Causes and risk factors for pituitary tumors
There is no obvious cause of pituitary tumors. Some pituitary tumors might be caused by stimulation from the hypothalamus — a part of the brain that signals the pituitary gland to make hormones. People who have the rare inherited conditions such as multiple endocrine neoplasia type 1 (MEN-1) — a disorder that causes tumors in the endocrine glands (which secrete hormones into the bloodstream and include the pituitary gland) and the first part of the small intestine — or Carney complex — a disorder that causes several types of tumors, including in the pituitary gland — have a higher risk of pituitary tumors. About 1-5% of pituitary tumors occur within families.
Antonio Bernardo, MD
Pituitary tumors
What is a pituitary tumor
A pituitary tumor is an abnormal growth of cells in the pituitary gland, which is the main hormone-producing gland in the body. About the size of a pea, the pituitary gland is located in the center of the brain behind the nose and eyes. Hormones are chemical substances the body produces that control and regulate certain cells or organs.A tumor in the pituitary gland can disrupt the normal balance of hormones in the body. This may cause a person to become sick.About 10% of all primary brain tumors are pituitary tumors. Only a very small number of pituitary tumors are malignant (cancerous). However, because of the location of the pituitary gland, at the base of the skull, a pituitary tumor grows upward. Eventually, some pituitary tumors will press against the optic nerves, causing vision problems.Many pituitary tumors are small, do not cause health problems and may never need treatment. Almost all pituitary tumors can be treated, usually through medications and surgery. Most pituitary tumors can be cured.
Diagnosis
Diagnosis of a pituitary tumor involves:
A physical exam: This includes questions about the patient’s symptoms, personal and family health history, physical exam, and tests of vision, and reflexes.
Scans of the brain: A magnetic resonance imaging (MRI) scan, which uses computers to create detailed images of the brain and pituitary gland, is the most common scan used to diagnose pituitary tumors. Patients with a pacemaker or who cannot have an MRI scan for another reason will receive a computerized tomography scan (CT or CAT scan) instead. A CT scan also uses computers to create detailed images of the brain and pituitary gland.
Blood and urine tests: An endocrinologist will perform blood or urine tests to determine the levels of hormones in the patient’s body. If the patient has abnormal amounts of specific hormones, this will help doctors diagnose a specific syndrome.
A biopsy: This is a rarely needed surgical procedure to remove a small sample of the tumor for examination under a microscope.
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Treatment
The treatment for a pituitary tumor will depend on many factors, including:
-The location of the tumor
-Whether the pituitary tumor produces excessive amounts of a specific hormone
-The patient’s general health and preferences regarding potential treatment options
Because having a pituitary tumor can affect many different organs and systems in the body, doctors from several medical specialties will work together to develop a customized treatment plan for the patient.
-Medication (drug therapy)
-Observation
-Radiation therapy
-Surgery
After surgery or radiation therapy, the patient might need to take medication to control the balance of hormones in the body. The patient might be able to stop taking medication eventually. The doctor will perform MRI scans and blood and urine tests after treatment to determine how well the patient’s pituitary gland is working.
For a small pituitary tumor that does not cause any significant signs or symptoms, observation — keeping a close watch on the tumor without any immediate treatment — might be an option. If the pituitary tumor does not grow, the patient may never need treatment.
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