Tumors that arise from the pituitary gland itself are called carcinomas or adenomas. Pituitary adenomas are slow growing tumors that are benign, while pituitary carcinomas are malignant. The pituitary gland is a pea-sized gland located at the base of the brain, above the back of the nose. It is responsible for producing different hormones that affect the way various parts of the body work.
Who is at risk?
People with a family history of Carney complex, multiple endocrine neoplasia types 1 (MEN1) syndrome or isolated familial acromegaly have an increased risk of developing pituitary tumors.
Signs and symptoms that may occur include:
Headache
Some loss of vision
Loss of body hair
In women, skipping or no menstrual periods
Lactation in a woman who is not pregnant or breast-feeding
Lower sex drive
Slowed growth and sexual development in children
Frequent bowel movements
Nausea and vomiting
Runny or "drippy" nose
Infertility
Weight gain in the neck, face and trunk of your body, and thin arms and legs
Easy bruising and fragile bones
Joint pain
Sweating more than usual
Dysmorphophobia
Shakiness
Anxiety, irritability, and depression
Acromegaly in adults
In children, the whole body can grow much larger and taller than normal
Tingling or numbness in the hands and fingers
Snoring or pauses in breathing during sleep
Weight loss
Trouble sleeping
Diagnosis
Imaging studies and blood and urine tests are used to diagnose a pituitary tumor. Pituitary carcinoma is diagnosed only when there are metastases inside or outside the nervous system. The following tests and procedures may be used:
Physical exam and history
Eye exam
Visual field exam
Neurological exam
MRI (magnetic resonance imaging) with gadolinium
Blood chemistry study
Blood tests
Urine test
High-dose dexamethasone suppression test
Low-dose dexamethasone suppression test
Venous sampling for pituitary tumors
Biopsy
Treatment
Because the pituitary gland revolves around so many of the body's functions, a multi-disciplinary approach to tumor treatment is required to ensure the best possible outcome. Treatment options depend on the following:
The type and size of the tumor
Whether the tumor is producing excess hormones
What signs or symptoms the tumor is causing such as problems with vision
Whether the tumor has spread to the brain or to other parts of the body
Whether the tumor has been diagnosed for the first time or has recurred.
Surgery: Treatment of pituitary tumors usually involves removing the tumor through surgery.
Medication: Medication may be used to reduce the size of the size of the tumor without surgery.
Radiation therapy: This treatment method can be used to treat a persistent or recurring tumor that does not respond to medication, as long as the tumor is a secreting hormone. For tumors that do not secrete hormone, radiation may be used following the partial removal of the tumor if it was invasive.
Replacement hormone therapy: This is often prescribed following surgery or radiation therapy.The chance of recovery depends on the type and size of the tumor, and whether it has spread into other areas of the central nervous system, such as the brain and spinal cord or outside of the central nervous system to other parts of the body.
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