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​Pituitary Tumor (Pituitary Adenoma)

What is a Pituitary Tumor (Pituitary Adenoma)?

Pituitary tumors are abnormal growths in the tissue of the pituitary gland. Nearly all pituitary tumors are benign, or non-cancerous.

Some pituitary tumors lead to excessive hormone production, while others restrict normal functions of this critical gland. These tumors are sometimes referred to as pituitary adenomas.

Pituitary tumors remain confined to the gland and don’t spread to other parts of the body. Some pituitary tumors lead to changes in hormonal balance, growth issues, and even nerve damage.

Macroadenomas are pituitary growths that are larger than 10 millimeters, while microadenomas are growths that are smaller than 10 millimeters.

Symptoms of a pituitary tumor

Symptoms and treatment options for pituitary tumors vary greatly and depend largely on whether the tumor is secreting one or more of a variety of hormones. Even without hormone secretion, the location of the tumor at the base of the brain can bring about a wide range of significant symptoms.

  • Headache and a feeling of “pressure”
  • Vision loss, particularly affecting peripheral vision
  • Some patients may experience an overproduction of hormones, resulting in changes in menstrual cycle, mood changes, and infertility

Adenomas are not cancerous and do not spread to other parts of the body.

Treatment options for a pituitary tumor

The preferred surgical treatment for pituitary adenoma is the Endoscopic Endonasal Approach (EEA), which removes the tumor. This innovative, minimally invasive technique uses the nose and nasal cavities as natural corridors to access hard-to-reach or previously inoperable tumors. EEA offers the benefits of no incisions to heal, no disfigurement to the patient, and a faster recovery time.

Pituitary Tumor Symptoms and Diagnosis

Diagnosing pituitary tumors

Some pituitary tumors secret hormones, which can lead to a variety of side effects, depending on the hormone produced. Even pituitary tumors that do not secret hormones can place pressure on certain structures of the brain, leading to symptoms.

Your doctor will ask you about your symptoms and medical history, and will perform a physical exam.

Symptoms of a pituitary tumor

Symptoms of pituitary tumor may include:

  • Headache
  • Dizziness
  • Nausea
  • Weakness
  • Unexplained changes in weight
  • Growth of skull, hands, and feet
  • Changes in facial appearance, including wider spacing of teeth
  • Anxiety, nervousness, moodiness or depression
  • Problems with eyesight, such as double or blurred vision, loss of peripheral vision, or sudden blindness
  • Irregular menstrual cycles (women)
  • Erectile dysfunction (men)

Complications of a pituitary tumor

Pituitary tumor complications may include:

  • Diabetes
  • Kidney stones
  • Cardiovascular disease
  • High blood pressure
  • Osteoporosis
  • Thyroid disease

Symptoms of hormone-secreting pituitary tumors

Pituitary tumors sometimes secret certain hormones, which can lead to a variety of changes to your health. Examples include:

  • Thyroid-stimulating hormone-secreting tumors can make too much of the hormone thyroxine. Thyroid-stimulating hormone secreting tumors can lead to symptoms including:
    • Weight loss
    • Rapid or irregular heart beat
    • Frequent bowel movements
  • Prolactin-secreting tumors can decrease normal levels of sex hormones, including estrogen and testosterone. Prolactin-secreting tumors can lead to symptoms including:
    • Irregular menstrual periods
    • Milky discharge from breasts
  • Adrenocorticotropic hormone-secreting tumors produce the hormone that stimulates the adrenal glands. Adrenocorticotropic hormone-secreting tumors can lead to symptoms including:
    • Thickening of the arms and legs
    • Exaggerated roundness of the face
    • High blood pressure and blood sugar
    • Acne
    • Bruising
    • Weakening of bones
    • Anxiety and mood swings

Lab and imaging testing to diagnose pituitary tumors

To make the diagnosis, your doctor may order various types of tests and procedures.

Blood and urine tests will measure your hormone levels and blood sugar values. These tests can identify other conditions that might cause your symptoms, and therefore rule out a pituitary adenoma.

Inferior petrosal sinus sampling may be performed.

In this test, small tubes are guided in the veins from your groin to the pituitary to collect blood on each side. These samples then are tested to confirm whether the pituitary gland is the source of the hormonal disease.

Your doctor may want you to receive an MRI or CT scan of your head. The scan will look for a tumor in your pituitary gland.

You also may be referred to an endocrinologist, a doctor who specializes in diseases of the endocrine glands and the hormones that those glands produce.

Pituitary Tumor (Pituitary Adenoma) Treatment and Surgical Options

Treatment for a pituitary adenoma depends on what hormones the tumor is secreting. Several treatments, including surgery, may be used together to provide the best care for the patient.

Pituitary tumor Surgery

Endoscopic Endonasal Approach (EEA)
For most patients, the best treatment is to remove the pituitary tumor. At UPMC, the preferred method for this surgery is the Endoscopic Endonasal Approach (EEA). This approach allows surgeons to see the pituitary gland well without making an open incision.

During the EEA surgical procedure, the pituitary tumor is removed through the nose and nasal cavities, and recovery time is faster than with a traditional approach. The remaining pituitary gland is explored carefully to check for other lesions, and all abnormal tissue is removed.

Stereotactic Radiosurgery
Stereotactic Radiosurgery (Gamma Knife, CyberKnife) uses highly focused beams of radiation to shrink the tumor. This treatment method is used in patients whose tumors do not respond to surgery or to medication.

Medication for pituitary tumors

Medications may be used to reduce the level of hormones that the pituitary produces. You may receive medication after surgery if a large tumor in the pituitary is affecting surrounding structures.