What are Pituitary Tumors?
A pituitary tumor develops when cells grow abnormally in the tissues of the pituitary gland, a pea-sized gland in the center of the brain just above the back of the nose. Pituitary gland hormones control the function of many other glands in the body. Although the majority of pituitary tumors are benign (noncancerous), they can cause health problems from increasing pressure on surrounding nerves as they grow, or when they cause overproduction or underproduction of hormones.
Pituitary tumors may be nonfunctioning or functioning. Nonfunctioning pituitary tumors do not make extra amounts of hormones. Functioning pituitary tumors make more than the normal amount of one or more hormones. Most pituitary tumors are functioning tumors, producing extra hormones that cause signs and symptoms.
There are three groups of pituitary tumors. Benign (noncancerous) pituitary adenomas grow very slowly and do not spread to other parts of the body. Invasive pituitary adenomas (malignant) may spread to the bone of the skull or the sinus cavities. Pituitary carcinomas are rare malignant tumors that can spread to other areas of the brain or spine.
About the host: UTHealth Neurosciences leader Dr. Arthur L. Day is a neurosurgeon and Vice Chair of the Vivian L. Smith Department of Neurosurgery at UTHealth. View his presentation on advanced treatment options for pituitary tumors.
What You Can Expect at UTHealth Neurosciences
At UTHealth Neurosciences, neurologists, neurosurgeons, interventional pain management specialists, neuro-oncologists, radiation oncologists, and neuropathologists work together to determine the care each patient needs, discussing treatment options as a group. This approach saves our patients time and money and allows our specialists to share each other’s insights, leading to better treatment decision-making and outcomes.
We first investigate options for nonsurgical treatment, including medical management, pain management, physical therapy, rehabilitation, and watchful waiting. When surgery is needed, our neurosurgeons routinely employ innovative minimally invasive techniques. Throughout the treatment process, our team works closely with the doctor who referred you to ensure a smooth transition back to your regular care plan. While you are with us, you can expect expert care, excellent communication, and genuine compassion.
Causes of Pituitary Tumors
There is no known specific cause for pituitary tumors, although research has shown that these types of tumors occur more frequently in people with hereditary disorders such as multiple endocrine neoplasia type 1 syndrome, Carney complex, and isolated familial acromegaly.
Early Signs of Pituitary Tumor
Depending on the type of tumor, symptoms may first appear as hormonal differences, or as nerve compression from tumor growth, or both. They may come on suddenly or appear gradually over time.
Signs and symptoms of a nonfunctioning pituitary tumor may include headache; some loss of vision; loss of body hair; less frequent menstrual periods in women; loss of facial hair, growth of breast tissue, and impotence in men; lower sex drive; and slowed growth and sexual development in children.
When a functioning pituitary tumor makes extra hormones, the signs and symptoms depend on the hormone produced.
Too much prolactin may cause headache, some loss of vision, less frequent or no menstrual periods, trouble becoming pregnant, impotence in men, and lowered sex drive.
Too much ACTH (adrenocorticotropic hormone) may cause headache; some loss of vision; weight gain in the face, neck, and trunk of the body and thin arms and legs; a lump of fat on the back of the neck; easy bruising; growth of fine hair on the face, upper back, or arms; and/or anxiety, irritability, and depression.
Too much growth hormone may cause headache; some loss of vision; in adults, growth of the bones in the face, hands, and feet (acromegaly); in children, the body may grow much taller and larger than normal; tingling or numbness in the hands and fingers; joint pain; excessive sweating; and/or extreme dislike of or concern about one or more parts of the body (dysmorphophobia).
Too much thyroid-stimulating hormone may cause irregular heartbeat, shakiness, weight loss, trouble sleeping, frequent bowel movements, and sweating.
Other general symptoms of pituitary tumor may include nausea and vomiting, confusion, dizziness, seizures, and a runny nose caused when cerebrospinal fluid surrounding the brain and spinal cord leaks into the nose.
To diagnose a pituitary tumor, your neurological team will do a physical exam, eye exam, and neurological exam and complete medical history. You will be asked to have an MRI scan, blood chemistry study, and blood test. You may be asked to collect urine for 24 hours to measure the amount of certain substances in your body; a higher than normal amount of cortisol may be a sign of a pituitary tumor and Cushing syndrome. Your team may also order other more specialized tests to measure the level of cortisol in your body.
Each patient’s treatment options are unique, and vary based upon the tumor size and location, as well as the patient’s age, overall health, and other factors. Some tumors may require watchful waiting, with specialists tracking growth over time.
In general, four treatments are available for pituitary tumor. Many tumors can be removed by either minimally invasive surgery or craniotomy, which is surgery through an opening made in the skull.
For invasive pituitary adenomas and pituitary carcinomas, which are cancerous, more than one treatment will likely be recommended to you, including surgery, radiation therapy, targeted drug therapy, or chemotherapy.
Neurologists, neurosurgeons, neuro-oncologists, radiation oncologists, and neuropathologists discuss cases in depth weekly at a tumor board review. Working as a team ensures that each patient benefits from the full spectrum of expertise and the best treatment options available, including new drug therapies and immunotherapies being tested in clinical trials.
At UTHealth Neurosciences, we offer patients access to specialized neurological care at clinics across the greater Houston area. To ask us a question, schedule an appointment, or learn more about the Pituitary Tumor and Vision Change Clinic, please call (713) 486-8000, or click below to send us a message. In the event of an emergency, call 911 or go to the nearest Emergency Room.