Pituitary Tumor

Pituitary Tumor

            Pituitary tumor is an abnormal growth developing in the pituitary gland. It is normally noncancerous growth and rarely spreads to other parts of the body. The occurrence of pituitary tumor affects several hormones that are important to many functions of the body. The treatment may include removal surgery, medications controlling the hormone level or a wait-to-see approach.

Symptoms

           Signs and symptoms of pituitary tumor are varied to the affected hormones. They also depend on the size and pressure of the tumor on other structures. The tumors with the size of 1 centimetre are considered as large pituitary tumors called macroadenomas. Other smaller tumors are called microadenomas.

            As the results of tumor pressure, patients may have headache and vision loss especially the loss of peripheral vision. The development of pituitary tumor can cause hormone-related symptoms including:

• Overproduction of hormone
• Hormonal deficiency
• Adrenocorticotropic hormone-secreting (ACTH) tumors

People with ACTH tumors may experience Cushing’s syndrome that may caused:

• • • Fat accumulation around the midsection and upper back
    • Facial roundness
    • Muscle weakness
    • Thin arms and legs
    • High blood sugar
    • High blood pressure
    • Acne
    • Weakened bone
    • Bruising
    • Stretch marks
    • Anxiety
    • Irritability
    • Depression

• Growth hormone-secreting tumors

                  Pituitary tumors can increase growth hormone that may cause:

• • • Coarsened facial features
    • Enlarged hand and feet
    • Increasing of sweating
    • High blood sugar
    • High blood pressure
    • Heart problems
    • Joint pain
    • Misaligned teeth
    • Increasing of body hair

• Prolactin secreting tumors

                     Women with this condition may experience:

• • • Incommon menstrual periods
    • Lack of menstrual periods
    • Discharge of milk from the breast

                      Men with this condition may experience:

• • • Decreased amount of sperm count
    • Loss of sex drive
    • Erectile dysfunction
    • Breast growth

• Thyroid-stimulating hormone-secreting tumors

Pituitary tumors may cause an overproduction of thyroid-stimulating hormone causing hyperthyroidism or overactive thyroid disease that may lead to:

• • • Loss of weight
    • Irregular or rapid heartbeat
    • Nervousness
    • Irritability
    • Frequent bowel movements
    • Increasing of sweating

When to see a doctor

            You may see a doctor if you have found any of the signs and symptoms mentioned above. You are also advised to consult the doctor if your family is involved with endocrine neoplasia, type 1 (MEN1).

Causes

            Pituitary tumors are caused by uncontrollable growth of cells forming a tumor in the pituitary gland. The reason for this abnormal growth is still unclear but it was found that genetic alterations may relate to the development of pituitary tumors.

Risk factors

            Multiple endocrine neoplasia, type 1 (MEN1) is one of hereditary conditions that can increase the risk of pituitary tumor since the tumors may occur in several glands of the endocrine system.

Complications

            Even though pituitary tumors seldom grow or spread to other parts of the body, it may lead to a vision loss or permanent hormone deficiency in some cases.

Diagnosis

            Since the symptoms of pituitary tumor are similar to other conditions, it is often undiagnosed and may be found from the tests for other conditions. However, to diagnose pituitary tumor, the doctor may conduct some conduct a physical exam and several tests including:

• Blood and urine test: to measure the level of hormones

• Brain imaging: such as a CT scan or MRI, to explore the location, and size of the tumor
• Vision testing: to determine the effect of the tumor your eye vision

Treatment

            The treatment for pituitary tumor depends on its type, size and growth. The doctor also considers your age and other conditions of individuals. Some people with pituitary tumors that are not causing signs or symptoms may not need any treatment. They may be required to have a wait-to-see approach including regular follow-up tests to monitor the growth of the tumor.

            However, the doctor may consider some treatment for people with pituitary tumors that cause some symptoms. The choices of treatment may include:

• Removal surgery

             In case the tumor affects the production of hormones or presses on the optic nerve, the doctor may recommend a surgical removal of a pituitary tumor. There are two main techniques of the removal surgery including:

• • Endoscopic transnasal transsphenoidal surgery

• • Transcranial approach (craniotomy)

If the tumor is large and more complicated, this technique allows the tumor to be removed through the upper part of your skull.

• • Radiation therapy

The aim of radiation therapy is to destroy the tumor by delivering high-powered beams of energy directly to the tumor. The doctor may use this treatment alone or after the surgery to increase the effectiveness of the treatment. There are several methods of radiation therapy including:

• • • Stereotactic radiosurgery
    • External beam radiation
    • Intensity modulated radiation therapy (IMRT)
    • Proton beam therapy

• Medication

             The doctor may prescribe some medications to shrink some types of pituitary tumor or to control the level of hormone including:

• Replacement of pituitary hormones

             You may need to take replacement hormones to maintain and control the level of hormone if the tumor or the surgery decreases the production of the hormone. People who have radiation treatment might be also required to take the hormonal replacement.

Preparing for an appointment

             Before your appointment,  you are advised to be aware of restrictions prior the appointment and you may prepare some information including:

• • your experienced symptoms
  • your key personal information
  • all medications you are taking
  • questions that you want to ask the doctor

            During the consulting, the doctor may ask some questions including the information such as:

• • the beginning of your symptoms
  • whether your symptoms are continuous or occasional
  • the severity of your symptoms
  • whether anything improve or worsen your symptoms
  • history of testing with medical images of the head area