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What are Pituitary tumors?

Pituitary tumors grow in the pea-sized pituitary gland, just under the brain. They are not considered brain tumors. The great majority of pituitary tumors are not cancerous, but they can still cause problems. That’s because the gland controls the endocrine system, and tumors often cause it to produce too many or too few hormones. That can lead to many different disorders tied to metabolism, mood, sexuality, reproduction and other body functions. Tumors can also squeeze the nerves controlling vision.

Despite their location near the brain, pituitary tumors are highly treatable — especially in the right hands. 

Our approach

At Northwell Health Cancer Institute, our physicians have the diagnostic expertise to recognize the disease when others may not, as well as the experience to know which approach to take: from “watchful waiting” to surgery.

Northwell Health doctors know when to follow their suspicions. They’re skilled with the complicated, sensitive tests required to look for hormones in the blood, urine or saliva—a tell-tale red flag of a pituitary tumor. They’re also experienced with drawing the distinction between hormonal and neurological symptoms, a challenge because of the pituitary gland’s location near the brain.

Our team of neurosurgeons helped refine the use of special surgical tools to give them a better view during minimally invasive surgery to remove pituitary tumors. They also have the most experience in the country using special, open MRIs during operations—freeing patients from restrictive scanners but giving physicians a continuously updated picture as they carefully navigate the delicate structures around the brain.

If you have been diagnosed with pituitary tumors, your oncologist will explain all your treatment options and create a treatment plan tailored to your specific needs and goals. Throughout your treatment, you will work closely with a dedicated team of specialists in medical oncology, surgical oncology and radiation oncology who collaborate to ensure seamless coordination of your care. Because every pituitary tumor diagnosis is unique, the physicians providing your treatment will meet once a week to share ideas and review every step of your care.

Research at Northwell

As part of your pituitary cancer treatment plan, you may have opportunities to participate in clinical trials. These trials study new chemotherapy drugs, radiation technologies and surgical approaches. While not every patient is a candidate for clinical trials, your care team will work with you to determine eligibility. Learn more about clinical trials at Northwell Health.

Symptoms

Sometimes pituitary tumors haven’t been causing any problems and are discovered during a scan for another medical issue. But in other cases, they can prompt the pituitary gland to produce too many hormones, press on the gland and slow hormone production or squeeze the nearby nerve (optic) controlling eye movement.

There are more than a dozen different disorders that can result from pituitary tumors and disease, with symptoms that can include:

  • Headaches
  • Vision problems
  • Menstrual cycle changes
  • Impotence
  • Infertility
  • Unusual breast milk production (galactorrhea)
  • Easy bruising
  • Aching joints
  • Muscle weakness
  • Cushing’s syndrome (combination of weight gain, high blood pressure, diabetes and easy bruising)
  • Acromegaly (enlargement of the extremities or limbs and thickening of the skull and jaw)
  • Fatigue
  • Mood changes
  • Irritability
  • Osteoporosis (bones becoming more fragile)
  • Obesity
  • Carpal tunnel syndrome

Having three or more of these symptoms may mean someone has a pituitary tumor, though there are other causes for these problems, too. See a doctor to determine the source of your symptoms. 

Risk factors

There are three rare, inherited disorders that increase the chances of developing a pituitary tumor. Genetic testing is available for these conditions, which include:

  • Multiple endocrine neoplasia type 1 (MEN1)—Causes the pituitary gland to become overactive
  • Carney complex—Changes the skin color
  • Familial acromegaly—Causes the production of too much growth hormone

When planning treatment, it may be beneficial to talk with a genetic counselor to determine if the tumor is associated with any specific syndrome. Learn more about genetic counseling at Northwell Health.

Diagnosis

Your doctor will use diagnostic tests to determine whether you have a tumor, and if so, whether the tumor is causing problems with hormonal levels or has spread to nearby areas like the sinuses. Tests could include:

  • Physical exam
  • Blood, urine and saliva tests
  • Vision test
  • Neurological exam—An examination of the central nervous system, including reflexes, motor and sensory skills, balance and coordination, and mental state
  • MRI (Magnetic resonance imaging)—A magnet, radio waves and a computer take detailed pictures of the inside of the body, sometimes injecting a contrast dye to create a clearer picture
  • Biopsy—Removal of cells or tissue to check for cancer and hormone production

Treatment types

Your treatment plan will be based on a variety of factors, including the type and stage of your tumor, side effects, your overall health and personal preferences. Treatment options include:

  • Surgery—Surgery is commonly performed to remove pituitary tumors. Most pituitary tumors are removed through the nasal passage, rather than through an opening in the skull, called a craniotomy.
  • Radiation therapy—External beam radiation therapy is an effective treatment for pituitary tumors. 
  • Hormone therapy—Hormone replacement therapy is sometimes needed following treatment for a pituitary tumor.

Prognosis

If diagnosed early enough, the prognosis for recovering from a pituitary tumor is excellent. But the disease can impact a dozen different hormones and related disorders with a broad spectrum of symptoms—often obscuring the culprit for those not experienced with the warning signs.

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