Pituitary Tumors

1 What are Pituitary Tumors?

The abnormal growths that develop in your pituitary glands are called pituitary tumors.

Some pituitary tumors may cause your glands to produce lower levels of hormones while some will result in too many of the hormones that will regulate important functions of your body.

Most of these tumors are noncancerous or benign growths (adenomas). This will remain in your surrounding tissues or pituitary gland and will not spread to the other parts of your body.

Some of the treatments for these tumors are managing your hormone levels with the use of medications, removing the tumor and controlling the growth of the tumor.

Your doctor may also suggest observation or “wait and see” approach.

2 Symptoms

Some pituitary tumors cause symptoms while others don’t have symptoms.

Pituitary tumors that make hormones (functioning) can have signs and symptoms depending on what kind of hormone they produce and the ones that do not make hormones (nonfunctioning) are related to the pressure they put on other structures and growth.

The smaller tumors are also known as microadenomas while large tumors are also known as macroadenomas that has a measure of about 1 centimeter and can put pressure on the normal pituitary gland because of its size.

The symptoms of pituitary tumor related to pressure are headache and vision of loss or particularly loss of peripheral vision.

The symptoms relates to hormone level changes include:

  • Over functioning – an overproduction of hormones that can cause specific symptoms and signs or a combination of them;

Symptoms of large tumors that causes hormonal deficiencies include:

  • weakness,
  • vomiting,
  • nausea,
  • sexual dysfunction,
  • feeling cold,
  • increased amount of urine,
  • no or less frequent menstrual period,
  • unintended weight gain or loss;

ACTH or Adrenocorticotropic hormone-secreting tumors produces adrenocorticotropin that stimulates your adrenal glands to make the hormone cortisol and can lead to Cushing’s syndrome.

Symptoms of Cushing’s syndrome include:

  • high blood pressure,
  • exaggerated facial roundness,
  • thinning of the legs and arms,
  • fat accumulation around your midsection and upper back,
  • acne,
  • high blood sugar,
  • irritability or depression,
  • stretch marks,
  • bruising,
  • anxiety,
  • bone weakening.

Growth hormone (acromegaly) secreting tumor symptoms are:

  • enlarged hands and feet.
  • Coarsened facial features,
  • heart problems,
  • high blood sugar,
  • joint pain,
  • excess sweating,
  • increased body hair,
  • misaligned teeth,
  • children and adolescents may grow too tall or too fast;

Prolactin-secreting tumors is an overproduction of prolactin that can cause a decrease in normal levels of sex hormones (testosterone for men and estrogen for women). The symptoms for women are:

  • irregular menstrual period,
  • milky discharge from the breasts,
  • and lack of menstrual period.

The symptoms for men that may cause hypogonadism include:

Thyroid-stimulating hormone-secreting tumors that can cause hyperthyroidism that have symptoms such as:

  • nervousness or irritability,
  • weight loss,
  • frequent bowel movements,
  • irregular or rapid heartbeat,
  • excessive sweating.

Consult your doctor if you have the signs and symptoms of pituitary tumor so that it will be treated and your hormone levels will return to normal. Seek advice if you suspect that multiple endocrine neoplasia type I (MEN I) runs in your family. 

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3 Causes

There is no known cause of pituitary tumors.

The pituitary gland is a tiny, bean-shaped gland that is located at the base of your brain and it influences nearly every part of your body, the hormones that it produces can help regulate relevant functions such as blood pressure, reproduction and growth.

Experts suspect that there is genetic alterations are involved on how these tumors developed.

4 Making a Diagnosis

Your doctor will first conduct a physical exam and several tests to make a diagnosis of pituitary tumors. Tests include:

  • blood and urine tests – to check if you have deficiency or overproduction of hormones;
  • vision testing – if the tumor has damaged your sight or peripheral vision;
  • brain imaging – MRI or CT scan of your brain to check the location and size of the tumor.

Your doctor may also refer you to an endocrinologist.

5 Treatment

Many pituitary tumors do not need treatment but for some that requires treatment, it will be based on the:

  • type,
  • its size,
  • how far it has grown,
  • your age,
  • and overall health.

The treatments involve medical experts including:

  • endocrinologist,
  • neurosurgeon,
  • and radiation oncologist.

They may use surgery, medications, and radiation therapy or a combination of the three.

Surgery

To remove the tumor pressing on the optic nerves, the two main surgical procedures are:

  • Transcranial approach (craniotomy) which is done by cutting in your scalp and removing the tumor through the upper part of your skull;
  • Endoscopic transnasal transsphenoidal approach which is done through your sinuses or nose without the use of cutting.
  • Radiation therapy – this is used for persisting or recurring tumors after surgery that uses high-energy X-rays. The methods of radiation therapy include:
    • Gamma Knife stereotactic radiosurgery that uses radiation beams without any cutting;
    • External beam radiation that uses radiation in small increments over time, usually 5 times a week over a 4-6 week period;
    • Proton beam therapy that uses positively charged ions (protons). The effect of these radiation therapies might be seen after a few months or even years.

Medication

That may help block excess hormone secretion are:

  • Prolactin-secreting tumors (prolactinomas) such as cabergoline and bromocriptine (Parlodel) to reduce the tumor size and decrease prolactin secretion;
  • Growth hormone-secreting tumors such as somatostatin (Somatuline Depot, sandostatin) for the decrease in growth hormone production, given by injections every 4 weeks.

Some of these drugs can cause side effects such

You will need to take replacement hormones to maintain normal hormone levels if a pituitary tumor or surgery decreases hormone production.

If your tumor is not causing signs and symptoms, you need to observe (watchful waiting) and to have follow-up tests to determine if it is growing.

6 Prevention

The exact cause of pituitary tumor is still unclear so there is no possible prevention for these tumors.

7 Alternative and Homeopathic Remedies

A few alternative and homeopathic remedies exist for pituitary tumors.

Some of the herbs for pituitary tumors are:

Chaste Tree Berry (Vitex) – that regulates hormones and supports the function of pituitary glands, this should be taken in months to be effective;

Astragalus Extract – for the support of the adrenal system.

These alternative medicines should be taken with professional advice.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with pituitary tumors.

To have been diagnosed and to go through the treatment and process can be very frightening and at the same time overwhelming.

That is why it is important that you should know a lot about your condition so you and your family can understand what you are going through.

Seek support from your family and friends.

You can also find a support group in your area, where the members are also dealing with the same situation like you so you can share your feelings and you might learn something from them.

9 Risks and Complications

The risk factors of pituitary tumors are people with a family history of certain hereditary conditions like multiple endocrine neoplasia type I (MEN I).

These tumors can affect your health that can cause:

  • vision loss because it can put pressure on your optic nerves;
  • permanent hormone deficiency that can alter your supply of hormones because of the removal of the tumor;
  • pituitary apoplexy that is rare but serious complication that occurs when there is bleeding in the tumor, this condition needs emergency treatment and requires surgery and corticosteroids.
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