The pituitary gland is a pea-sized gland at the base of the brain, just above the back of the nose. It makes different hormones that affect the way many parts of the body work. Most pituitary tumors are benign (not cancer), and are called pituitary adenomas. These tumors grow very slowly. They do not spread from the pituitary gland to distant parts of the body, but they sometimes spread to the bones of the skull or sinus cavity near the pituitary gland. A very small number of pituitary tumors are malignant (cancer) and can spread to distant parts of the body.
Signs & Symptoms
- Non-functioning Pituitary Tumor. Sometimes, a pituitary tumor may press on or damage parts of the pituitary gland, causing it to stop making one or more hormones. Too little of a certain hormone will affect the work of the gland or organ that the hormone controls. The following signs and symptoms may occur:
- Some loss of vision
- Loss of body hair
- In women, less frequent or no menstrual periods or no milk from the breasts
- In men, loss of facial hair, growth of breast tissue, and impotence
- In women and men, lower sex drive
- In children, slowed growth and sexual development.
- Most of the tumors that make LH and FSH do not make enough extra hormone to cause signs and symptoms. These tumors are considered to be non-functioning tumors.
- Functioning Pituitary Tumor. When a functioning pituitary tumor makes extra hormones, the signs and symptoms will depend on the type of hormone being made.
- Too much prolactin may cause headache, some loss of vision, less frequent or no menstrual periods or menstrual periods with a very light flow, trouble becoming pregnant or an inability to become pregnant, impotence in men, lower sex drive, or flow of breast milk in a woman who is not pregnant or breast-feeding.
- Too much ACTH may cause headache, some loss of vision, weight gain in the face, neck, and trunk of the body, and thin arms and legs, a lump of fat on the back of the neck, thin skin that may have purple or pink stretch marks on the chest or abdomen, easy bruising, growth of fine hair on the face, upper back, or arms, bones that break easily, or anxiety, irritability, and depression.
- Too much growth hormone may cause headache, some loss of vision, acromegaly (growth of the bones in the face, hands, and feet), tingling or numbness in the hands and fingers, snoring or pauses in breathing during sleep, joint pain, sweating more than usual, or dysmorphophobia (extreme dislike of or concern about one or more parts of the body).
- Too much thyroid-stimulating hormone may cause irregular heartbeat, shakiness, weight loss, trouble sleeping, frequent bowel movements, or sweating.
- Other general signs and symptoms of pituitary tumors are nausea and vomiting, confusion, dizziness, seizures, runny or “drippy” nose (cerebrospinal fluid that surrounds the brain and spinal cord leaks into the nose).
There are four types of standard treatment. Your OHC doctor will help you determine the best care plan for you.
- Surgery: Many pituitary tumors can be removed by surgery using one of the following operations:
- Transsphenoidal surgery: A type of surgery in which the instruments are inserted into part of the brain by going through an incision (cut) made under the upper lip or at the bottom of the nose between the nostrils and then through the sphenoid bone (a butterfly-shaped bone at the base of the skull) to reach the pituitary gland. The pituitary gland lies just above the sphenoid bone.
- Endoscopic transsphenoidal surgery: A type of surgery in which an endoscope is inserted through an incision (cut) made at the back of the inside of the nose and then through the sphenoid bone to reach the pituitary gland. An endoscope is a thin, tube-like instrument with a light, a lens for viewing, and a tool for removing tumor tissue.
- Craniotomy: Surgery to remove the tumor through an opening made in the skull.
Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
- Radiation therapy: Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. The way the radiation therapy is given depends on the type of the cancer being treated. External radiation therapy is used to treat pituitary tumors.
- Drug therapy: Drugs may be given to stop a functioning pituitary tumor from making too many hormones.
- Chemotherapy: Chemotherapy may be used as palliative treatment for pituitary carcinomas, to relieve symptoms and improve the patient’s quality of life. Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type of the cancer being treated.