Pituitary tumor

Pituitary tumor symptoms

Symptoms of pituitary tumors vary widely depending on their size and on whether they’re functioning or nonfunctioning. Pituitary gland tumors that don’t secrete hormones usually have symptoms that depend on their size and the amount of pressure they cause on part of the pituitary gland or on the brain. Symptoms of large nonfunctioning pituitary adenomas may include:

• Trouble with eye movement which can cause blurred or double vision
• Vision problems, especially loss of peripheral vision
• Blindness that comes on gradually
• Headaches
• Facial numbness or pain
• Dizziness
• Loss of consciousness

Nonfunctioning tumors that grow even larger can also damage parts of the pituitary and lead to lower-than-normal levels of pituitary hormones (hypopituitarism). Symptoms of hypopituitarism may include:

• Feeling tired or weak
• Unexplained weight loss or weight gain
• Low blood pressure
• Loss of body hair
• Feeling cold
• Menstrual changes or loss of menstrual periods in women
• Erectile dysfunction (trouble with erections) in men

Functioning pituitary tumor symptoms depend on the type of hormone the tumor secretes. If the tumor secretes prolactin, it may cause infertility or a milky discharge from the nipples (galactorrhea). Tumors that secrete growth hormones can cause a person to have enlarged hands, feet and head.

Your potential pituitary adenoma symptoms will guide your doctor’s decision about your diagnosis.

Complications of pituitary adenomas

Pituitary adenomas can cause complications, including:

• Blindness
• Weakened bones (osteoporosis)
• High blood pressure
• Cardiovascular disease
• Kidney stones
• Hormone deficiencies
• Diabetes

A pituitary tumor can be life-threatening if you develop pituitary apoplexy with bleeding either into or out of your pituitary gland. Symptoms of pituitary apoplexy are:

• Severe headache
• Paralysis of eye muscles, causing double vision or problems opening an eyelid
• Loss of peripheral vision or loss of vision in one or both eyes
• Low blood pressure, nausea and vomiting
• Personality changes due to the sudden narrowing of one of the arteries in your brain

If someone has symptoms of pituitary apoplexy, call 911 or seek emergency care as soon as possible.

Diagnosis of pituitary tumors

Your diagnosis starts with an appointment where your doctor will perform a physical exam and talk to you about your medical history and potential pituitary adenoma symptoms. Your first diagnosis will be based on the symptoms you have. For example, if you have a tumor that secretes excess prolactin, your first diagnosis will be hyperprolactinemia, which just means you have high levels of prolactin.

If your doctor suspects you have a pituitary tumor, they may order tests, including:

• Blood and urine tests to measure hormone and blood sugar levels.
• Inferior petrosal sinus sampling, in which blood samples are taken from the pituitary and tested to determine if a tumor could be causing the symptoms.
• MRI and CT scans to show if a tumor is present.
• Vision screening to see if your eyesight has been affected.

Some pituitary tumors are found coincidentally when a person has a brain scan for some other reason. Researchers think that many people may have pituitary tumors that aren’t causing symptoms and are never discovered.

Pituitary tumor vs. craniopharyngioma

Pituitary tumors and craniopharyngiomas are both considered to be primary brain tumors. However, craniopharyngiomas grow near the pituitary gland instead of in it. Craniopharyngiomas are rare and don’t become cancerous.

Both kinds of tumors can become dangerous if they grow too big. Your doctor will diagnose your brain tumor based on testing and the location of the tumor.

Pituitary tumor treatments

If you’re diagnosed with a pituitary tumor, your Aurora Health Care team, including neurologists, neurosurgeons and endocrinologists, will work with you to determine the best treatment options.

Pituitary adenoma treatments for functioning tumors may start with medications to lower hormone levels. Medications can be very effective in shrinking the tumor and stopping it from producing excess hormones.

If medications don’t work or for nonfunctioning tumors, you’ll receive some combination of these surgical and nonsurgical pituitary adenoma treatments.

Surgical pituitary tumor treatment

• Surgery using the Expanded Endonasal Approach (EEA), a minimally invasive procedure in which the tumor is removed through the nasal passages, resulting in no incisions, a shorter hospital stay and faster recovery.
• Neuroendoscopic surgery (also called transsphenoidal surgery), in which a surgeon makes a tiny hole in the skull, mouth or nose and inserts a thin tube (endoscope) to view and remove the tumor.
• Craniotomy, in which a piece of the skull is removed to access and remove the tumor.
• CyberKnife® radiosurgery, in which a noninvasive, robotic system delivers high radiation doses to tumors with pinpoint accuracy.
• Radiation therapy, where multiple narrow radiation beams (light energy) precisely target the tumor.

For cancerous pituitary tumors, surgery to remove as much of the tumor as possible will be recommended and may be followed up by chemotherapy or radiation therapy.

Learn more about pituitary tumor surgery.

After pituitary tumor treatment

If your low hormone levels persist after surgery or other treatments, your doctor will prescribe medications to replace those hormones. You’ll need to take them for the rest of your life.

Because pituitary adenomas can recur, regular follow-up visits are recommended after any kind of pituitary tumor treatment. You’ll be scheduled for regular visits to report on any new or returning symptoms, receive imaging tests to monitor any remaining tumor or be tested to make sure hormone replacement therapy is working as needed.