secretion
These symptoms occur only if the adenoma is secreting.
- Cushing's Disease — secondary to ACTH hypersecretion by the corticotropic adenoma, stimulating adrenal cortisol production.
- Acromegaly — secondary to growth hormone hypersecretion by the somatotropic adenoma.
- Prolactin Hypersecretion — lactotropic adenoma or prolactinoma.
- Central Hyperthyroidism — secondary to TSH hypersecretion by the thyrotropic adenoma. A very rare situation.
Cushing's Disease
Facio-truncal weight gain, rounded and red face, buffalo hump, hirsutism, stretch marks, skin fragility, muscle fatigue, high blood pressure, diabetes. Sometimes irritability and psychiatric disorders.Acromegaly
Thickening of the face and extremities, prognathism, dental spacing, excessive sweating, snoring, sleep apnea, joint pain, carpal tunnel syndrome, high blood pressure, diabetes.Prolactinoma
Absence of menstruation (amenorrhea), milky discharge (galactorrhea), sexual dysfunction, and decreased libido.Central Hyperthyroidism
Classic signs of hyperthyroidism. A very rare situation linked to thyrotropic adenoma.2. Symptoms related to compression of surrounding structures
These symptoms can be observed in all types of adenomas, provided they are sufficiently large.
- Visual disturbances — compression of the optic chiasm: reduction of the visual field, decreased visual acuity.
- Headaches
- Double vision (diplopia) — compression of the oculomotor nerves in the cavernous sinus. Often indicates necrosis or bleeding within the tumor.
- Drooping eyelid (ptosis)
3. Symptoms related to compression of the healthy pituitary gland
This compression can lead to insufficient secretion of hormones normally produced by the pituitary gland (hypopituitarism), resulting in fatigue, pallor, sexual dysfunction, and thin skin.
- Cortisol deficiency (adrenocorticotropic insufficiency) — the most dangerous, associated with a vital risk. Leads to asthenia, low blood pressure, and digestive disorders in case of decompensation.
- Thyroid hormone deficiency (thyrotropic insufficiency) — pallor, weight gain, constipation, mood disorders (depression).
- Sex hormone deficiency (gonadotropic insufficiency) — absence of puberty, amenorrhea, decreased libido, impotence, infertility.
- Growth hormone deficiency (somatotropic insufficiency) — growth retardation in children.
Given these symptoms, a hormonal assessment will be performed first. When suspicion is confirmed, the reference examination is pituitary MRI.
Guide
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