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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.

Pituitary Tumors

The most frequent cause of pituitary disorders is pituitary tumors. The pituitary gland is made of several cell types. Each cell type releases one of the hormones mentioned above. Sometimes these cells grow too much or produce small growths.

These growths are called pituitary tumors, and they are fairly common in adults. These are not brain tumors and are not a form of cancer. Cancerous tumors of this sort are extremely rare. Pituitary tumors can interfere with the normal formation and release of hormones, however. In addition, some pituitary tumors make too much of the type of hormone produced by the pituitary cells forming the tumor.




Common cause of pituitary disorders

The most common cause of pituitary disorders is pituitary tumors. There are two types of pituitary tumors and they are usually noncancerous abnormal growths of pituitary cells.

Tumors that produce too much of specific hormones (such as prolactin, ACTH, and TSH) are called secretory tumors. A non-secretory tumor interferes with the ability of the normal pituitary gland to make hormones. Any change in the normal balance of the pituitary hormones causes problems within the body. In addition, as a tumor mass grows, it presses against the normal pituitary gland or other areas in the brain causing headaches, vision problems, and too little hormone secretion.

Blood and urine tests as well as X-ray, CT scan, or MRI may be used for detecting pituitary disorders. Treatment depends on the nature of the problem. Hormone replacement therapy is common for replacing a low supply of hormones. Tumors are removed by radiation or surgery.

Because a variety of symptoms exist for pituitary disorders and tumors, people are often misdiagnosed, especially as tumors grow.

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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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