The neurologists and neurosurgeons at Torrance Memorial Medical Center
offer expert care for pituitary disorders that are caused by pituitary
tumors. We also work with other medical specialists — including
endocrinologists and primary care physicians — to treat pituitary
disorders that are caused by infections, injuries, autoimmune diseases,
and other conditions.
Our affiliation with the neurology and neurosurgery team at Cedars-Sinai
— which is ranked among the best hospitals in the nation for neurology
and neurosurgery care by
U.S. News & World Report — means that our patients have access to some of the nation’s
top doctors, the most promising clinical trials, and the latest and best
treatments.
What is a Pituitary Disorder?
A pituitary disorder is a problem with your pituitary gland, which is located
near your brain. Pituitary tumors are the most common cause of pituitary
gland disorders. However, pituitary gland disorders can also be caused
by infections, injuries, autoimmune diseases, and other conditions.
Pituitary disorders include:
- Acromegaly
- Adult growth hormone deficiency
- Craniopharyngioma
- Cushing syndrome
- Diabetes insipidus
- Hypopituitarism
- Non-functioning pituitary tumor
- Pituitary adenoma
- Pituitary cancer
- Pituitary gland failure (pituitary apoplexy)
- Prolactinoma
What is a Pituitary Tumor
A pituitary tumor is a growth of abnormal cells in your pituitary gland.
Your pituitary gland is responsible for regulating your endocrine system
and hormone levels. Most pituitary tumors are benign or noncancerous,
which means they will not spread to other parts of your body.
Noncancerous pituitary tumors are very common and often have no symptoms.
Up to 20 percent of the adult population is estimated to have a noncancerous
pituitary tumor.
Although most pituitary tumors are benign, they can still grow large and
cause symptoms. In rare cases, the tumor may be malignant or cancerous,
which means it can spread to other parts of your body and create new tumors,
or metastasize.
Types of Pituitary Tumors
Pituitary tumors are categorized in several ways depending on their size,
growth, and whether or not they secrete hormones.
Categories include:
-
Hormone secretion. A functioning pituitary tumor secretes one of the major hormones produced
by the pituitary gland: prolactin, adrenocorticotropin, thyroid stimulating
hormone, or growth hormone. This can cause symptoms due to the elevated
levels of these hormones in your body.
-
Aggressiveness. Most pituitary tumors are benign, do not spread, and grow slowly. However,
some pituitary tumors may be faster growing, or malignant, and spread
to other parts of your body.
Symptoms
Symptoms of pituitary tumors can vary greatly depending on the type and
size of the tumor. Symptoms may include
Hormone deficiency. Hormone deficiency can cause:
- Nausea and vomiting
- Feeling cold
- Lowered frequency or stopped menstrual periods
- Problems with sex
- Increased urination
- Changes in your weight
- Weakness
Overproduction of hormones. Hormone overproduction may occur when a pituitary tumor forms from cells
that still produce hormones. This can lead to a wide range of symptoms
depending on the hormones produced.
Adrenocorticotropic hormone-secreting (ACTH) tumors. This type of tumor causes your adrenal glands to produce too much cortisol,
which can lead to:
- Depression, anxiety, or irritability
- A rounder-looking face
- Thinner limbs
- High blood pressure
- High blood sugar
- Weakened bones
- Acne
- Bruising
- Stretch marks
- Too much fat around your midsection and upper back
Growth hormone-secreting tumors. This type of tumor can produce too much growth hormone, which may cause
symptoms including:
- Children and adolescents growing too quickly or too tall
- Rough or coarse facial features
- Larger hands or feet
- Joint pain
- Sweating
- High blood sugar
- Excess body hair
- Heart problems
- Crooked or misaligned teeth
Prolactin-secreting tumors. This type of tumor can produce too much prolactin and cause decreased levels
of sex hormones.
Thyroid stimulating hormone-secreting (TSH) tumors. This type of tumor can produce too much TSH and may cause symptoms including:
- Irritability or nervousness
- Frequent bowel movements
- Sweating
- Weight loss
- Irregular or rapid heartbeat
Pituitary tumors that grow very large may also cause vision problems by
putting pressure on the optic nerve.
Causes and Risk Factors
The cause of abnormal cell growth that leads to pituitary tumors is unknown.
There are very few confirmed risk factors for pituitary tumors, and all
of them are genetic.
Risk factors for pituitary tumors include:
- A family history of pituitary tumor
-
Hereditary conditions, including:
- Multiple endocrine neoplasias, type 1 (MEN 1)
- Multiple endocrine neoplasias, type 4 (MEN IV)
- McCune-Albright syndrome
- Carney complex
Diagnosis
Diagnosing a pituitary tumor can be difficult because the symptoms of a
pituitary tumor often resemble those of other conditions.
A pituitary tumor may be diagnosed in multiple ways, including:
-
Imaging tests. Your doctor may order tests such as a CT (computed tomography) scan or
MRI (magnetic resonance imaging) scan, which create highly detailed pictures
of your brain to find abnormalities, including a pituitary tumor.
-
Blood or urine testing. Your doctor may order these tests to measure your hormone levels and check
for overproduction or deficiencies.
-
Biopsy. During a biopsy, samples of abnormal tissue will be collected and tested
to determine if the tumor is cancerous or benign. Biopsies are rarely
needed to diagnose a pituitary tumor, but are usually done when removing
the pituitary tumor.
-
Vision testing. Your doctor may order vision tests to determine if your pituitary tumor
is affecting your vision.
Treatment
When presenting treatment options for a pituitary tumor, your doctor will
consider the type of tumor, your signs and symptoms, and your general
medical condition.
Treatments for pituitary tumor include:
-
Surgery. Surgery usually is only necessary if the tumor is putting pressure on your
optic nerve or over producing hormones. Surgery can be done in two ways,
depending on the size of your pituitary tumor:
-
Endoscopic transnasal transsphenoidal surgery. This procedure involves removing your pituitary tumor through your nasal
cavity and nose with minimal incisions. This is most successful with small tumors.
-
Transcranial surgery. This procedure involves making an incision in your scalp and removing
the tumor through it. Larger tumors are more easily removed this way.
-
Medication. Medications can be used to block the production of hormones that your
pituitary tumor may be secreting in too high amounts, shrink your pituitary
tumor, or replace hormones that you lack because of a pituitary tumor.
-
Radiation therapy. Radiation therapy treats your pituitary tumor using x-rays or proton beams.
-
Observation. If your pituitary tumor is not causing any symptoms, your doctor may recommend
observing your pituitary tumor to see if any changes that would require
further intervention occur.