Pituitary tumors: What to know

David Straus, MD

Neurosurgery

Most pituitary tumors are not serious. In fact, most people with pituitary tumors never even know they have them. However, there are times when treatment is needed. Neurosurgeon David Straus, MD, explained what pituitary tumors are, the symptoms to look for and how they’re treated.

What is a pituitary tumor?

A pituitary tumor is a benign (not cancerous) growth that grows from within the pituitary gland, which is in the base of the brain and helps to regulate the hormonal production and functions of the rest of the body. Pituitary tumors evolve when a cell within the pituitary gland becomes unregulated in its growth.

How can you tell if you might have a pituitary tumor?

Pituitary tumors can cause a wide range of symptoms that can be divided into two main categories: those that are caused by pressure from the mass of the tumor itself and those that come from dysfunction of the hormones in the gland, causing it to either under-secrete or over-secrete a particular hormone.

Symptoms due to tumor pressure

As the tumor grows, it can press on areas in the brain surrounding the pituitary gland and can cause dysfunction of the pituitary gland as well as injury to the nerves and parts of the brain that surround the gland.

“Most commonly these symptoms include difficulty with vision, whether that be a loss of vision from pressure on the eye nerves that run directly above the gland, or whether that be issues with the cranial nerves that control the movement of the eyes that can cause double vision and other sorts of issues,” Dr. Straus said.

Symptoms due to hormone changes

As they grow, tumors can cause the pituitary gland to under-secrete the hormones that are needed in the rest of the body. This can cause symptoms such as:

• Nausea
• Muscle weakness
• Less frequent or no menstrual periods
• Sexual dysfunction
• Unintended weight loss or gain

“The other situation that can arise is when a pituitary tumor produces too much of a particular hormone,” Dr. Straus said. “This is called a secreting tumor.”

There are three common types of hormones that are over produced by these tumors:

• Prolactin secreting tumors. Overproduction of prolactin (prolactinoma) can cause enlargement of the breast tissue and lactation (milk production).

• ACTH secreting tumors. ACTH controls the levels of cortisol in the body. This excess of steroid or cortisol in the body can lead to several significant problems including heart dysfunction, high blood pressure, diabetes and obesity.

• Growth hormone secreting tumor. The results of increased growth hormone secretion cause enlarged hands and feet, as well as growth of the frontal bone and nose and other soft tissue structures in the body.

What are the treatment options?

“Treatment options revolve very much on what effects the tumor is having on the body,” Dr. Straus said. “In some cases of very small tumors less than a centimeter in size, which do not secrete hormones, do not cause dysfunction of the pituitary gland itself and do not cause any visual symptoms, these tumors can often be carefully observed without any direct intervention.”

Tumors that don’t fit into that group, whether they grow to a point of causing visual disturbances or whether they are producing hormones and causing effects from hormonal overproduction, need to be treated. “The best treatment option for them is a surgical treatment where the tumor is removed from around the gland,” Dr. Straus said.

Other treatment options include radiation therapy and medication.

If you’re experiencing symptoms, talk to your primary care provider.