Pituitary tumors form in the pituitary gland, a small organ located in the center of the brain, near the back of the nose. The pituitary gland is often referred to as the “master endocrine gland” because it produces hormones that influence various functions throughout the body. Additionally, it regulates the hormones produced by several other glands in the body.
What are the three types of pituitary tumors?
Benign pituitary adenomas:
Non-cancerous tumors grow very slowly and remain confined to the pituitary gland, without spreading to other parts of the body.
Pituitary carcinomas:
Malignant pituitary tumors, or cancerous tumors, can spread to other areas of the central nervous system, such as the brain and spinal cord, or even beyond it. However, very few pituitary tumors are malignant.
Invasive pituitary adenomas:
Non-cancerous tumors that can grow into the bones of the skull or the sinus cavity under the pituitary gland.
What are the hormones produced by the pituitary gland?
Prolactine
A hormone that stimulates a woman’s breasts to produce milk during and after pregnancy.
Growth hormone:
A hormone that regulates body growth and the metabolism of sugar and fat. It is also known as somatotropin.
Adrenocorticotropic hormone (ACTH):
A hormone responsible for stimulating the adrenal glands to release cortisol. Cortisol regulates the metabolism of sugar, protein, and fats and helps the body manage stress.
Luteinizing hormone (LH) and follicle-stimulating hormone (FSH):
Hormones that regulate the menstrual cycle in women and sperm production in men.
Thyroid-stimulating hormone:
A hormone that stimulates the thyroid gland to produce hormones that regulate growth, body temperature, and heart rate. It is also known as thyrotropin.
What are the two forms of pituitary hormones?
Functioning pituitary tumors:
Active pituitary tumors produce excessive amounts of one or more hormones. Most pituitary tumors are active, and the excess hormones they produce can lead to various symptoms or health issues.
Nonfunctioning pituitary tumors:
Nonfunctioning pituitary tumors do not produce extra hormones.
What are the symptoms of pituitary tumors?
Symptoms can result from the tumor’s growth, the hormones it produces, or other conditions. Some tumors may not cause any noticeable symptoms. Should you encounter any of these problems, speak with your physician.
The signs and symptoms of a nonfunctioning pituitary tumor:
Sometimes, a pituitary tumor can press on or damage parts of the pituitary gland, which may lead to a decrease in hormone production. When there is not enough of a particular hormone, it can impact the function of the gland or organ that the hormone controls.
- Loss of body hair
- Headache
- Loss of vision
- Lower sex drive
- Less or no menstrual periods and unable to produce milk
- Delayed growth and sexual development especially in children
- Loss of facial hair, growth of breast tissue, and fertility issues especially in men
Most tumors that produce LH and FSH do not produce enough extra hormone to cause noticeable symptoms. These tumors are considered nonfunctioning.
The signs and symptoms of functioning pituitary tumor:
When a functioning pituitary tumor produces extra hormones, the signs and symptoms will vary depending on the type of hormone being produced.
When there is excess prolactin:
- Lower sex drive in men
- Infertility in men
- Headache
- Loss of vision to a certain level
- Absence of menstrual cycle in women
- Inability or trouble in getting pregnant
- Flow of breast milk in women who are not pregnant
Excess ACTH hormone can cause:
- Loss of vision
- Headache
- Fat buildup at the back of neck
- Bruising easily
- Easily broken bones
- Depression, irritability, and anxiety
- Pink or purple stretch marks in the chest or abdomen
- Putting on weight in neck and face area
- Fine hair growth on the face
Excess growth hormone can cause:
- Loss of vision
- Headaches
- Joint pain
- Acromegaly (growth of extra bones on face, hands, and legs)
- Joint pains
- Snoring
- Excessive sweating
- Numbness or tingling in fingers and hands
- Excess concern regarding a certain body part
Excess thyroid-stimulating hormone can cause:
- Trouble sleeping
- Sweating
- Frequent bowel movements
- Shakiness
- Weight loss
- Irregular heartbeat
What are the other general symptoms of pituitary tumors?
- Seizures
- Confusion
- Dizziness
- Vomiting and nausea
- Dripping nose
Reach out to the top ENT specialist in Coimbatore if you are experiencing any of these symptoms.
How do pituitary tumors affect the functioning of the body?
Because the pituitary gland is situated within the skull, a growing tumor can lead to worsening headaches. Additionally, since the gland is close to the eyes, it may press on the optic nerves and cause vision problems. Peripheral vision loss might occur first and go unnoticed, potentially leading to blindness if the pressure isn’t relieved. The tumor can also affect the nerves that control eye movement, causing double vision. In very large cases, the tumor might press on other parts of the brain, leading to issues with memory, weakness, or numbness.
What are the imaging studies recommended for pituitary tumors?
Along with asking about your personal and family health history and doing a physical exam, your doctor may carry out the following tests and procedures:
Neurological exam:
A series of questions and tests to assess the brain, spinal cord, and nerve function. The exam evaluates mental status, coordination, walking ability, and how well muscles, senses, and reflexes are working. This may also be referred to as a neuro exam or neurologic exam.
Eye checkup:
An exam to assess vision and the overall health of the eyes.
Visual field exam:
An exam to evaluate a person’s field of vision, which is the total area where objects can be seen. This test measures both central vision (what can be seen directly ahead) and peripheral vision (what can be seen from the sides while looking straight ahead). Each eye is tested individually, with the other eye covered.
MRI studies:
A procedure that uses a magnet, radio waves, and a computer to create detailed images of the brain and spinal cord. A substance called gadolinium is injected into a vein, which highlights cancer cells by making them appear brighter in the images. This procedure is also known as nuclear magnetic resonance imaging (NMRI).
Blood tests:
Tests to determine the blood’s concentration of estrogen or testosterone. Abnormal levels of these hormones can indicate a possible pituitary tumor.
Urine test:
A test where urine is collected over 24 hours to measure the levels of specific substances. Abnormal amounts of these substances can indicate a problem in the organ or tissue that produces them. An elevated level of the hormone cortisol might suggest a pituitary tumor or Cushing syndrome.
Biopsy:
Removing cells or tissue samples to examine them under a microscope for signs of cancer.
What are the different treatment options to treat pituitary tumors?
Transsphenoidal surgery:
A type of surgery where instruments are inserted into the brain through an incision made under the upper lip or between the nostrils, and then through the sphenoid bone (a butterfly-shaped bone at the base of the skull) to access the pituitary gland, which is located just above this bone.
Craniotomy:
It is surgery to remove a tumor from the pituitary gland through a cut made in the skull.
Endoscopic transsphenoidal surgery:
A type of surgery where an endoscope is inserted through a cut made inside the back of the nose and then through the sphenoid bone to access the pituitary gland. An endoscope is a thin, tube-like instrument equipped with a light, a lens for viewing, and tools for removing tumor tissue.
After the doctor removes all visible cancer during surgery, some patients may receive chemotherapy or radiation therapy afterward to target any remaining cancer cells.
What are the factors that might affect the treatment and recovery for pituitary tumors?
The outlook depends on the type of tumor and whether it has spread to other parts of the central nervous system (brain and spinal cord) or to other areas of the body.
It depends on:
- If the tumor is producing hormones
- The size and type of the tumor
- In case the tumor has spread in the brain or any other part of the body
- The point of diagnosis and in case it has recurred
- In case the tumor is causing symptoms like loss of vision
What happens if a pituitary tumor is left untreated?
Remember that even though large pituitary adenomas are not cancerous, if left untreated, they can still cause serious health problems due to their impact on the normal pituitary gland, optic nerves, and brain.
Are pituitary tumors considered serious?
In over 99% of cases, this is not cancer; it is benign. However, even though the tumor is benign, it can still cause issues due to its size, such as vision loss, reduced pituitary function (hypopituitarism), headaches, or excessive hormone production.
Are pituitary tumors curable?
If a pituitary tumor is diagnosed early, the chances of recovery are usually excellent. However, larger or rapidly growing tumors are more likely to cause problems and are harder to treat. Lifelong treatment or follow-up is often necessary to ensure the tumor doesn’t come back.
Can you live without a pituitary gland?
You can live without your pituitary gland if you take medication to replace the missing hormones. These hormones are essential for a wide range of body processes. Without pituitary gland tumor surgery, a lack of all pituitary hormones is life-threatening.
Important Takeaway:
Pituitary tumors aren’t always a reason for concern, as the majority of the time the pituitary tumors are non-cancerous. At times, these tumors may not cause any serious symptoms. But in case this tumor grows rapidly it may cause serious trouble in several important functions of the human body. Consult a best ENT hospital in Coimbatore if you are experiencing any signs of pituitary tumors.
