Overview
Pituitary tumors are abnormal growths that develop in your pituitary gland. Sometimes pituitary tumors can cause excessive production of hormones that regulate important functions of your body. Other times, pituitary tumors can restrict your pituitary gland, causing it to produce lower levels of hormones.
Most pituitary tumors are noncancerous, nonspreading growths (adenomas). Adenomas remain confined to your pituitary gland or surrounding tissues and don't spread to other parts of your body.
Treatment for pituitary tumors involves various options to either remove the tumor or control its growth. You may also need medications to correct hormone production that is too high or too low.
What causes pituitary tumors?
Researchers do not know at this time what causes pituitary tumors. However, research studies show that having a hereditary condition, multiple endocrine neoplasia, type I (MEN 1), increases the risk of developing pituitary tumors, thyroid tumors, and pancreatic tumors. Multiple endocrine neoplasia, type I (MEN 1) has been shown to be responsible for about all inherited (those that run in families) pituitary tumors, but only 3 percent of all pituitary tumors.
Signs and Symptoms
If a pituitary tumor exists, the pituitary gland may make an excessive amount of hormones. Tumors that make hormones are called functioning tumors and those that don't make hormones are called nonfunctioning tumors.Tumors that secrete hormones tend to be smaller than the pituitary gland when they're diagnosed. In fact, most pituitary tumors are microadenomas that measure 3 to 9 millimeters in diameter. Less common tumors are macroadenomas that are 10 millimeters or larger in diameter.
Tumors that don't secrete hormones, called endocrine-inactive adenomas, tend to be larger and may compress other tissue such as the optic nerves, causing vision loss.
Patients with pituitary tumors may experience one or more of the following symptoms: -
- Headache
- Loss of peripheral vision or decreased acuity in one or both eyes
- Double vision
- Nausea with or without vomiting
- Weight loss or gain
- Loss of appetite
- Fatigue or decreased energy
- Joint pain
- Increase in shoe or ring size
- Development of high blood pressure or diabetes mellitus
- Decreased mental function
- Dizziness
Diagnosis
During your visit to the California Center for Pituitary Disorders at UCSF Medical Center, our medical team will ask you about your medical history as well as your immediate family's medical history. If your primary care physician has sent your previous medical records, we will review this information. Be sure to tell your doctors about any medications you are currently using, including over-the-counter medications, vitamins, nutritional supplements or herbal remedies.We will examine you in an attempt to discover the cause of your medical problem. This evaluation may include the following: -
- Blood or Urine Tests - These simple tests are used to measure the hormone levels in your blood and urine.
- Electrocardiogram (ECG or EKG) - A simple, painless test that records the electrical activity of the heart through electrodes placed on the skin of the chest.
- X-rays - High-energy radiation is used to take pictures of the pituitary gland.
- Magnetic resonance imaging (MRI) - This is a non-invasive procedure that produces two-dimensional views of an internal organ or structure, particularly your brain and spinal cord.
- Computed tomography (CT) - This is a non-invasive procedure that takes cross-sectional images of the brain or other internal organs to detect any abnormalities that may not show up on an ordinary X-ray.
For patients with possible pituitary tumors, we also will perform a complete endocrinological evaluation.
What is the prognosis?
If diagnosed early enough, the prognosis is usually excellent. If diagnosis is delayed, even a non-functioning tumor can cause problems if it grows large enough to press on the optic nerves, the brain, or the carotid arteries (the vessels that bring blood to the brain). Early diagnosis and treatment is the key to a good prognosis.
What research is being done?
The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health (NIH) conduct research related to brain tumors, including pituitary tumors, in their laboratories at the NIH and also support research through grants to major medical institutions across the country. Much of this research focuses on finding better ways to prevent, treat, and ultimately cure pituitary tumors.
Treatment for pituitary tumors
TreatmentPituitary tumors are usually not cancerous and therefore won't spread to other areas of the body. However, they can cause serious problems by putting pressure on important nerves and blood vessels.
Surgery to remove the tumor is often necessary, especially if the tumor is pressing on the optic nerves, which could cause blindness.
Most of the time, pituitary tumors can be removed through the nose and sinuses. However, some tumors cannot be removed this way and will require removal through the skull (transcranial).
Specific treatment for pituitary tumors will be determined by your physician based on: -
- your age, overall health, and medical history
- extent of the disease
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
Treatment may include: -
- surgical removal of the tumor
- External radiation (external beam therapy) - a treatment that precisely sends high levels of radiation directly to the cancer cells. The machine is controlled by the radiation therapist. Since radiation is used to kill cancer cells and to shrink tumors, special shields may be used to protect the tissue surrounding the treatment area. Radiation treatments are painless and usually last a few minutes.
- Radiosurgery (stereotactic radiosurgery) - a type of radiation therapy that uses a single high dose of radiation sent directly into the cancerous tissue with very narrow beams of radiation. This is a precise technique that targets the cancer tumor, causing less damage to the surrounding tissues. Radiosurgery is called "surgery" because it is a one-session radiation therapy treatment that creates a similar result as an actual surgical procedure. An example of radiosurgery is called "gamma knife."
- Medications - to control the growth-hormone production by the tumor (i.e., bromocriptine and cabergoline - medications which act on hormone-producing tumors to suppress its hormone-producing function).
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