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Did you know that up to 20 percent of people have pituitary tumors, but many of them cause no problems, if they are ever even diagnosed? While this may be considered good news for many people, pituitary tumors are not always benign.
If you develop a pituitary tumor that interferes with your hormones or presses on the surrounding nerves, you could experience a broad range of health issues that should be addressed. Read on to learn about pituitary tumors so you can spot the signs and seek the treatment you need.
First, What Is the Pituitary Gland?
Before you can understand the symptoms, you first need to understand the purpose of the pituitary gland. It is a tiny gland located at the base of the brain, which makes several important hormones, including:
- TSH (thyroid stimulating hormone), which controls the thyroid gland;
- ACTH (adrenocorticotropic hormone), which affects the production of cortisol (the body’s stress hormone) from the adrenal gland;
- FSH (follicle stimulating hormone) and LH (Luteinizing hormone) that regulate male and female sex organs and fertility;
- Growth hormone, which regulates growth, particularly in children; and
- Prolactin, which controls breast growth and lactation.
You can think of the pituitary gland as the conductor of the endocrine orchestra. It regulates the production of hormones by other glands in the body, just like a conductor controls the production of sound by individual musicians.
Symptoms of Pituitary Tumors
Pituitary tumors can be functional (overproduction of one or more hormones by the tumor cells) or non-functional. Symptoms of pituitary tumors therefore fall into two categories: those related to hormonal excess and those related to mass effect of the tumor on surrounding structures.
Tumors that do not increase hormone production can press on important structures around them, such as the nerves connecting the eyes to the brain. These tumors can cause headaches and vision problems. On the other hand, tumors that raise hormone levels can create health issues tied to the hormone they produce.
For example, a tumor that secretes too much ACTH which then stimulates the adrenal glands to make cortisol can cause Cushing's disease, a state of cortisol excess associated with weight gain, muscle weakness, depression, high blood pressure, diabetes, and an increased risk of heart disease, osteoporosis, fractures and blood clots in the blood vessels of legs and lungs. A tumor that produces too much prolactin can cause menstrual problems (in women) and decreased sex drive, problems with fertility and low bone mineral density with increased risk for fractures in both men and women.
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Diagnosis and Risk Factors
For nonfunctional tumors, you may only find out that you have this kind of tumor when it shows up on an unrelated MRI or when the tumor has grown large enough to compress the surrounding structures causing headaches, visions problems and symptoms of hormonal deficiency (due to compression of the normal pituitary cells). Functional tumors can present with symptoms of hormonal excess, as described above, but they can still be difficult to diagnose, as many of these symptoms can have other possible causes with overlap between various disorders and the diagnosis is often best made at a tertiary referral center.
Unfortunately, experts don’t know exactly what causes pituitary tumors. Some very rare genetic disorders can make them more likely, but these are associated with symptoms of other components of the syndrome as well. Most tumors have no apparent cause and therefore at present there is no known way to prevent them.
How Pituitary Tumors Are Treated
Some pituitary tumors require surgical resection. If this is needed, the doctors treating you will first need to correct your hormone levels to ensure you are safe during the operation. Following the procedure, you may need to have radiation therapy or take medication to treat any residual tumor and regulate your hormone levels.
That said, not all pituitary tumors need surgery. Asymptomatic small tumors can simply be observed. Also, there are medical treatments available for some tumors, such as those that produce prolactin.
If you have symptoms such as headaches, vision problems, sudden weight gain or menstrual problems, you need to reach out to a center that has experience with handling pituitary tumors. Experienced teams can formulate a treatment plan using different approaches that is optimal for you.
Finally, if your pituitary tumor requires surgical intervention, it is imperative to engage a surgeon who has experience with pituitary tumors. When in doubt, talk to your physician. They can help you with answers to your questions, guidance or a referral.