USMLE/COMLEX - Step 2 - Pituitary Adenomas

USMLE/COMLEX - Step 2 - Pituitary Adenomas The exact pathophysiology of pituitary adenomas is not entirely elucidated. However, it is believed to be associated with genetic mutations and changes in signaling pathways that regulate cellular growth and differentiation. Certain pituitary adenomas may result from hereditary genetic mutations, such as mutations in MEN1 or PRKAR1A genes, while others may occur sporadically with no apparent genetic cause. Hormonal imbalances Neurological symptoms Headaches Vision problems Sexual dysfunction Fatigue Elevated levels of pituitary hormones Visual field defects Enlarged pituitary gland on imaging Neurological symptoms Hormone-related symptoms Blood tests to measure levels of pituitary hormones Magnetic resonance imaging Visual field testing Hormone stimulation or suppression tests Genetic testing The treatment of pituitary adenomas depends on several factors, including the size and location of the tumor, hormone secretion status, and the presence of symptoms. Treatment options may include: 1. Observation: Some small pituitary adenomas that are not causing symptoms may be monitored with regular imaging and hormone testing. 2. Medications: Medications such as dopamine agonists, somatostatin analogs, and cortisol-lowering drugs can manage hormonal imbalances associated with pituitary adenomas. 3. Surgery: Surgery may be recommended for larger tumors or those causing significant symptoms or hormone imbalances. Transsphenoidal surgery involves removing the tumor through the nose, a common approach for pituitary adenomas. 4. Radiation therapy: Radiation therapy may shrink the tumor or prevent regrowth in cases where surgery is not an option or has not been successful. 5. Combination therapy: A combination of surgery, radiation therapy, and medications may be used in some instances to manage pituitary adenomas.