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Overview of Pituitary Tumour: Types, causes, symptoms & treatment

Dr. Ajay KohliNov 22, 2022

Almost 1 in 1,000 people will have a Pituitary Tumour (PT) at some point in their life, which makes PTs a common occurrence.There are many types of PTs, but benign adenomas are the most common. SomePTs are tiny, while others are large. Many tumours do not cause problems, but some do, and a few can even kill if not diagnosed and treated early. Treatment usually includes surgery, medication, and radiation therapy. Read ahead for an overview of this disease.

Pituitary Tumour

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What is a Pituitary Tumour?

Pituitary Tumours are disorders that arise when groups of pituitary gland cells grow out of control. Most Pituitary Tumours are almost always non-cancerous adenomas meaning they grow slowly and are confined to the pituitary gland. Carcinoma of Pituitary Tumours is extremely rare. 

The pituitary gland is a small bean-shaped gland located inside the skull, right at the base of your brain, in a small bone cavity called sella turcica. The gland is often called the “master gland”, as it watches over your body while telling other glands what to do when things need to be changed. It produces various hormones that have a wide range of effects on several vital body processes. This makes the pituitary gland a junction between the brain, the mind, and the body structurally and functionally.

Signs and symptoms of Pituitary Tumour

Since Pituitary Tumours don't cause any physical symptoms, about a quarter of people with Pituitary Tumours don't know they have them. However, when symptoms arise, they vary with each person, depending on the tumour mass or the hormonal changes (too much or too low) caused by them. But again, be aware of the fact that some other unrelated health conditions may also cause these symptoms.

A Pituitary Tumour that releases excess hormones may trigger one or more of the following based on which hormone it affects.

  • Headaches

  • Vision problem

  • Aching joints

  • Muscle weakness

  • Increased size of hands, feet, and face

  • High blood pressure and sugar levels

  • Excess sweating

  • Bone weakening

  • Rapid heart rate

  • Anxiety and irritation

  • Unexpected weight loss and weight gain

  • Easy bruising

  • Frequent bowel movement

  • Nipple discharge and irregular menstrual cycle

  • Decreased sexual function

Furthermore, tumours that grow larger in size cause "mass effects", potentially compressing the area of the brain, nerves, and pituitary gland, resulting in the following symptoms.

  • Visual impairment, especially peripheral vision (occurs when a tumour presses the optic nerve or nerves controlling eye movement)

  • Sudden Headaches

  • Deficiency in one or more hormones

Please speak to your doctor if you think you've any of the listed symptoms. Your doctor will provide the correct diagnosis and suggest the best care per your unique case.

What causes Pituitary Tumours?

Thus far, experts do not know the exact cause behind these tumours. But the disorder is thought to run in families due to certain changes in a person’s genes inherited from a parent. For instance, men are at increased risk of Pituitary Tumours if they inherit genes of multiple endocrine neoplasias, type 1 (MEN 1), from each parent.

Likewise, other genetic conditions that may increase a person’s risk of pituitary adenoma include the following.

  • Multiple endocrine neoplasia type 4 (MEN4)

  • Carney complex (CNC)

  • Familial isolated pituitary adenomas (FIPA)

Remember, there are also Pituitary Tumours that do not run in families, which questions whether abnormal genes can be accounted for causing Pituitary Tumours.

Types of Pituitary Tumour

Pituitary Tumours are classified in various ways depending on their size and the type of hormone they secrete. In terms of size, Pituitary Tumours can range from a few millimetres to several centimetres and are essentially of two types.

  • Microadenomas that measure less than 1 centimetre and

  • Macroadenomas that grow larger than 1 centimetre

Nearly half of all pituitary adenomas are macroadenomas, which interfere with the pituitary gland's normal function, causing it to produce too little hormones. This causes Hypopituitarism, a condition characterised by fatigue, decreased sex drive, nausea, vomiting, irregular menstrual cycles in women, low blood pressure, dry skin, and weak reflexes.

Again, depending on their ability to secrete hormones, Pituitary Tumours can be functional or non-functional.

  • Functioning or secreting adenomas make too much of a particular pituitary hormone, causing specific symptoms and conditions. 

  • Non-functioning (non-secreting) adenomas are macroadenomas that cause symptoms by growing and compressing nearby structures.

Rarely, functional adenomas can also become too large, like macroadenomas, compressing pituitary gland tissue to deplete other pituitary hormones.

Treatment of Pituitary Tumours

The treatment of Pituitary Tumours is patient-centric, usually based on the symptoms you may have and the size and location of the tumour. 

Regardless, transsphenoidal surgery is the initial treatment of choice for patients with microadenoma, and in scenarios where the patient has the following.

  • Compression of the optic nerve that impairs vision

  • Loss of pituitary gland function

  • Progressive growth of the Pituitary Tumour

However, your doctor may opt for rare skull surgery to extract larger tumours. Again, if the tumour is small and does not cause symptoms, no treatment is suggested; instead, a "watchful waiting" approach may be taken.

Patients with prolactinoma may be managed through medication, surgery, and radiation combined. In certain situations, your doctor may use a high-energy X-ray or other radiation beams to destroy cancer cells when the tumour persists or returns after surgery. During your treatment, you will receive radiation doses ranging from high to low for four to six weeks, but it may take months or years to see any noticeable effect. You may also need to take medications for the rest of your life to correct your hormonal condition and control the growth of the tumour. 

Diagnosis of Pituitary Tumour

Pituitary Tumours are often detected incidentally during imaging tests of separate health problems. Even so, your doctor will review your symptoms, take note of your medical history, and perform a physical examination.

You may also undergo the following tests to confirm the diagnosis.

  • Blood and urine tests: Determine hormone levels to detect Pituitary Tumours early and treat them before they cause problems.

  • Imaging test: CT (computerised tomography) or MRI (magnetic resonance imaging) scans of the head can provide images of the pituitary gland and brain that can help detect tumours and determine their size.

  • Visual field exam: It is conducted to determine how well your eyes work since a large Pituitary Tumour can impair your ability to see objects at the edges of your visual field by pressing on your optic nerves.

How can I prevent Pituitary Tumours?

Unfortunately, at this time, no environmental or lifestyle factors are known to contribute to Pituitary Tumours, so prevention is practically unknown. Despite this, you can get genetic testing done to see if you have one of those gene-associated disorders that can increase your likelihood of Pituitary Tumour while you follow a healthy lifestyle. 

Risk factors of Pituitary Tumour

Pituitary Tumours have very few known risk factors, mostly associated with inheritance. But some scientific studies have suggested obesity increases the odds of Pituitary Tumours. 

Frequently Asked Questions (FAQs)

Here’s a list of common questions and answers related to Pituitary Tumour.

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Are Pituitary Tumours common?

About 10% to 20% of all tumours found within your skull are Pituitary Tumours, typically asymptomatic microadenomas that never get diagnosed in a person’s lifetime.

Is Pituitary Tumour a brain cancer?

As confusing as it might seem, Pituitary Tumours are not brain cancer because pituitary tissue has a distinct origin from brain tissue. Also, the gland is located at the base of the skull, underneath and separate from the brain. Yet, many organisations, including the WHO, classify Pituitary Tumours under brain tumours.

Can you live with a Pituitary Tumour?

Yes, you can live if the tumour is a microadenoma that causes no symptoms. In fact, most people discover they have a pituitary adenoma when they undergo an imaging test for another reason. However, you may need treatment if the adenoma continues to grow. Again, for large and functioning tumours, it is essential to seek treatment as soon as possible since some adenomas can seriously interfere with your quality of life and health.

What are the possible side effects of Pituitary Tumour treatment?

In about 50 to 60% of patients, Hypopituitarism is the common side effect after surgery or radiation treatment. But the condition is correctable with hormone-replacement medications. Additionally, a treated person may also experience the following.

  • Nausea and vomiting

  • Dizziness

  • Hair loss

  • Infertility

  • Vision loss (rare)

Rarely, surgery can lead to complications such as the following.

  • Bleeding

  • Leak in brain fluid

  • Infection of the brain

  • Diabetes

What is the outlook for the Pituitary Tumour?

The prognosis (outlook) of a Pituitary Tumour is generally determined by its size and function. After surgery and medication therapy, macroadenomas and prolactinomas have a favourable prognosis, with a 5-year survival rate ranging from 97% to 100%. But several other co-morbidities and problems are associated with functional-type adenomas that can lead to Cushing's disease and acromegaly. Patients with Cushing's disease may succumb if medical or surgical therapy is delayed.

References:

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.

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