Carcinoma or adenoma is the name given to the tumors that form in the pituitary gland. Pituitary adenomas account for only 10% of primary brain tumors and are usually slow-growing masses that are mostly benign in nature. The potentially dangerous malignant types of pituitary adenomas that rarely occur are called pituitary carcinomas.
The pituitary’s front two-third area is where the bulk of the pituitary adenomas usually grow. “Non-secreting” and “secreting” are the two classifications of such tumors. High production of hormones is associated with a “secreting tumor”. The type (s) of hormones produced by a pituitary gland tumoris the factor on which further classification of these tumors is made.
Signs and Symptoms of Pituitary Gland Tumor
Patients with pituitary tumors sometimes don’t experience any symptoms at all or have them because of an illness unrelated to the tumor. Some of the signs and symptoms that a person suffering from a pituitary gland tumor might encounter are:
- Eye-sight issues
- Menstrual cycle changes in women
- Male impotence or erectile dysfunction because of hormonal changes
- Disproportionate breast milk production
- Cushing’s syndrome due to ACTH overproduction
- Acromegaly because of excess growth hormone production
- Unexplained tiredness
- Mood swings
Pituitary tumor symptoms manifest themselves in the following three ways:
Overproduction of Hormones
- Growth hormone: In minors, it can produce gigantism if the bone plates haven’t closed while in adults, the overproduction of growth hormones can lead to acromegaly.
- Thyroid stimulating hormone (TSH): Overproduction of TSH leads to overproduction of thyroid hormone that can cause heart disease, weight loss and thinning of skin.
- Prolactin: Overproduction of prolactin can lead to impotence, infertility, osteoporosis, irregularities in menstrual cycle and unusual breast milk secretion.
- Adrenocorticotropic hormone: Overproduction of this hormone results in brittle bones, weight gain, easy bruising, stretch marks on skin and emotional changes.
- Gonadotropins (FSH and LH): Too much of these hormones can rarely cause irregularities in menstrual cycle and infertility.
Pressure on Pituitary Gland Resulting In Less Production of Hormones
- Growth hormone: Low growth hormone causes weak bones, irritability, inappropriate muscle strength and late growth in children.
- TSH: Weight gain, low energy, fatigue and constipation are some symptoms of low TSH.
- Prolactin: Less prolactin results in inability of a new mother to breastfeed her baby.
- Adrenocorticotropic hormone: Low levels of this hormone cause upset stomach, low energy, fatigue and low blood pressure and blood sugar.
- Gonadotropins (FSH and LH): Low FSH and LH leads to decreased sex drive and infertility.
Pressure on Optic Nerves Resulting In Double Vision or Partial or Permanent Loss of Sight
Causes of Pituitary Gland Tumor
The reason for the creation of a pituitary gland tumor remains a mystery. The pituitary gland lies at the bottom of your brain. It is a bean-shaped gland which is small in size but impacts almost every part of the body. Regulation of functions like reproduction, growth and blood pressure is done by the hormones this gland produces. Although some cases of pituitary gland tumors are hereditary but most of them aren’t. Scientists believe that development of pituitary tumors is linked to genetic alternations.
Diagnosis of Pituitary Gland Tumor
The following are some of the tests that your doctor might conduct when diagnosing a pituitary gland tumor.
- Blood and urine tests. Deficiency or excess of hormones can be detected by testing the samples of your urine and blood.
- Brain imaging. The size and location of the pituitary tumor can be ascertained by the doctor through an MRI (Magnetic Resonance Imaging) or CT (Computerized Tomography) scan of the brain.
- Vision testing. Impairment of peripheral vision or eyesight caused by pituitary tumor growth can be determined by vision testing.
Visiting an endocrinologist for further testing is usually recommended by the doctor.
Treatments for Pituitary Gland Tumor
1. Active Surveillance
People who do not experience any kind of pituitary gland tumor symptoms and have normally functioning hormones can avail the active surveillance treatment. Such form of treatment can also be referred to as watchful waiting in which the patient is closely monitored and regular tests are conducted to watch for any sign of tumor growth. Treatment begins after sign appear.
2. Hormone Replacement Therapy (HRT)
If the pituitary gland is not producing enough hormones because of the pituitary tumor, then hormone replacement therapy can become inevitable. Since your body requires the hormones, they would have to be replaced from elsewhere. The hormones that would need replacing include adrenal and thyroid hormones, estrogen in women and testosterone in men and growth hormones.
3. Drug Therapy
There are drugs available that can help if your pituitary tumor is causing the gland to produce excess hormones. Tumors that cause overproduction of growth hormones can be treated by Somavert (pegvisomant) or Sandostatin (octreotide) while Dostinex (cabergoline) and Parlodel (bromocriptine) are excellent drugs for those tumors that secrete prolactin. Pituitary tumors secreting thyroid-stimulating hormone can be treated by Octreotide too.
Research on drugs that are suitable for treating pituitary tumors is still ongoing. Therefore, it is best to ask your doctor regarding the medications prescribed to, their function and the possible harmful effects that they might have.
Surgery is the most common treatment method suggested for a pituitary gland tumor which helps in complete removal of the tumor successfully. It involves removal of the tumor and the tissues present around it via an operation. The trans sphenoidal route is used for performing the surgery in over 95% of the cases while opening of the skull or craniotomy is required in other cases. Surgery through the trans sphenoidal route involves entry through the nasal passage and then going along the septum through the sphenoid sinus cavity, which lies in the back of the throat to reach the pituitary gland which is located behind it. Craniotomies are performed using an endoscope or a microscope or both. If performed by an experienced and skilled surgeon, both surgeries are equally effective and safe.
5. Radiation Therapy
The use of x-rays for destroying the cells of the tumor is known as radiation therapy. Radiation oncologist is the name given to the doctor who specializes in performing radiation therapy to tumor patients. External-beam radiation therapy is the most common form of radiation treatment in which the body receives the radiation from a machine from the outside. Radiation therapy is usually given over a set of period time and consists of a number of treatments.
Upset stomach, fatigue and skin reactions are some of the side-effects of radiation therapy. The end of the treatment spells the end of most of these side-effects. Short-term memory changes and vision issues might also develop depending on the direction of the radiation therapy. However, advances in technology have reduced the risk of such problems. Since the pituitary gland might lose its ability to produce hormones because of radiation therapy, you might require HRT.