Pituitary Tumor Treatment

The treatment of pituitary tumors depends on the following factors:

• Age
• Overall health
• Type of tumor
• The extent of tumor cells

The treatment includes:

• Surgery: Often advised for small tumors. The different surgical methods to treat pituitary tumors are:
  • Transsphenoidal surgery: The most common method used to remove pituitary tumors. Instead of opening the skull in a conventional craniotomy, the neurosurgeon accesses the tumor via the nasal passages and the sphenoid sinus.
  • Craniotomy: The craniotomy procedure is performed when the pituitary tumors are large. The surgery is done by opening the skull. The craniotomy may result in brain damage and has more side effects than transsphenoidal surgery.
• Radiation: External beam radiation therapy to kill cancer cells.
• Chemotherapy: Uses powerful medications are used alone or combined with other therapies to destroy cancer cells effectively.
• Drug therapy: Dopamine agonists can usually prevent prolactinomas from producing too much prolactin and shrink the tumor. The most commonly used medications are cabergoline and Parlodel (bromocriptine). For these tumors, one of these drugs is frequently the only treatment required.

Pituitary tumors are the abnormal growth of the pituitary gland. The pituitary gland helps secrete various hormones in the body. It is located at the base of the skull behind the nose in the pituitary fossa or sella turcica and weighs less than one gram.

Most pituitary tumors are benign (noncancerous) and do not spread to other organs.

Abnormal growth of the pituitary gland may result in the overproduction of certain hormones, resulting in the symptoms of certain hormones. The abnormal growth of the pituitary gland may compress the optic nerve (which connects the back of the eye and the brain), resulting in vision problems.

Pituitary tumors are rare, and there is no standard staging system for these tumors.

The different types of pituitary tumors are:

• Nonfunctional adenomas: The most common type of pituitary tumor and does not affect hormone production. When the size of the gland is increased, it results in pain, vision problems, and suppressed production of new pituitary cells, leading to decreased hormone secretion.
• Prolactin-producing tumors: Benign and common pituitary tumors that result in excess prolactin secretion. In women, increased prolactin levels result in irregular menstrual cycles and milk production even if not breastfeeding or pregnant. In men, the increased prolactin production may result in decreased sexual interest, low sperm count, erectile dysfunction, enlarged breasts, and less body hair.
• Adrenocorticotropic-producing tumors: Adrenocorticotropic hormones stimulate the production of glucocorticoids. They decrease inflammation and weaken the immune system. Cushing's disease is caused by excessive secretion of adrenocorticotropic hormones, which causes swelling of the face, neck, back, and abdomen. They may weaken the bones and present with headaches and vision loss.
• Growth hormone-producing tumors: Result in too much production of growth hormone. In children, the excess growth hormone results in gigantism, quick growth, joint pain, and heavy sweating. In adults, it may result in acromegaly. The symptoms include:
  • Extra growth in the skull, hands, and feet
  • Wide spacing in teeth due to extra facial bones
  • Facial deformation is seen due to the growth of facial bones
  • Deepened voice
  • Joint pain

The exact cause of pituitary tumors is unknown, but the condition inherited from parents called multiple endocrine neoplasia type 1 might increase the risk of pituitary tumors.

The symptoms of pituitary vary among people and depend on the type of pituitary tumor and the affected area of the gland.

The common symptoms include:

• Headache
• Vision loss
• Hormonal changes result in:
  • Irregular menstruation
  • Abnormal milk secretion even if you are not nursing or pregnant
  • Erectile dysfunction, low sperm count, decreased sexual desire, breast growth, and decreased body hair (men)
  • Gigantism, acromegaly, or Cushing’s disease

The doctor will ask for the symptoms and do a physical examination.

If your healthcare provider suspects any tumor or abnormal cells, they may order the following:

• An eye examination to check the condition of the eyes
• A neurological examination to check the mental status
• A dexamethasone suppression test to measure cortisol levels
• Blood and urine tests to check hormone levels
• X-rays, MRI, and CT to get a detailed picture of the tumor
• Biopsy (the doctor obtains a small tissue sample from the tumor using a needle and checks under the microscope to find out the type of tumor)