QLexNursing

Pituitary Adenoma → Hormonal Disturbances

🔶Pituitary adenomas arise from the anterior pituitary gland, which is the body’s major endocrine control center, regulating hormones such as ACTH, TSH, GH, LH, FSH, and prolactin.

🔶Because of this central endocrine role, pituitary tumors most commonly cause hormonal disturbances, either through hormone hypersecretion (e.g., Cushing disease, acromegaly, hyperprolactinemia) or hyposecretion due to compression of normal tissue.

🔶Clinical features may include menstrual irregularities, galactorrhea, infertility, weight gain, hypertension, acne, enlarged hands/feet, or fatigue, depending on which hormone is affected.

🔶Pituitary adenomas can also cause mass effect, such as bitemporal hemianopsia, but their most characteristic hallmark remains endocrine dysfunction rather than hearing loss or systemic metastasis.

🔶Metastasis outside the CNS is very rare for pituitary adenomas; instead, their impact is dominated by local compression and hormonal imbalance, which is why hormonal disturbances are the key association.

Meningioma → Metastasis Rare

🔶Meningiomas arise from the meninges (arachnoid cap cells), not from neurons or glial cells, and are most often benign, slow-growing tumors.

🔶These tumors commonly cause symptoms from local compression (e.g., seizures, focal neurologic deficits, headaches), but they rarely metastasize beyond the central nervous system.

🔶Histologically and clinically, meningiomas are typically well-circumscribed and often described as extra-axial masses (sitting on the brain surface), making surgical resection possible in many cases.

🔶Because they are generally noninvasive and non-metastatic, the classic teaching point is that meningiomas = rare metastasis, in contrast to more aggressive malignant brain tumors like glioblastomas.

🔶While they can recur or cause significant morbidity from compression, their systemic spread is uncommon, supporting the match “metastasis rare” as the most characteristic feature.

Acoustic Neuroma (Vestibular Schwannoma) → Loss of Hearing / Tinnitus

🔶Acoustic neuromas (vestibular schwannomas) arise from Schwann cells of the vestibulocochlear nerve (cranial nerve VIII), usually at the cerebellopontine angle.

🔶Because CN VIII is responsible for hearing and balance, the classic initial symptoms are unilateral sensorineural hearing loss, tinnitus (ringing in the ear), and sometimes vertigo or unsteadiness.

🔶Patients often report gradual hearing decline on one side, difficulty localizing sound, or persistent ringing, making hearing symptoms the key early clinical clue.

🔶As the tumor enlarges, it can compress nearby structures, such as the facial nerve (CN VII) causing facial weakness, or cerebellum leading to gait disturbances, but hearing/tinnitus remain hallmark features.

🔶These tumors are not primarily associated with hormonal disturbances or distant metastasis; their most exam-relevant association is hearing loss + tinnitus linked to CN VIII involvement.

Glioma → Metastasis Common (within CNS / aggressive behavior)

🔶 Gliomas are tumors arising from glial cells (astrocytes, oligodendrocytes, ependymal cells) and include highly malignant types such as glioblastoma multiforme.

🔶 These tumors are typically infiltrative and aggressive, spreading extensively within the brain and along white matter tracts, making complete surgical resection difficult.

🔶 While they may not always metastasize outside the CNS like systemic cancers, they demonstrate “metastasis-like” spread within the central nervous system, with multifocal lesions and rapid progression.

🔶 Clinically, gliomas can cause headaches, seizures, focal neurologic deficits, personality changes, or signs of increased intracranial pressure, depending on their location.

🔶 Compared to benign tumors like meningiomas, gliomas are considered malignant and more likely to disseminate within the CNS, making the association “metastasis common” the best match among the listed options.