Pituitary Adenomas
Pituitary adenomas originate in the pituitary gland, which controls the secretion of hormones from other endocrine glands in the body. These slow-growing tumors are common, treatable and typically not cancerous. Treatment often requires a coordinated, multi-disciplinary approach because of the pituitary gland’s important role in the body.
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Meet the specialists at the Gerald J. Glasser Brain Tumor Center who are experts in treating pituitary adenomas.
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Pituitary adenomas can be classified by their size. Small tumors are called microadenomas and larger ones are called macroadenomas. They are also categorized by whether they impact hormone production.
Non-hormone secreting (non-functional) – Pituitary adenomas that don’t release hormones can be small and not cause symptoms. However, symptoms can occur when the tumor gets larger and presses on the nearby optic nerves and brain. When the tumor compresses the normal pituitary gland, it can reduce the production of normal hormones (hypopituitarism).
Hormone secreting (functional) – Some pituitary tumors lead to overproduction of certain hormones (Cushing’s syndrome, acromegaly or hyperthyroidism). These excess hormones (ACTH, GH, TSH and PRL) can interfere with a wide variety of bodily functions.
Symptoms
- Vision loss
- Lack of menstrual period
- Infertility
- Production of breast milk without pregnancy
- Excess or abnormal body growth
- Weight gain
- Hyperactive thyroid
- High blood pressure and unusual changes in the skin and body
- Headaches
Diagnosis
Pituitary adenomas are diagnosed through a physical exam and specialized testing. Diagnosis can be challenging because of the wide variety of hormone-related symptoms they can cause. Specialized tests can include:
- Endocrine assessment – Blood tests are used to evaluate the patient’s hormone levels and determine if the pituitary gland is functioning normally. An endocrinologist may be consulted at this stage.
- Ophthalmic assessment – An ophthalmologist may examine the patient’s eyes and perform a visual field test to determine if the tumor is affecting clarity of vision or impairing peripheral vision.
- Imaging studies – A variety of scans are used, like computed tomography (CT), magnetic resonance imaging (MRI) with contrast dye or magnetic resonance angiogram, a type of MRI that uses a magnetic field and pulses of radio-wave energy to provide pictures of blood vessels inside the body. A CT scan of the chest or abdomen may also be done to rule out other causes for a hormone imbalance.
An exact diagnosis can only be confirmed once the tumor has been removed. Tissue analysis by a neuropathologist defines the diagnosis and genetic profile of the tumor.
Treatment
Our team will develop a personalized treatment plan for you based on your tumor’s hormonal activity, size and location along with your age, health and symptoms. Certain tumors present technical challenges because they adhere to vital neural and vascular structures at the base of the brain.
Treatment could include a combination of:
- Observation – used over time for some small, benign tumors without symptoms or hormonal imbalances.
- Surgery – may be recommended based on the tumor’s size, effect on the surrounding brain and optic nerves or impact to hormones. An ear, nose and throat surgeon and neurosurgeon who specialize in skull base surgery typically collaborate and use endoscopic minimally invasive techniques to access the tumor through the nose and sinuses.
- Medications – often prescribed in collaboration with an endocrinologist and may be used alone (particularly for tumors that produce prolactin) or following surgery.
- Non-invasive, stereotactic radiosurgery (CyberKnife®) – used as a primary treatment or alongside other treatments for tumors in difficult-to-reach locations or in patients who can’t have surgery.
After surgery, tumor tissue is microscopically examined to establish an accurate diagnosis and subtype, which help determine the next steps in treatment.
Our team will closely monitor you and personalize your follow-up care. Our patient navigator will also connect you with our support group and other resources.