Pituitary Tumor

A pituitary tumor starts in the pituitary gland, a small gland at the base of the brain. This gland makes hormones that help control growth, blood pressure, reproduction, thyroid function, and many other body processes.

Most pituitary tumors are not cancer. They usually do not spread to other parts of the body and are often called pituitary adenomas.

Types & Stages

Most pituitary tumors are benign (noncancerous) adenomas. They tend to grow slowly and stay in or near the pituitary gland. Doctors often group them into two main types:

• Functioning adenomas. These make extra hormones, which can cause a range of symptoms depending on the hormone involved. Common types include:
  • ACTH-producing adenomas
  • Growth hormone-producing adenomas
  • Prolactin-producing adenomas
  • TSH-producing adenomas
  • Gonadotroph adenomas
     
• Non-functioning adenomas. These do not make enough extra hormones to cause clear hormone symptoms. They are usually noticed because they grow large enough to press on nearby structures.

Pituitary cancers (carcinomas) are very rare. A few other rare growths can also form near the pituitary, such as craniopharyngioma or Rathke cleft cyst.

Pituitary tumors are not staged like many other cancers. Instead, doctors often describe them by size. Some are small and cause no problems, while larger tumors can press on nearby nerves, the brain, or other structures.

Signs & Symptoms

Some pituitary tumors cause no symptoms and are found by chance during imaging done for another reason. When symptoms do occur, they tend to fall into two groups.

Pressure symptoms can happen when a larger tumor presses on nearby areas. These may include:

• Headache
• Vision changes, especially loss of side vision
• Double vision
• Facial pain
• Drooping eyelid
• Nausea or vomiting

Hormone-related symptoms can happen when a tumor makes too much of a hormone or affects how the gland works. These may include:

• Fatigue or weakness
• Sexual or menstrual changes
• Weight changes
• Feeling cold
• Increased thirst or urination

Some functioning tumors cause specific patterns of symptoms:

• Cushing disease (too much ACTH): weight gain around the midsection, a rounded face, easy bruising and thinning skin
   
• Acromegaly or gigantism (too much growth hormone): larger hands, feet, and facial features in adults, or unusually fast growth in children
   
• Prolactinoma (too much prolactin): irregular periods, breast discharge, erectile problems or trouble with fertility
   
• Hyperthyroidism (too much TSH): weight loss, rapid heartbeat, nervousness and trembling

Many of these symptoms can be caused by conditions that are not a tumor. Still, if a symptom is new, lasting, or worries you, talk with a healthcare provider. Treatment can often bring hormone levels back to normal and ease symptoms.

Diagnosis

Tests and procedures used to diagnose a pituitary tumor may include:

• Blood and urine tests. These check hormone levels to see whether the pituitary gland is making too much or too little of certain hormones.
   
• MRI. This is the main imaging test. It creates detailed pictures of the pituitary gland and nearby structures.
   
• CT scan. This may be used in some cases to provide additional detail.
   
• Visual field exam. If the tumor may be pressing on the nerves to the eyes, this test checks for vision changes, such as loss of side vision.

A biopsy is uncommon for pituitary tumors. When tissue is examined, it is usually collected during surgery or in unusual cases.

Treatment

Treatment depends on the type and size of the tumor, your symptoms, any hormone changes, your age, and your overall health. Your care team can help explain the benefits and risks of each option.

Treatment may include:

• Observation. If a tumor is small and not causing problems, your doctor may simply monitor it over time with regular exams and imaging.
   
• Medicines. Some hormone-producing tumors can be controlled with medication. Medicines can also replace hormones if levels are too low.
   
• Surgery. Many pituitary tumors can be removed through the nose or sinuses, which avoids an opening in the skull. Open skull surgery is used only for selected larger or more complex tumors.
   
• Radiation therapy. Radiation may be used in select cases, including focused treatment such as stereotactic radiosurgery, which delivers a precise dose to the tumor.

Your doctor may suggest a combination of these treatments. Clinical trials may also be an option. These studies test new treatments or new ways to use current ones. Ask your care team whether a clinical trial may be right for you.

Causes & Risk Factors

Most pituitary tumors have no clear cause. In rare cases, they are linked to conditions that run in families.

• Family history. Although uncommon, some pituitary tumors are inherited.
• Inherited syndromes. Certain genetic syndromes can raise the risk of pituitary tumors, including:
• Multiple endocrine neoplasia type 1 (MEN1)
• Multiple endocrine neoplasia type 4 (MEN4)
• McCune-Albright syndrome
• Carney complex
• Familial isolated pituitary adenoma (FIPA)

Having a risk factor does not mean you will develop a pituitary tumor and many people with one have no clear risk factors. Talk with your healthcare provider about your personal risk.

Screening

Routine screening for pituitary tumors is not recommended for most people.

Many pituitary tumors are found by accident during a CT or MRI scan done for another reason. Others are found because hormone-related symptoms lead to testing. Functioning tumors are often found while still small, since extra hormones can cause noticeable symptoms. Non-functioning tumors may not be found until they grow large enough to press on nearby structures.

If you have symptoms that are new, lasting, or unusual for you, talk with a healthcare provider about whether further evaluation is needed.

This information is for general education only and is not a substitute for medical advice. Please consult a qualified healthcare provider for diagnosis, treatment recommendations, and guidance based on your personal health history.