Posted 8/9/2016 8:34 PM (GMT 0)
First, a few basics about pituitary adenomas.
A pituitary gland tumor is generally composed of one of the primordial cell types that constitute the primary pituitary hormones expressed.
The primary pituitary hormones are: ACTH, GH (growth hormone), prolactin, TSH, FSH, and LH.
A pituitary tumor of 9mm, as is yours, is called a micro adenoma. A tumor less than 1 cm in size is a micro-adenoma. A tumor 1 cm and greater is called a macro adenoma.
The larger the size of pituitary tumor the greater the concern for mass effects, that is, compression of the pituitary stalk and compression of one or both of the optic nerves.
Pituitary tumors are classed as either "functional" or "non-functional." Functional tumors are those that excrete too much/excessive pituitary hormone of which the tumor is comprised (the primordial cell type and hormone produced, ex. growth hormone tumor that excretes excessive growth hormone causing acromegaly). Non-functional tumors are tumors that are quiet and quiescient, they produce no additional or excess hormone.
My pituitary tumor completely obliterated my pituitary gland. The tumor grew to the extend that it "squished" my pituitary gland, such that I now have no pituitary gland. Think of an Oreo cookie where the inner filing has been compressed to the point where only the two chocolate cookies remain.
I now have what is called an empty sella. The sella tursica is the concave boney enclosure where the pituitary gland sits at the base of the brain.
Summary: I have no pituitary gland because the pituitary adenoma that I had (a growth hormone secreting macro-adenoma) grew to where the size and pressure of the tumor obliterated any functioning gland that remained.
As such, my body is a physiologically mess. The pituitary hormones are chemical messengers that relay information to the body's organs and systems - relaying information that regulates all manner of blood pressure, electrolytes, metabolism, digestion, cellular growth and repair, emotions/mood.
The world that I live in, the body that I live in, is very different from that of a "normal" person.
I take a slew of medications that serve to replace the actions of the pituitary hormones. But it is no comparison to the intricate and finely dosed hormone section as is the case with a functioning pituitary gland. I equate my medication management to that of a rubix cube.
In your case, with a 9 mm micro adenoma, it is likely that a portion of your pituitary gland has been rendered non-functional - again, due to pressure effects of the tumor obliterating patent cellular function.
The area of your pituitary gland affected would be associated with the location of your particular adenoma.
The pituitary gland has defined zones/regions for each of the primary pituitary hormones. The anterior pituitary gland is responsible for production of the key/most essential hormones (ACTH, TSH, GH, vasopressin). The posterior pituitary gland has less essential hormones (prolactin, FSH, LH). The primordial cells for each of the primary hormones are mapped out in distinct zones/regions of the pituitary gland.
These primordial cells are evident in the earliest stages of fetal development. They remain as undifferentiated cells - and are unique in this regard. Similar to umbilical embryonic cells that are undifferentiated (and which parents often bank/store as a safe guard if they child should ever develop cancer, etc where the undifferentiated cells could be useful medically).
Most micro-adenomas are located in the anterior pituitary gland.
Your pituitary-specific MRI and blood laboratory levels would give evidence of your degree of pituitary failure and the area(s) affected.
OK . . . the long and the short of your particular situation . . .
Your micro adenoma likely has caused cellular death of a portion of your pituitary gland. The exact portion would be able to be discerned/known by evidence of an MRI (area of cellular death will appear black instead of an optic white on MRI imaging) + your blood laboratory profile of each of the pituitary hormones. That is, the primary hormone levels that show to be low-normal, low, or even absent.
Ex. If your laboratory results show that your blood levels for ACTH are low, then you are described as having secondary adrenal insufficiency and placed on replacement hydrocortisone (for life).
Ex. If your laboratory results show that your blood levels for TSH are low, then you are described as having hypothyroidism and placed on replacement T3 (cytomel) and T4/T3 (levothyroxine). For life you will need these replacement.
Ex. If your laboratory results show that your blood levels are low for diuretic hormone (vasopressin) you are described as having diabetes insipidous and placed on replacement anti-diuretic hormone.
Are you seeing an endocrinologist or just a primary care physician?
Be aware that the majority of endocrinology practices focus on diabetes management as the bread and butter of the practice and its physicians. Disorders of the pituitary gland are the genre of the average endocrinologist.
Do you know what pituitary hormone levels were low? What hormones were normal? What hormones were high?
What hormone replacements have you been prescribed? In what dosages.
Pituitary failure is rarely a light bulb event. It usually occurs gradually over time, years in the making, and the pituitary gland is compromised.
Pituitary failure is also a leading cause of underlying psychiatric conditions. Once hormone levels are better normalized, many people find emotional and psychological clarity.
The Pituitary Network Association is an outstanding on-line resource. Just Google "Pituitary Network Associaiton." There is no better educational and informational source than the PNA. I purchased their resource "A Patient's Guide to Pituitary Disorders" and was amazed at the book's depth and detail.
Let me know your particular questions and I would be glad to help you.
People think of "hormones" and they think of estrogen and testosterone. Which is inaccurate at best.
The body produces hundreds of different hormones. Hormones serve as chemical messengers, replaying information as to how the body works.
The Pituitary Gland is called the "master gland" because it is the command center and directs all of the body's hormones. It is like the central processing unit of a large computer. Because of its vital role in the physiology of the body (how the body works) the pituitary gland - when injured or in the presence of an adenoma - does not relinquish easily. The pituitary gland will compensate as best as it can for as long as it can. Failure of the pituitary gland is not a casual happening. Failure of the pituitary gland has widespread effects on the body, mind, and emotions.
Bless you for doing the best that you can with partial pituitary failure. It is no picnic. I can attest to that.
Let me know what questions you may have and I will help you in your understanding as best as I can. In the meantime, go to the Pituitary Network Association web site.
www.pna.org
Best to you,
- Karen -