Pituitary Adenoma

Pituitary Disease

What is a pituitary adenoma? — A pituitary adenoma is an abnormal growth in the pituitary gland. The pituitary gland is located at the base of the brain (figure 1). The pituitary gland has different cells in it that make different types of hormones. There are different types of pituitary adenomas, depending on which cells are involved.
Pituitary adenomas can cause problems in different ways:
They can make too much of a certain hormone.
They can press on nearby tissues in the head, such as the nerves that go from the eye to the brain. This can cause vision problems.
They can press on other cells in the pituitary gland and keep those cells from making enough hormone.
What are the symptoms of a pituitary adenoma? — Symptoms depend on the type of pituitary adenoma you have and how big it is.
Some pituitary adenomas, especially small ones, cause no symptoms. People find out they have it after their doctor does an imaging test of their brain for another reason. Imaging tests create pictures of the inside of the body.
When a pituitary adenoma does cause symptoms, they can be from having abnormally high or low levels of hormones in the body. Depending on the hormone involved, symptoms can include:
Absent or irregular monthly periods, and a milky discharge from the breasts (in women)
A low sex drive or trouble getting an erection (in men)
A condition called "acromegaly" – This is when some parts of the body (especially the hands, feet, and jaw) grow bigger than normal. This usually happens over a long time.
A condition called "Cushing's syndrome" – This condition can cause medical problems such as weight gain, high blood pressure, thin bones, and weak muscles.
A condition called "hyperthyroidism" – This can make people feel shaky, nervous, or tired.
A condition called "gigantism" (in children) – This condition causes children to grow very fast and taller than other children their age. Children with this condition sometimes have large heads.
Symptoms related to the pituitary adenoma's size can also happen if it grows big or presses on nearby tissues. These symptoms can include:
Vision changes
Headaches
Will I need tests? — Yes. Tests for a pituitary adenoma include:
Hormone tests – Your doctor will do blood and urine tests to measure the levels of different hormones in your body.
An imaging test, called an MRI scan, of your brain
Vision tests – Your doctor might order tests to check your vision. One test you might have is called "visual field testing."
How is a pituitary adenoma treated? — A pituitary adenoma that is found by chance and causes no symptoms does not usually need treatment. But the doctor will monitor the growth over time by doing regular follow-up tests.
A large pituitary adenoma or a pituitary adenoma that causes symptoms usually needs treatment. Treatment depends on the type of pituitary adenoma you have, how big it is, and your symptoms.
The different treatments can include:
Medicines – Medicines are used to treat some types of pituitary adenomas. The medicines can shrink the growths and lower the amount of hormones they make. But medicines do not work for all types of pituitary adenomas.
Surgery – Many pituitary adenomas are treated with surgery. During surgery, the doctor makes a small cut in the back of the nose and then uses a special tool to take out the growth (figure 2).
Radiation – Radiation uses high doses of X-rays to destroy or shrink the growth. Doctors usually use radiation after surgery to keep a pituitary adenoma from growing back.
After treatment, your doctor might do regular follow-up tests to monitor your pituitary adenoma and make sure it doesn't grow back. Some people also need long-term hormone treatment to correct the hormone levels in their body.
What if I want to get pregnant? — If you want to get pregnant, you should talk with your doctor. Your doctor might want to treat your pituitary adenoma before you start trying to get pregnant. Plus, if you take medicines for your pituitary adenoma, your doctor will check that the medicines are safe to take during pregnancy.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 82820 Version 6.0
Release: 28.2.2 - C28.105
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