Doctor's Notes on Pituitary Tumor Symptoms & Treatment
A pituitary tumor is a growth of abnormal cells in the tissues of the pituitary gland. There are 3 types: benign and invasive adenomas (both non-cancerous) and carcinomas (cancerous, malignant). In addition, the tumors may be either functioning or non-functioning, meaning that the tumor cells either function and produce excessive amounts of one or more pituitary hormones or are non-functioning and do not make extra hormones. The following signs and symptoms may occur with pituitary tumors:
- no symptoms,
- some vision loss,
- body hair loss,
- lower sex drive in men and women, and
- in children, slow growth and slowed sexual development.
Women may have infrequent or no periods and no milk production in breasts, while in men, loss of facial hair, growth of breast tissue, and impotence can occur. Other general signs and symptoms may include
- nausea and vomiting,
- seizures, and
- possible runny nose where cerebrospinal fluid leaks into the nasal passage.
However, the above are general symptoms that can be increased or decreased depending if the tumor is a functioning tumor that is producing one or more hormones in excess. Hormones produced by the pituitary include prolactin, adrenocorticotropic hormone (ACTH), growth hormone, thyroid-stimulating hormone, luteinizing hormone (LH), and follicle-stimulating hormone (FH); each has its particular effects, too many to cover here.
The underlying causes of the types of pituitary tumors is unknown. Reported risk factors are hereditary diseases like multiple endocrine neoplasia (MEN1), Carney complex (multiple neoplasia syndrome), and acromegaly.
What Are the Treatments for a Pituitary Tumor?
Many pituitary tumors do not need treatment; however, your doctors will likely monitor your situation with follow-up appointments. If the tumor needs treatment (due to size, type, hormone production, for example), medications, radiation therapy, and surgery are the main options for treatments. Treatment plans often include combinations of therapies and/or have specific medications used for tumor types; the following include examples of types and drug treatments:
- Prolactinomas: cabergoline, bromocriptine
- ACTH-producing tumors: mitotane, mifepristone, pasireotide
- Growth hormone-secreting tumors: octreotide, pegvisomant
Radiation therapy may be used alone or after surgery and include the following:
- Stereotactic radiotherapy: single high-dose radiation
- External beam radiation: multiple small-dose radiation
- Intensity modulated radiation therapy (IMRT): radiation beam sizes and strength changed to fit the tumor's shape
- Proton beam therapy: use of protons to kill tumor cells (not widely available)
Surgery is another option; there are two main types:
- Endoscopic transnasal transsphenoidal approach: use of an endoscope to remove the tumor through the sinuses and nose
- Transcranial approach: tumor removal through an incision through the skull (craniotomy)
Your doctors can design a treatment plan for your individual condition; some patients need to take hormones after treatments.
Must Read Articles:
Anatomy of the Endocrine SystemThe endocrine system is made up of glands that produce and secrete hormones. The glands that make up the endocrine system include the hypothalamus, pituitary, thyroid, parathyroid, adrenal, pineal, reproductive, and the pancreas.
What Causes Pituitary Adenoma?A pituitary adenoma (a type of benign tumor) may be caused by a number of genetic conditions. It can lead the gland and surrounding tissue to produce harmfully high levels of hormones.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.