Pituitary tumours- What are they? Symptoms, risk factors, diagnosis, treatment and more

Pituitary tumours are seldom diagnosed at their early stages and often go undetected for a lifetime. Read on to learn about the symptoms, types and treatment for pituitary tumours.

What are pituitary tumours?

Pituitary tumours are abnormal growths occurring in the pituitary gland. Most of them are non-cancerous and slow growing. Some of these tumours cause the pituitary gland to produce more hormones while others lead to the decreased production of hormones.

What is the pituitary gland?

The pituitary gland is a small pea-sized hormone-producing gland located at the base of your brain. It produces several hormones that control hormone production of other glands as well as the overall functioning of the body

The pituitary gland has an anterior lobe (anterior pituitary) and a posterior lobe (posterior pituitary). The hypothalamus is the part of the brain that controls the synthesis of hormones by the pituitary gland.

What causes pituitary tumours?

The cause of most pituitary tumours remains unknown. However, genetic factors are known to contribute to some of these tumours. In addition, tumours developing in the same part of the brain can affect the pituitary gland and give rise to similar symptoms.

What are the risk factors for pituitary tumours?

Some genetic syndromes, such as multiple endocrine neoplasia syndrome (MEN syndrome) and Carney complex are linked to an increased risk. Currently, there are no known environmental factors that contribute to pituitary tumours.

What are the types of pituitary tumours?

Non-functional adenomas: These are the most common type of pituitary tumours. These do not produce any hormones. But, as they grow larger, they can compress the normal hormone-producing parts of the pituitary gland and lead to decreased hormone production.
Adrenocorticotropic hormone (ACTH)-secreting tumours
Growth hormone (GH)-secreting tumours
Prolactin-secreting tumours
Thyroid stimulating hormone (TSH)-secreting tumours

Are pituitary tumours cancerous?

Cancerous tumours of the pituitary gland are rare. In 99% of cases, these tumours are non-cancerous. However, they can produce symptoms due to their increased size and hormone production.

What are the symptoms of pituitary tumours?

The symptoms depend on the size and hormone production status of the tumours. They remain symptomless if they are small and don’t produce hormones. In such cases, they can be incidentally discovered while doing a CT or MRI scan for another purpose.

When they enlarge in size, these tumours can cause a hormone deficiency.

Symptoms include –

Changes in the menstrual cycle in women and erectile dysfunction in men
Tiredness
Weight gain
Increased sensitivity to cold
Constipation
Joint pains
Low blood pressure
Nausea and vomiting
Abdominal pain

When an enlarged tumour compresses the adjacent brain structures, it produces symptoms such as –

Impairment of eyesight, including decreased vision or double vision
Headache

Some tumours produce excess pituitary hormones. Symptoms due to increased hormone production are specific to the type of hormone secreted –

ACTH secreting tumours:

They can lead to –

Weight gain
Weakness of muscles
Changes in mood
Fractures
Easy bruising of the skin
Round face (moon face)
Bleeding under the skin (ecchymosis) etc.

TSH secreting tumours: These can cause –

Rapid or irregular heartbeat (palpitations)
Enlargement of the thyroid gland leading to a swelling on the neck
Weight loss
Tremors

Growth hormone-secreting tumours: They may result in –

An increase in the ring or shoe size
Arthritis
Increased sweating
Protrusion of forehead and jaws
Enlargement of nose and tongue
Skin tags
Increased blood pressure
Heart problems
Polyps in the intestine

Prolactin secreting tumours: These can lead to –

Infertility, decreased sexual drive and osteoporosis in both sexes
Decreased or absent menstruation in women
Erectile dysfunction and increased breast size in men (gynecomastia)

How are pituitary tumours diagnosed?

Smaller pituitary tumours are usually discovered accidentally while doing a CT or MRI scan for other purposes. If your physician suspects a pituitary tumour, they may take a detailed medical history and perform a physical examination. Specific tests done for the diagnosis include –

Blood and urine tests: To identify any changes in the hormones level
Imaging (CT, MRI, PET scan)
Biopsy

How are pituitary tumours treated?

Surgery: Surgical removal of the whole tumour is performed when the tumour is causing vision disturbances or producing excess hormones
Radiation therapy: This involves destroying the tumour tissue through radiation. It is used when surgery is not a treatment option or if the tumour has recurred after surgery
Medications: Medications can block the production of hormones or shrink certain types of tumours

What are the side effects of radiation therapy on the pituitary gland?

As a result of radiation therapy, the pituitary gland can lose its normal functioning. You may have to take medicines for hormone replacement. In rare cases, radiation therapy to the pituitary gland can cause loss of vision.

Do I have to take medicines after treatment of pituitary tumours?

If the tumour is removed through surgery or radiation therapy, it may cause decreased production of hormones. In such an event, you will have to take medicines for pituitary hormone replacement.

What are the complications due to untreated pituitary tumours?

Delayed or non-treatment can lead to –

Vision changes (due to compression of the large pituitary tumour on adjacent nerves)
Haemorrhage into the pituitary tumour (pituitary apoplexy) presents with symptoms such as headaches and vision changes

When do I need to consult a doctor?

Consult a doctor if you are experiencing the above symptoms. If you have a family history or genetic syndromes such as MEN syndrome, follow-up with your physician periodically and undergo routine testing to ensure early detection of tumours.