|
|
| |
Pituitary tumour
| |
| |
The endocrine system is made up of glands that secrete chemicals called hormones into the bloodstream. The master gland is the pituitary, a pea-sized structure located at the base of the brain just behind the nose. The pituitary oversees the other glands of the endocrine system and keeps hormone levels in check. It can bring about a change in hormone production somewhere else in the system by releasing its own ‘stimulating’ hormones. The pituitary gland is also connected to the nervous system by a part of the brain called the hypothalamus.
A pituitary tumour is a mass of cells that grow on the gland. Some tumours secrete hormones, and some do not. Generally, pituitary tumours are benign and slow growing, and pituitary cancers are extremely rare. Benign tumours don’t spread to other parts of the body, so there is no chance of secondary tumours developing. Treatment options include:
- Surgery
- Radiation therapy
- Medication therapies.
Symptoms
Symptoms of a pituitary tumour may have different causes. If the tumour is secreting a hormone, high levels of that hormone may be present in the bloodstream. If the normal pituitary gland function has been affected, there may be deficiency in one or more of the pituitary hormones. There could also be symptoms caused by a growth or ‘mass effect’, resulting in pressure of the tumour on surrounding structures. The possible signs and symptoms include:
- Persistent headaches.
- Visual disturbances, such as loss of peripheral vision or (rarely) double vision.
- Nausea and vomiting.
- Loss of libido (sex drive) or erectile dysfunction (inability to have an erection) in men.
- Menstrual period irregularities in women.
- Changes to appearance.
- Cognitive difficulties, including problems with thinking.
- Light-headedness on standing.
- Fatigue.
Roles of the pituitary gland
The pituitary gland regulates many important bodily processes by releasing hormones into the bloodstream. Some of the key hormones include:
- Adrenocorticotropic hormone (ACTH) - stimulates the adrenal glands to produce the hormone cortisol, which is essential for life and helps to regulate blood pressure and blood sugar levels.
- Antidiuretic hormone (ADH) - helps the kidneys to maintain the correct amount of water in the body.
- Follicle stimulating hormone (FSH) and luteinising hormone (LH) - regulate the menstrual cycle in women, sperm production in men and sex hormone levels in both sexes.
- Growth hormone - influences an individual’s height, contributes to bone and muscle building and restricts accumulation of body fat.
- Oxytocin - involved in childbirth and breastfeeding. This hormone is also thought to play a role in counteracting the physical effects of stress.
- Prolactin - prompts milk production after childbirth.
- Thyroid stimulating hormone (TSH) - stimulates the thyroid gland to produce the hormone thyroxine, which regulates energy expenditure.
Different types
Although the effects of pituitary tumours are understood, like many tumours, the causes remain largely unknown. A small percentage may arise because of an abnormal gene. The different types of pituitary tumour include:
- ACTH-producing tumour
- Prolactin-producing tumour
- Growth hormone-producing tumour
- Non-functioning pituitary tumour.
ACTH-producing tumour
This type of tumour secretes adrenocorticotropic hormone (ACTH), which causes the adrenal glands (situated above the kidneys) to produce greater than normal amounts of cortisol. This causes a disorder known as Cushing’s syndrome. Other causes of Cushing’s syndrome include adrenal gland tumours or other tumours situated outside the pituitary that make too much ACTH. The symptoms include:
- Build-up of fat on the face (producing a ‘moon face’ appearance) plus a build up of fat on the abdomen and upper back
- Wasting of the arm and leg muscles
- High blood sugar levels
- A reddened, flushed face
- High blood pressure (hypertension)
- Osteoporosis (thinning of the bones)
- Thinning of the skin and easy bruising
- Purple stretch marks.
Prolactin-producing tumour
This type of tumour secretes prolactin, the hormone that naturally increases during pregnancy and after childbirth to stimulate milk production. A woman with a prolactin-producing tumour (prolactinoma) may have irregular or absent menstrual periods and her breasts may make milk, even if she isn’t pregnant. The effects of this type of tumour for men include loss of libido and erectile dysfunction.
Growth-hormone producing tumour
This type of tumour secretes growth hormone. Too much growth hormone forces certain body structures such as the face, hands and feet to enlarge and thicken considerably. This condition is called acromegaly, or gigantism if it occurs before growth stops during the teenage years. The cardiovascular changes caused by the high levels of growth hormone can be fatal if untreated. This condition also increases the risk of bowel polyps and cancer.
Non-functioning pituitary tumour
This type of tumour doesn’t secrete any hormones. Symptoms are caused by a deficiency in the normal pituitary hormones (because the tumour restricts the function of the normal gland), or by pressure on surrounding structures situated near the pituitary. Some of the symptoms of a non-functioning pituitary tumour include:
- General fatigue and feeling unwell
- Persistent headaches
- Menstrual cycle irregularities
- Loss of peripheral vision
- Loss of libido.
Diagnosis methods
A pituitary tumour is diagnosed using a number of tests including:
- Medical history
- Physical examination
- Blood tests
- Magnetic resonance imaging (MRI) scans
- Computed tomography (CT) scans.
Treatment options
Treatment depends on the type and size of the tumour, and the person’s age and general health. Generally, the treatment options include:
- Surgery - an incision is made through the nostrils and the pituitary gland accessed via the nasal sinuses. The tumour is then removed. This operation is called a transsphenoidal hypophysectomy. In some cases, the tumour may have to be removed through the front of the skull (craniotomy). Surgery is the first line treatment for all tumours except prolactinomas.
- Radiation therapy - to target and destroy the tumour cells. Radiotherapy is used less often these days, but still has a place where surgery and medication cannot entirely control the tumour.
- Medication therapies - to shrink the tumour and stop it from producing hormones. Medication is the first line treatment for prolactinoma.
Specialist advice
Your local doctor may refer you to either of both of the following medical specialists:
- Endocrinologist - your doctor should refer you to an endocrinologist experienced in the management of pituitary tumours. They will decide on the appropriate investigations. If surgery is necessary, they will refer you to a neurosurgeon with a special interest in pituitary tumour surgery.
- Neurosurgeon - the skill of the neurosurgeon is the most important variable in a cure, especially for functioning tumours (that are making excessive amounts of a hormone). You are better to be treated by a neurosurgeon who deals with these all the time rather than a couple of times a year.
Where to get help
- Your doctor
- Specialist endocrinologist
- Specialist neurosurgeon
- Cancer Council of Victoria, Information and Support Service Tel. 131 120
- The Australian Pituitary Foundation Tel. (02) 9594 5550
Things to remember
- The pituitary gland at the base of the brain oversees the endocrine system and keeps hormone levels in check.
- Some pituitary tumours produce hormones, while others do not.
- Treatment options for pituitary tumours include surgery to remove the tumour, radiation therapy and medication.
You might also be interested in:
Cushing's syndrome.
Hormonal (endocrine) system.
Want to know more?
Go to More information for support groups, related links and references.
|  |
|
| |
This page has been produced in consultation with, and approved by:
St Vincent's Hospital - Department of Medicine
|
|
Copyight © 1999/2009 State of Victoria. Reproduced from the Better Health Channel (www.betterhealth.vic.gov.au) at no cost with permission of the Victorian Minister for Health. Unauthorised reproduction and other uses comprised in the copyright are prohibited without permission.
|
•
|
This Better Health Channel fact sheet has passed through a rigorous approval process. For the latest updates and more information visit www.betterhealth.vic.gov.au.
|
|
|
Fact sheet currently being reviewed.
Last updated: April 2008
Linking to the Better Health Channel
It's easy to link to this page |
Close
If you would like to link to this fact sheet on your website, simply copy the code below and add it to your page:
Pituitary tumour - Better Health Channel
Most tumours in the pituitary gland are benign and slow growing, and pituitary cancers are extremely rare. Some pituitary tumours secrete hormones and some do not. Symptoms may include headaches, nausea, visual disturbances such as double vision and menstrual period irregularities. Treatment options include surgery, radiation therapy and drug therapy...
The link should appear like this:
Pituitary tumour - Better Health ChannelMost tumours in the pituitary gland are benign and slow growing, and pituitary cancers are extremely rare. Some pituitary tumours secrete hormones and some do not. Symptoms may include headaches, nausea, visual disturbances such as double vision and menstrual period irregularities. Treatment options include surgery, radiation therapy and drug therapy...
© State of Victoria. All rights reserved
The information published here was accurate at the time of publication and is not intended to take the place of medical advice. Please seek advice from a qualified health care professional.
|
|
|
| |
Site map | Terms and conditions | Privacy | Download help | Accreditation
|
| |
Tell us how to stay the healthiest website in Australia and go in the draw for some great healthy prizes. Take ten minutes to do our online survey and give us your feedback on how we can stay on top as the number one health and medical information website in Australia.
|
