Tumours arising near to the pituitary gland can also affect pituitary
function. These tumours include craniopharyngioma which is probably
the most common and presents in younger patients from childhood, other
conditions being epidermoid cysts, Ratke's pouch cysts etc.
At the time the condition presents, the symptoms have usually been
present for some years. Visual impairment and headache are features of
pituitary deficiency. In childhood it is also associated with growth
failure and may also be a cause for squints. Presentation of raised
intra-cranial pressure causing hydrocephalus is a serious condition
requiring urgent therapy.
Investigation includes an endocrine assessment and also an MRI scan.
The patient will require referral to a specialist unit. These cases
usually require surgery by open craniotomy. Because of the location of
the tumour, it is not always possible to achieve complete tumour removal
and post-operatively radio-therapy may be required. These tumours may
recur after surgery.
All of these patients require long-term care and follow-up, usually
in a specialist unit. If patients suffer with hypopituitism they will
require hormone replacement. In addition there may be problems due to
hypothalamic dysfunction, obesity and diabetes insipidus which will
require treatment. Steroid replacement will also be required. A
presentation, particularly with hydrocephalus could be associated with
more serious problems such as neurological disabilities and partial or
complete loss of eye-sight. Multidisciplinary support and treatment is
therefore, required in these cases.
For further information:
The Pituitary Foundation,
PO Box 1944,