Sushrut-Brain-Conditions

Pituitary Surgery

Pineocytomas

A kind of non-cancerous tumors especially seen in adults that derive from the pineal cells are called Pineocytomas. They are non-invasive, slow-growing and homogeneous. In most cases they develop at the center of the brain. It can be removed successfully with the help of microsurgical techniques.

Pituitary Adenoma

They are considered to be the most common intracranial tumors next to meningiomas, gliomas and schwannomas. 10-15 % of all intracranial tumors are Pituitary Adenoma. Among the pituitary adenomas, those smaller than 10 mm are called as microadenomas and those exceeding 10 mm are macroadenomas.

Most of the Pituitary Adenomas are non-cancerous and slow-growing. Malignant pituitary adenomas are very rarely seen. Adenomas are considered to be the most common disease that affect the pituitary. They can be seen among children and more common among people in the age group of 30s-40s. Most cases can be successfully cured with appropriate treatment options.

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Signs and symptoms

In Children: Headaches, bumping in objects placed on sides, visual difficulties etc.
In adult females: Visual difficulties, irregularities in the menstrual cycles.
In adult males: Loss of sexual desire, visual difficulties.

Other general signs and symptoms may vary according to the type of adenoma. Some of them are:

Treatment :

Pineocytomas pituitary adenoma is better to treat as soon as possible. Surgery is considered to be the best option and if the patient does not posses any other complications.

Surgery:

Trans Nasal Endoscopic Surgery uses the high definition optics and 4 hand techniques for the procedure. It is one of the best methods for removing the tumor completely with minimum chance for morbidity and because of the following factors, these procedure is considered to be a best choice by most of the clinics and professionals:

• Less invasive

• Fewer side effects

• Faster recovery as the

patient is able to leave the hospital in 2-4 days after the surgery.

Transcranial approach: It is chosen only when the Trans nasal approach fails to achieve the goals as the tumor crosses the coronal plane.

Radiation Therapy:

Radiation therapy is the treatment method used in cases where the surgery and medication have proved to be ineffective to cure the tumor. It can also be a choice if there is a small residual or recurrent tumor.

Stereotactic Radiosurgery (Gamma Knife and Cyber knife):

Theis procedure is a combination of external beam radiotherapy with a technique that focuses the radiation through many different ports. Such procedure may evoke fewer injury to the tissues near to the pituitary gland.

Medication Therapy:

Bromocriptine and cabergoline are the most prevalent agents used in medication therapy. Varied changes in the size of the tumors can be seen in most of the Prolactinoma patients with medication therapy. It can be also:

• Improve the vision

• Restore menstrual cycle and fertility in women

• Resolve headache.

Bromocriptine can have side effects and moderate doses are usually prescribed. Cabergoline is the long-acting oral dopamine which has been approved for hyperprolactinema by the Food and Drug Administration in USA. It has the fewer side effects when compared to that of Bromocriptine and can be taken twice in a week. It is more effective in patients whose prolactinomas are inresponsive to bromocriptine therapy.