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What are pituitary tumors?

A pituitary tumor is an abnormal, uncontrolled cell growth in your pituitary gland. These tumors can cause the pituitary gland to produce either too much hormone, or too little. This change in hormone levels can cause a wide range of symptoms.

The pituitary gland is a small gland at the base of your brain, behind your nose. It influences almost every function of your body by controlling the release of most of the body’s hormones, which it also produces. These hormones regulate growth, blood pressure, reproduction, and many other bodily functions.

Are pituitary tumors cancer?

No, most of them are benign (not cancerous), and do not spread to other parts of your body. They tend to grow very slowly.

How common are pituitary tumors?

They are the fourth most common type of brain tumor, and the most common disease affecting the pituitary gland. They are most common in people in their 30s or 40s, but can occur in children.

Causes

What causes pituitary tumors?

The cause is unknown. However, a small percentage of cases tend to occur in families. This suggests that genetic changes can influence how they develop.

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Symptoms

What are the symptoms of pituitary tumors?

Sometimes there are no symptoms. If you have symptoms, they are generally caused by too much or too little production of one or more hormones. Symptoms can also be caused by compression of the tumor on surrounding structures. Symptoms vary widely and depend on which hormone is over- or under-producing.

The symptoms that each hormone can cause include:

Growth hormone symptoms

Symptoms depend on age. In children, increased growth hormone can cause gigantism, causing extra height and a large body. Low levels of growth hormone can cause children to have delayed growth, weak bones and muscles, irritability, and a generally sick feeling.

In adults, excess growth hormone can cause:

Acromegaly, which causes a thickened skull or jaw; or enlarged arms, legs, hands and feet
High blood glucose
High blood pressure
Heart disease
Sleep apnea
Headaches
Excessive sweating
Coarsened facial features
Increased body hair
Misaligned teeth
Joint pain

Thyroid hormone symptoms

Changes in the thyroid stimulating hormone (TSH) can cause too much or too little active thyroid hormone, resulting in these symptoms:

Nervousness or irritability
Rapid heart rate
Increased sweating
Weight loss with high TSH
Weight gain with low TSH
Fatigue
Sensitivity to hot or cold temperatures
Constipation or diarrhea

Abnormal prolactin production symptoms

Too much prolactin can cause:

Menstrual cycle changes in women
Loss of sex drive
Erectile dysfunction in men
Infertility
Breast growth in men
Production of breast milk in women or men
Osteoporosis

Insufficient prolactin can prevent a woman from breastfeeding her newborn.

Abnormal ACTH production symptoms

Too much adrenocorticotropic hormone (ACTH) can cause:

Weight gain, especially in your midsection
High blood pressure
High blood glucose
Osteoporosis
Irritability
Easy bruising
Acne and increased hair growth
Stretch marks
Muscle weakness

Too little ACTH can cause:

Fatigue or low energy
Low blood pressure
Low blood glucose
Upset stomach

FSH and LH symptoms

FSH and LH are gonadotropin hormones. They’re rarely high enough to cause symptoms, but in rare cases they can cause infertility. Women may have irregular menstrual cycles; men may have erectile dysfunction.

Can a pituitary tumor cause vision problems?

Yes, if the tumor is pressing on your optic nerves or the nerves that control eye movements, it can cause:

Vision changes
Double vision
Partial vision loss
Blindness
Headaches

Diagnosis

How are pituitary tumors diagnosed?

Tests can be performed to diagnose pituitary tumors, depending on your symptoms, age, general health, and the type of tumor you have.

Diagnostic tests include:

Lab tests measure the amounts of hormones in your blood.
MRI, now the standard diagnostic test for these tumors, can produce detailed images of your body, including soft tissues.
CT scans can provide a three-dimensional image of the tumor and measure its size.
Visual field test can determine if there are eye or vision problems.

Treatment

How will my treatment be determined?

Treatment of pituitary tumors is determined by test results, and by the type and stage of tumor, your overall health, and your treatment preferences. Be sure you understand all your treatment options, and what to expect during treatment. Your treatment should also include medications for discomfort and side effects.

A team of several types of doctors, called a multidisciplinary team, is often involved in treating pituitary tumors. Your treatment team will likely be led by an endocrinologist -- a specialist in gland problems and the body’s endocrine system. If you’re having vision problems, an ophthalmologist will be on your team. If surgery is needed, a neurosurgeon will be included.

Options for treatment can include:

“Watchful waiting” is for people who have no symptoms and normal hormones. You’ll have regular exams and/or tests to watch for tumor growth. If the tumor begins to grow, you’ll start active treatment.
Surgery is the most common treatment for pituitary tumors. The goal is to remove the entire tumor, usually performed through the nasal passage.
Radiation therapy uses high-energy X-rays (external-beam radiation) to destroy tumor cells. This treatment is used when some of the tumor is not removed during surgery or cannot be treated with medications. Radiation is very effective in stopping tumor growth, and eventually shrinking the tumor. Radiation side effects may include fatigue, upset stomach, and skin reactions in the short term. Long term, it can cause short-term memory problems or cognitive changes. Radiation can cause your pituitary gland to lose the ability to produce hormones, possibly requiring hormone replacement therapy. ‍
Medication to treat pituitary tumors is called systemic therapy. It includes hormone replacement therapy or other drugs. You may receive more than one type of medication, or you may take medications along with surgery or radiation therapy.

Treatment for aggressive pituitary tumors, or those that have spread to nearby tissue (called locally invasive), or to other parts of the body (called metastatic cancerous tumor) are more likely to benefit from radiation therapy.

Can a pituitary tumor return after treatment?

Yes, it can recur in the same place, a nearby area, or rarely, in a distant place. If this happens, it will need to be re-evaluated and retested.

Being diagnosed with a pituitary tumor can be an emotional and frightening experience. You’ll need the best care from highly trained specialists. Call Inland Endocrine today for an appointment with our specialists.

References

**Mayo Clinic Staff. 2021. Pituitary Tumors. Patient Care and Health Information. Retrieved 07.01.2021, {https://www.mayoclinic.org/diseases-conditions/pituitary-tumors/symptoms-causes/syc-20350548**}

**American Association of Neurological Surgeons. N.d. Pituitary Gland and Pituitary Tumors. AANS. Retrieved 07.01.2021, {https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Pituitary-Gland-and-Pituitary-Tumors**}

**American Society of Clinical Oncology. 2019. Pituitary Gland Tumor: Symptoms and Signs. Cancer.net. Retrieved 07.01.2021,{https://www.cancer.net/cancer-types/pituitary-gland-tumor/symptoms-and-signs**}

**American Society of Clinical Oncology. 2019. Pituitary Gland Tumor: Diagnosis. Cancer.net. Retrieved 07.01.2021, {https://www.cancer.net/cancer-types/pituitary-gland-tumor/diagnosis**}

**American Society of Clinical Oncology. 2019. Pituitary Gland Tumor: Types of Treatment. Retrieved 07.01.2021, {https://www.cancer.net/cancer-types/pituitary-gland-tumor/types-treatment**}

Information

Medically reviewed by:‍

Stuart Seigel, MD

Dr. Seigel is a board certified Endocrinologist. He completed his residency in internal medicine and fellowship in endocrinology, diabetes and metabolism at the University Of Pittsburgh Medical Center in 2011 and 2013.

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