Neurology and Neurosurgery

Curious about pituitary tumors? A neurosurgeon explains.

A neurosurgeon who specializes in pituitary tumors sitting with a female patient in the doctor’s office reviewing her medical record on an iPad.

08/08/2024

Pituitary tumors can cause headaches and vision changes and affect your hormones. Learn more about pituitary tumors symptoms and treatment options.

 

By David Penn, MD, Neurosurgery, Nuvance Health

 

About 10,000 pituitary tumors are diagnosed each year in the United States. However, the actual number of people living with pituitary tumors is likely higher because these benign tumors are usually small and do not cause symptoms.

 

Pituitary tumors may become worrisome if they cause symptoms and health concerns such as vision problems and headaches. They can also cause over secretion of hormones, such as Cushing’s disease or acromegaly. 

 

Here are pituitary tumor facts so you can understand what it is, symptoms and treatment options.

 

 

What is a pituitary tumor?

 

A pituitary tumor, also called a pituitary adenoma, forms in the pituitary gland. The small, pea-sized gland is at the base of the brain and behind the nose. The pituitary gland is part of the endocrine system. It produces hormones that control important bodily functions such as growth, metabolism and reproduction.

Related content: What is the thyroid? Your endocrine superstar

 

Pituitary tumors can occur at any age but are most common in older adults. Pituitary tumors usually grow slowly.

What are pituitary tumor symptoms?

 

Sometimes people can live with pituitary tumors and never know it because they are small and do not cause symptoms. Also, pituitary tumors are not cancerous, and they do not spread beyond the skull.

 

Pituitary tumors can affect how the pituitary gland functions, causing it to either produce too much or not enough hormones. Symptoms vary depending on what hormones are affected and what bodily functions they control.

 

Pituitary tumors can also press on the optic nerves and cause vision loss. They can particularly affect peripheral vision. They can also cause headaches.

 

 

How is a pituitary tumor diagnosed?

 

An MRI scan is required to diagnose a pituitary tumor. You could also have blood tests and eye exams depending on your symptoms.

 

Most people will start by seeing a primary care doctor if they consistently feel fatigued, have unexplained weight gain or loss, or have reproductive or sexual health concerns. Blood tests may reveal hormonal abnormalities that might indicate a problem with the pituitary gland.

 

Some people may also see an eye doctor. Vision problems associated with pituitary tumors include:

 

  • Loss of peripheral vision

  • Blurred or double vision

  • Eye muscle weakness

  • Sudden blindness

 

Some people may also see a neurologist or go to the emergency department if they have neurological symptoms associated with pituitary tumors such as:

 

  • Headaches

  • Facial numbness or pain

  • Dizziness

 

 

How are pituitary tumors treated?

 

Medication for pituitary tumors

 

An endocrinologist may recommend medication to treat pituitary tumors that cause hormonal or metabolic fluctuations. Pituitary tumors can decrease endocrine function, which can result in abnormally low levels of certain hormones. Some medications can help to replace these hormones.

 

One pituitary tumor called prolactinoma can secrete too much of a hormone called prolactin. A medication that can eliminate the tumor is usually the best treatment for prolactinoma.

 

Surgery for pituitary tumors

 

A neurosurgeon may recommend surgery to remove a pituitary tumor if it is causing concerning symptoms such as vision loss, debilitating headaches or severe hormone abnormalities. A pituitary tumor can cause permanent optic nerve damage and complete vision loss if it is not removed.

 

 

Traditional pituitary tumor surgery required neurosurgeons to perform a craniotomy; they had to make a large incision and temporarily remove a piece of the skull to access the tumor.

 

Now, some neurosurgeons perform minimally invasive surgery to remove pituitary tumors.

 

At Nuvance Health, neurosurgeons and otolaryngologists (ear, nose and throat (ENT) specialists) perform innovative surgery together.

 

The surgery requires no incisions at all. Working as a team and using an endoscope, the ENT specialist moves the structures in the nose to access the pituitary gland and tumor. An endoscope is a thin tube with a video camera and light at the end of it. The high-definition camera gives the surgical team clear visualization, so they preserve all the important structures while completely removing the tumor.

 

The neurosurgeon then removes the tumor in pieces through the nose.

 

Before and after surgery, the endocrinologist helps monitor and regulate your hormones to help you feel better.

 

Most people usually get their vision back after surgery if the optic nerve damage is not too extensive. We are usually able to reverse about six months of vision damage.

 

Compared to traditional surgery, endoscopic pituitary tumor surgery is much quicker. People feel like they had surgery on their nose and not their brain, they leave the hospital sooner and heal much faster.

Related content: When do you need surgery for a pituitary tumor?

  

The bottom line:  If you have sudden, worsening vision changes or other neurological concerns such as headaches and dizziness, see a primary care doctor, eye doctor or neurologist. If an MRI scan shows a pituitary tumor that should be removed, rest assured knowing Nuvance Health neurosurgeons offer a minimally invasive, endoscopic surgical option so patients can heal faster.

 

 

Frequently Asked Questions

 

Are there any lifestyle changes or preventive measures to reduce the risk of developing pituitary tumors?

 

While there are no specific lifestyle changes proven to prevent pituitary tumors, maintaining overall health through a healthy diet, regular exercise and avoiding regular exposure to harmful substances, such as chemicals and pesticides, can support general well-being. However, since the exact cause of most pituitary tumors is unknown, specific preventive strategies are not well established.

 

What are the long-term outcomes for people who undergo surgery for pituitary tumors, particularly regarding hormone regulation and recurrence?

 

Long-term outcomes for people who undergo surgery for pituitary tumors vary. Successful removal can lead to symptom relief and normalization of hormone levels. However, some people may require lifelong hormone replacement therapy if the surgery affects hormone production. The recurrence rate, or chance the tumor grows back, can vary depending on the type of tumor and how completely the tumor is removed.

 

It’s important to have regular follow-up visits with your care team for the best possible long-term outcome. Your care team will recommend the appropriate medications, if necessary, and monitor for any possible regrowth. Your follow-up care team will most likely include an endocrinologist and a neurosurgeon. Depending on the symptoms you experienced and other structures affected, you may also have follow-up care with an ophthalmologist (eye doctor) or an  otolaryngologist (ear, nose and throat (ENT) specialist).

 

How do pituitary tumors affect children differently than adults, and what are the specific treatment considerations for pediatric cases?

 

In children, pituitary tumors can impact growth and puberty, potentially leading to conditions like gigantism or delayed puberty. Treatment considerations for pediatric cases include preserving normal development and minimizing long-term side effects. Pediatric patients may require different surgical techniques and follow-up care to monitor growth and hormonal balance.