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Pituaitary Adenoma Treatment & Symptoms

Approximately 1 in 1,000 people will develop a pituitary adenoma and many of these adenomas cause no problems or symptoms. These slow-growing benign tumors arise spontaneously without a known cause from the tissues of the pituitary gland and seldom are cancerous. About 10% to 15% of all intracranial tumors are pituitary adenomas.

Pituitary Macroadenoma Symptoms

Small adenomas less than 10 millimeters in size are called microadenomas while adenomas greater than 10 millimeters are called macroadenomas. Otherwise, adenomas are classified as hormone-producing or hormone-inactive adenomas based upon their impact on the activity of the pituitary gland. Hormone-producing adenomas cause the pituitary gland to secrete an excess amount of a hormone and disrupt the normal balance of hormones in the body. Hormone-inactive adenomas are larger tumors that, due to their size, may damage the pituitary gland or exert pressure on surrounding brain tissues.
The most common hormone-producing adenomas are named in conjunction with the hormone they stimulate:

• ACTH-secreting pituitary adenomas cause secretion of excess cortisol by the adrenal glands and cause Cushing’s syndrome. Cushing’s syndrome caused by an ACTH-secreting pituitary adenoma is cased Cushing’s disease.

• Growth hormone-secreting pituitary adenomas cause secretion of excess growth hormone and can result in acromegaly in adults and giantism in children. In both cases, individuals continue to grow and reach an unusually large size.

• Prolactin-secreting pituitary adenomas, also called prolactinomas, primarily affect females. Excess production of the hormone prolactin shuts down menstrual periods, causes breast enlargement, and production of breast milk.

• Thyroid stimulating hormone (TSH) producing pituitary adenomas are a rare form of pituitary adenomas that cause hyperthyroidism, an excess of thyroid hormone in the body.

Pituitary Gland Tumor Symptoms

The symptoms hormone-producing adenomas cause are related to the hormone that is affected by the tumor as already noted. Hormone-inactive adenomas exert pressure on surrounding brain structures and can produce a variety of symptoms depending upon the area of the brain affected by the tumor.
Compression of the pituitary gland by a hormone-inactive tumor can result some form of pituitary failure with one or more of the following pituitary tumor symptoms:

• Low blood pressure

• Fatigue

• Inability to handle stress

• Sexual dysfunction

Compression of the pituitary stalk which connects the pituitary gland to the hypothalamus can result in mildly elevated levels of prolactin, causing irregular menstrual periods in females. This condition is different from a prolactin-secreting pituitary adenoma.
A macroadenoma that grows upward from the pituitary gland can impact the optic chiasm, part of the pathway in the brain between the eye and the visual cortex. The visual cortex is the portion of the brain that ultimately controls eyesight. This type of pituitary adenoma results in:

• Blurry vision

• Loss of peripheral vision, called bitemporal hemianopsia

• Loss of color perception, the ability to distinguish colors

• Headache

Pituitary apoplexy can be a severe result of any type of pituitary adenoma. With pituitary apoplexy the adenoma bleeds into itself and causes a sudden headache accompanied by a loss in vision. Pituitary apoplexy is a medical emergency.

Pituitary Macroadenoma Diagnosis

A pituitary adenoma diagnosis is typically accomplished by an endocrinologist through sophisticated blood tests that measure applicable hormone levels along with MRI (magnetic resonance imaging) of the brain and pituitary gland.

Pituitary Tumor Treatment Without Surgery

Medical management with drugs through an endocrinologist is the first-line treatment for pituitary adenomas secreting prolactin. Pituitary tumors rarely require any other treatment. Medical management may also play a role, along with surgery, in acromegaly, Cushing’s disease, and pituitary failure (hypopituitarism). Otherwise, surgery to remove the adenoma is the treatment of choice. Some patients with incidentally discovered non-secretory adenomas may be best treated with observation alone.