More than 10,000 pituitary tumors are diagnosed every year, according to the American Cancer Society. Most of these are benign adenomas that grow slowly.
Pituitary tumors are not cancerous, but some of them can cause harm because they compress and damage normal pituitary tissue, interfering with hormone production. Other tumors can overproduce hormones. Either way, producing too much or too little hormone, can cause problems throughout the body.
Pituitary tumors can lead to an assortment of symptoms, symptoms based on the hormones they affect. The variety of symptoms makes it challenging to diagnose pituitary disease. It requires a skilled and experienced team to do so.
To diagnose what could be a pituitary problem, we take a complete medical history and do a physical examination. Tests may include:
- Measurement of hormones in the blood and/or urine
- Neuroendocrine suppression or stimulation testing
- Magnetic resonance imaging or computed tomography scans
- Vision testing
- Petrosal sinus sampling (similar to an angiogram)
Depending on what we find, we work with you to develop a treatment plan that addresses the associated tumor and the symptoms it is causing. The plan may include medication management, pituitary surgery, or radiation therapy.
There are several types of pituitary tumors:
Adrenocorticotropic hormone- (ACTH) producing tumors cause the pituitary gland to secrete increased amounts of ACTH, which then causes the adrenal glands to produce excess cortisol. This rare pituitary condition, known as Cushing's disease, causes a variety of symptoms and physical changes, including easy bruising; facial roundness and redness; loss of hair on the head and increased hair on the face and body in women; muscle loss that causes thinning of the arms and legs; fragile and thin skin, with red stretch marks; and weight gain, often in the abdomen, upper back, and neck.
Other risks from Cushing’s disease include depression and anxiety, diabetes mellitus (high blood sugar), high blood pressure, loss of bone, leading to osteoporosis, and poor concentration and memory.
Growth Hormone Tumors
About one in five pituitary adenomas are growth hormone tumors, according to the American Brain Tumor Association. Growth hormone tumors produce excess growth hormone, which makes your bones grow bigger, especially in the hands, feet, and face (acromegaly). When these tumors are greater than 1 cm in size, we call them “macroadenomas.” These large growth hormone tumors trigger a loss of peripheral vision and reduced levels of the normal pituitary hormones.
This tumor causes a variety of physical changes, which appear gradually. The changes can include broadening of the brow and nose, adjustments in your jaw and bite; enlarging of the hands and feet; excessive sweating; and oily skin.
It also carries the increased risk of colon polyps, diabetes mellitus (high blood sugar), heart disease, high blood pressure, and sleep apnea. In children, growth hormone tumors can cause gigantism, which produces abnormally large muscles, bones, and connective tissue.
About one in four pituitary adenomas are non-functioning tumors, according to the American Brain Tumor Association. These tumors grow slowly and cause few symptoms. As a result, they can grow to a large size before we are aware they are present. These “silent” tumors can put pressure on the optic nerves giving you headaches and difficulty seeing. They can also compress the pituitary gland to the point where it cannot function properly, thereby reducing the amount of hormones produced (called hypopituitarism).
Prolactin-producing tumors (prolactinomas) account for about half of pituitary adenomas. They can decrease the levels of estrogen in women and testosterone in men. As a result, women may experience irregular or lack of menstrual periods, infertility, and inappropriate breast milk production, as well as an increased risk for osteoporosis. Men may have enlarged breasts and decreased body hair, erectile dysfunction or impotence, infertility, and loss of interest in sexual activity.
Thyroid-simulating tumors (TSH) are the rarest of the pituitary tumors. They lead to an overproduction of TSH, which stimulates the thyroid glands to make too much thyroxine, causing hyperthyroidism. This condition accelerates the metabolism and can result in a variety of symptoms, including fatigue and difficulty sleeping, heat intolerance and excessive sweating, increased bowel movements or diarrhea, light or absent menstrual periods, nervousness, rapid heartbeat, tremors, and weight loss.