Overview and Facts about Pituitary Adenoma
A pituitary adenoma is a slow-growing tumor on the pituitary gland, a small structure located at the bottom of the brain, just behind the nasal sinuses.
Often referred to as the “master gland,” the pituitary gland helps monitor bodily functions and balances hormone levels in the body. Over 90% of these tumors are benign (noncancerous).
Pituitary adenomas are the third most common intracranial tumor, and typically affect people in their 30s through 70s, but may also affect children.
Symptoms and Signs of Pituitary Adenoma
There are two main kinds of pituitary tumors: functional and non-functional.
Some pituitary tumors produce excess hormone and are called functional or secretory tumors.
Depending on which hormone is being overproduced, you may exhibit a variety of unusual symptoms, even with very small tumors. Having excess of a specific hormone can lead to significant health concerns.
The majority of pituitary adenomas are non-functioning or non-secretory tumors and do not produce any excess hormones.
Small non-functioning pituitary adenomas (10 millimeters or less) do not cause symptoms. These are known as microadenomas.
Symptoms often develop when tumors grow larger than 10 millimeters (macroadenomas) and put pressure on other brain structures and nearby nerves. Symptoms may also appear when the tumor causes the normal pituitary gland to make too few hormones, causing problems in the body.
The following symptoms may occur:
-
Headaches
-
Vision problems (loss of peripheral vision, double vision, drooping eyelid)
-
Nausea or vomiting
-
Changes in behavior, including hostility, depression and anxiety
-
Changes in the sense of smell
-
Nasal drainage
-
Sexual dysfunction
-
Infertility
-
Fatigue
-
Unexplained weight gain or loss
-
Achy joints or muscle weakness
-
Growth problems (children)
-
Early menopause
Tests and Diagnosis of Pituitary Adenoma
A diagnosis is made based on a physical examination, lab tests, and imaging tests. Blood and urine tests are performed to evaluate the hormone levels in the blood.
Computerized tomography (CT) scans and magnetic resonance imaging (MRI) confirm the presence and size of the tumor. A vision test to detect visual field deficits may also be performed.
Causes and Risk Factors of Pituitary Adenoma
Most patients with pituitary adenomas do not have an underlying condition that predisposed them to developing this tumor. Researchers have not yet pinpointed the exact cause of these types of adenomas.
There is a very rare hereditary condition known as multiple endocrine neoplasia type I (MEN 1) that may increase the risk of developing pituitary tumors.
This condition causes multiple tumors to occur in various glands of the endocrine system and patients often present with many other problems.
Treatment and Care for Pituitary Adenoma
Pituitary adenomas may be treated with surgery, radiation therapy, medication, or a combination of these therapies. Small tumors that are not causing symptoms or hormonal excess often do not need any treatment but are routinely monitored closely.
Functional tumors and large non-functioning tumors that are growing or causing symptoms usually require treatment:
-
Surgery: This is typically performed by a skull base team comprised of a fellowship-trained otolaryngologist (ENT) and neurosurgeon. The transphenoidal approach is most commonly used where a small endoscope and light along with long instruments are passed through the nostrils to remove the tumor without any external incisions.
-
Radiation therapy: A unique form of radiation therapy, called stereotactic radiosurgery, helps to shrink the tumor by delivering precise, high-power radiation with the help of advanced imaging technology.
-
Medical therapy: Medications may be prescribed to shrink the tumor and to return hormone production to normal levels but are used for very specific types of functional tumors. Medication can be used alone or with the other treatments.
