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Pituitary Tumors

The pea-size pituitary gland is important to the functioning of the human body. It is located at the base of the brain. Despite its size, the pituitary gland is responsible for producing hormones that regulate critical body organs and glands, including those that affect body tissues, such as bones and the milk-producing breast glands. Some of these glands include the thyroid gland, the adrenal glands, the ovaries, and the testicles.

Although a minority of these tumors are part of a genetic disorder, the cause of most pituitary tumors is unknown. There are no known environmental or lifestyle-related risks.

About 10,000 patients a year in the United States receive a diagnosis of pituitary tumors, which can occur at any age (including in children), but which are most often found in older adults. Almost all of these tumors are benign pituitary adenomas (adenoma is non-cancerous).

The actual number of pituitary tumors, however, may be much higher than the number of tumors that are found each year. Through examination of other health problems or post-mortem, it has been found that as many as 1 of 4 people may have a pituitary adenoma without knowing. Since these tumors are often small and never cause any symptoms or health problems, few of them would ordinarily be diagnosed at all.

Cancer of the pituitary gland is rare. Only a few hundred pituitary cancers have ever been recorded, according to the American Cancer Society. Most of those were diagnosed in older people. In the event of a cancerous tumor, however, it is treated with surgery and radiation.

Hormone-producing pituitary adenomas produce symptoms related to the hormone action of the body. Clinically nonfunctioning pituitary adenomas typically cause problems related to the tumor growth, which exerts pressure on surrounding brain structure.

There are many signs and symptoms of a pituitary tumor, depending on the type of tumor.

These include any of the following:

  • Extra hormones in the blood
  • Headache, vision loss or double vision
  • Nausea, vomiting
  • Dizziness, confusion, anxiety, lethargy, depression
  • High blood pressure, irregular heartbeat
  • Nasal drainage of clear fluid (because of cerebrospinal fluid leaking into the nose)
  • Abnormal sexual, menstrual or breast milk issues
  • Delayed growth and sexual development in children
  • Large hands and feet (acromegaly)
  • Weight gain, bruising easily, loss of body hair

 

Diagnosis

Diagnosis of a pituitary tumor includes a medical history and physical exam. It may also include X-ray, MRI, CT scans, and specialized pituitary blood tests (venous sampling). Blood and urine tests can be used to determine hormone levels.

Treatments

Treatments for a pituitary tumors include surgery, radiation therapy and medication. Sometimes a combination of treatments is used. For example, surgery may be done to remove some of the tumor, while drugs can be used to relieve symptoms and sometimes shrink the remaining tumor.

The primary treatment, however, for most pituitary tumors is surgery.  If the pituitary tumor is benign and in a part of the brain where neurosurgeons can safely, and completely, remove it, surgery might be the only treatment needed. The patient will also probably need surgery if the tumor is pressing on the pituitary gland or parts of the nervous system; producing hormones unable to be controlled by medication; or, still growing despite previous treatments.

Special Minimally Invasive Surgery Done at ANA

Most pituitary tumors are removed through transsphenoidal surgery, performed by our experts at ANA. Transsphenoidal literally means “through the sphenoid sinus.” This surgery is done through the nose and sphenoid sinus to remove pituitary tumors.  Transsphenoidal surgery can be done with a microscope, endoscope, or both. In results published in 2005 of a study with a large series of patients with pituitary adenoma, it was found that transsphenoidal surgery is an effective and safe treatment for most patients with this condition and could be considered the first-choice therapy for most of these types of tumors.