Endocrinologists Hear Report of High Incidence of Brain Tumors

The pituitary gland, a small structure which sits on the sphenoid bone at the base of the skull and weighs around 1/2 gram, has long been called the “master gland” because of its role in regulating hormones and important physiological functioning in the rest of the body. Also called the hypophysis, it produces six hormones (growth hormone, prolactin, leuteinizing hormone, thyroid stimulating hormone, adrenocorticotropic hormone, and follicle stimulating hormone) and it also stores two other hormones: oxytocin and vasopressin.
For endocrinologists, specialists in hormone physiology and its disorders, the pituitary gland has nearly as much importance as the heart does to cardiologists. It has long been known from autopsy reports and incidental radiographic findings that anywhere from 6 to 24 percent of the patient population has a finding of pituitary microadenoma (small pituitary tumor) but until now there has been little focus on pinning down the epidemiology or clinical significance of this pathology.
According to a recent meta-analysis of nine carefully designed autopsy and radiographic studies, nearly one in five adults has a pituitary tumor, the July 1, 2001 edition of Family Practice News reported. Keith E. Friend, the principal investigator in the study was quoted by the newspaper as saying, “About one-third of these may result in pituitary excess syndromes” with symptoms including irregular menses, sexual dysfunction, infertility, changes in physical appearance, headaches, visual field disturbances, or even unexplained mood changes.
Dr. Friend asserted that even “small tumors can be clinically relevant” in his presentation to the annual meeting of the American Association of Clinical Endocrinologists.
He commented that diagnosis of pituitary microadenomas can be difficult because of the complexity in interpreting biochemical tests and the necessity of performing “thin slice” MRI imaging through the region of the pituitary.
Data from the study was obtained from the University of Toronto, New York University, and the M.D. Anderson Cancer Center at the University of Texas. The analysis also suggested that in adults older than 65 the prevalence of macroadenomas (greater in size than 10 millimeters) is as high as one in 500. Macroadenomoas are significant because of a possible pressure effect that can interfere with other parts of the brain causing such problems as visual disturbances.

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