If your doctor has diagnosed you with a pituitary tumor, you'll want to choose an expert medical team. UPMC neurosurgeons, endocrinologists, and other specialists diagnose and treat more pituitary tumors than any other hospital in the region.
Together they make up the only designated Pituitary Center of Excellence in the region. UPMC experts developed and refined the preferred pituitary tumor surgery technique, Endoscopic Endonasal Approach (EEA).
Learn about the treatment options for Pituitary Tumors at the UPMC Pituitary Center of Excellence.
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Pituitary tumors are abnormal growths in the pituitary gland. The pituitary is a tiny gland that sits in the center of the skull behind the eyes and below the brain. Known as the body's master gland, the pituitary tells other glands when to make and release hormones.
Nearly all pituitary tumors are benign, or noncancerous. But pituitary tumors can cause major health problems because the pituitary is so close to the brain. These tumors can also cause harmful hormone imbalances — or grow into the skull or sinuses and cause vision loss or pain.
Pituitary tumors are usually a type of tumor called a pituitary adenoma. Adenomas are noncancerous tumors that can grow in many different parts of the body. Pituitary tumors grow in and near the pituitary, but don't spread to distant body parts.
Depending on your tumor's size, your doctor may call it a:
According to the American Cancer Society, about 10,000 people in the U.S. receive a pituitary tumor diagnosis each year. These tumors are common, and the National Cancer Institute estimates that 10% to 25% of tumors in the skull are pituitary adenomas.
Doctors don't know what causes pituitary adenomas. There are virtually no risk factors for pituitary tumors, and you can't prevent them.
Not all pituitary tumors cause symptoms. In contrast, if the tumor damages the pituitary or makes excess hormones, you may experience a wide range of symptoms. You may also have symptoms if the tumor presses on the brain or optic nerves.Large pituitary tumors often cause peripheral vision loss since the pituitary gland lies close to where the eye nerves enter the brain.
Pituitary adenomas can create significant problems, including:
Many pituitary adenomas secrete one or more hormones. When hormone levels rise too high, you may develop hormone-specific symptoms.
Pituitary tumor symptoms will vary according to which hormone the tumor secretes. Examples include:
ACTH-secreting tumors produce the hormone that stimulates the adrenal glands. This makes the adrenal glands release too much of the stress hormone cortisol. Doctors call this Cushing's disease.
Symptoms of ACTH-secreting tumors include:
Growth hormone-secreting tumors cause the pituitary to make too much growth hormone. Symptoms include:
Prolactin-secreting tumors can decrease normal levels of sex hormones in both men and women. This includes testosterone and estrogen. Symptoms include:
TSH-secreting tumors cause the thyroid gland to release too much of the hormone thyroxine. Symptoms include:
Because the pituitary gland controls most of the glands and systems in the body, complications can be serious and widespread. Left untreated, pituitary tumor complications can include:
If you have any pituitary tumor symptoms, see your doctor promptly. Your doctor will ask you about your symptoms and medical history and will perform a physical exam. This will include a neurological exam to check your mental status and how well your nerves work.
Expect your doctor to order a variety of tests. These include:
You will also need to see an endocrinologist. This is a doctor who specializes in diseases of the endocrine glands and their hormones.
If blood tests show that your tumor makes ACTH, but the pituitary looks normal on MRI, doctors may do one additional test. In this test, the petrosal sinuses are sampled.
In petrosal sinus sampling, your doctor will insert tiny tubes into the veins in your groin. The doctor will guide the tubes from your groin to your pituitary. Once the tubes are in place, the doctor will collect blood samples from each side of the pituitary.
The lab will test this blood to confirm whether the pituitary is the source of the disease. If not, you may need additional testing.
Once you receive your diagnosis, your doctor will recommend treatment based on your symptoms and what hormone your pituitary adenoma secretes. Your doctor might use several treatments, including surgery, to get the best results. Several doctors evaluate pituitary tumors to decide which course of treatment is most effective for each patient, including endocrinologists and surgeons.
For most patients with a pituitary adenoma, the best treatment is surgery to remove the tumor. Approximately 10% of tumors (prolactinomas) are treatable primarily with medications.
Endoscopic Endonasal Approach (EEA): At UPMC, our nationally renowned neurosurgeons offer the Endoscopic Endonasal Approach (EEA) for this surgery. Your surgeon will reach the pituitary by operating through your nose and sinuses.
A specially designed endoscope provides light to help the surgeon see the tumor clearly. The scope magnifies real time views to a screen that the surgeon can use to perform precise surgical removal of tumors. With tools designed specifically for access by nose and sinuses, the surgeon can safely remove tumors without making open incisions.
Stereotactic Radiosurgery: When pituitary tumors don't respond to surgery or medication, UPMC doctors often use stereotactic radiosurgery. In stereotactic radiosurgery, also known as Gamma Knife, highly focused beams of radiation shrink the tumor. Stereotactic radiosurgery typically takes just one session.
Your doctor may also prescribe medication to reduce the level of hormones that the pituitary produces. You may receive medication after surgery if a large pituitary tumor still affects the brain or nearby bones, nerves, or blood vessels.
Your doctor will prescribe a medication that affects the specific hormone that is causing your symptoms. The goal is to get the pituitary to produce less of that hormone. Each medication works slightly differently.
Medications don't work very well on this type of tumor, which nearly always requires surgery. But if surgery and radiation don't work, your doctor may prescribe:
As with ACTH-secreting tumors, medications are less effective. They are not usually the first treatment for these tumors. Medications include:
Medications are often so effective on this type of tumor that you may not need surgery. Medications include:
These tumors may require surgery. Medications probably won't be your first treatment for a TSH-secreting tumor. But if your condition requires more treatment, several medications are available, including:
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