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The REAL Guide to Pituitary Tumors

Pituitary tumors account for about 15 percent of all primary brain tumors. They can occur in every age group, but are more common in post-pubescent adults. Although the exact cause is not understood, most pituitary tumors are benign and often curable.



What are pituitary tumors

Although rare, most pituitary tumors are non-cancerous (benign). However, because of the location of the pituitary gland, at the base of the skull, a pituitary tumor grows upward. And, eventually, most pituitary tumors press against the optic nerves, causing vision problems.

A tumor in the pituitary gland causes symptoms by either releasing too much of a hormone or by pressing on the gland causing it to release too little hormone. The symptoms experienced from the pituitary tumor are often determined by the type of tumor. A tumor that secretes hormones produces symptoms by releasing too much of the hormone.

Some tumors cause the gland to stop releasing enough hormones. In this case symptoms arise from lack of hormones. A pituitary tumor may also cause symptoms by growing and pressing on the structures, like the nerves to the eyes, surrounding the gland.

What are pituitary adenomas?

Pituitary adenomas are benign tumors (meaning that they are non-cancerous and do not travel to other parts of the body) that arise exclusively within the anterior pituitary. Although it can be frightening to have a tumor beneath the brain, it is important to note that these tumors are generally non-aggressive, non-cancerous and non-metastatic.

Adenomas are basically growths found on or within the pituitary gland. In fact, these tumors are quite common representing 10-15 % of all intracranial tumors. Adenomas are by far the most common disease affecting the pituitary and are usually found in people in their 30s or 40s. Many of these tumors can be successfully treated.

Pituitary tumors can vary in their 1) size, 2) secretory patterns, 3) aggressiveness, and 4) invasiveness (growth of tumor into surrounding brain and skull).

Although most adenomas are benign, small, and slow-growing, some tumors can be associated with disability and occasional death.

These problems are related to the sensitive location of the pituitary gland: 1) the internal carotid arteries (supplying blood to the front part of the brain) and large veins are located next to the edges of the pituitary gland, 2) the optic nerves (carry visual information) cross above the pituitary gland, 3) multiple cranial nerves (that control important functions in the head and neck) pass near the pituitary gland, and 4) the pituitary lies near the brain cortex (the outer surface of the brain).



Symptoms of pituitary tumors

Symptoms vary depending upon what type of tumor is growing and what area of the pituitary gland is affected. Pituitary tumors can cause symptoms that are caused by excess production of pituitary hormones and symptoms caused by reduced production of pituitary hormones.

Each individual also experiences symptoms differently, and the symptoms many resemble other conditions or medical problems. Always consult your physician for a diagnosis.

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Pituitary Disease Treatment

Treatment is determined by the type of tumor and by whether it has invaded tissues adjacent to the pituitary gland.

Hormone-secreting tumors can be successfully treated with surgery, radiation, bromocriptine (Parlodel), Sandostatin (Octreotide), or other somatostatin analogues (drugs similar to somatostatin).

Surgery is usually used to remove all or part of a tumor within the gland or the area surrounding it, and may be combined with radiation therapy to treat tumors that extend beyond the pituitary gland. Removal of the pituitary gland requires life-long hormone replacement therapy.

Radiation therapy should not be used routinely for pituitary tumors. Damage to the remaining pituitary occurs frequently and may also cause blindness due to injury of the optic nerves. Individuals who have had their tumors resected are followed with yearly MRI and recurrences are treated with reoperation. Radation is reserved for those unresectable tumors that continue to grow.

Some pituitary tumors stabilize without treatment, but a neurosurgeon will operate at once to remove the tumor (adenectomy) or pituitary gland (hypophysectomy) of a patient whose vision is deteriorating rapidly.

Patients who have pituitary apoplexy may experience very severe headaches, have symptoms of stiff neck, and sensitivity to light. This condition is considered an emergency. Magnetic resonance imaging (MRI) is the best imaging technique for patients with these symptoms.

If the tumor is small, surgery may be done through the nose. If the tumor is large, it may require opening the skull for tumor removal.

Selected patients do well with proton beam radiosurgery (the use of high energy particles in the form of a high energy beam to destroy an overactive gland).

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