Underneath our brains, there is a tiny, but very important gland. We call it the Pituitary Gland. Although it is small, it acts like the big boss of our body. It controls many very important things, such as our growth, heart rate, and ability to have children. It is also the one that tells the other glands in the body, "Okay, now make your hormones." That's why we call it the "Master Gland."
So, when these pituitary gland cells start to grow abnormally and out of control, we call it a pituitary tumor. But what many people are afraid of here is whether it is cancer. In fact, most pituitary tumors are not cancerous. Pituitary cancer is very rare. However, even if these tumors are not cancerous, they can cause serious problems because of their size (large tumors) or because they produce extra hormones that the body does not need (functional tumors). This is usually treated with surgery, medication, or radiation therapy.
Why do these pituitary tumors occur?
In fact, doctors are still not sure what causes these tumors. Sometimes there is a change in the genes of the pituitary cells, but it seems to happen randomly.
However, there are certain genetic conditions that make people with them more likely to develop pituitary tumors. Some of these conditions include:
- Carney complex: This is a rare genetic condition that causes many noncancerous tumors to form in the body.
- Familial isolated pituitary adenoma (FIPA): This is also a rare condition. It causes the body to become larger than normal.
- Isolated familial acromegaly: This is similar to FIPA.
- McCune-Albright syndrome: This rare condition causes abnormalities in the bones and skin.
- Multiple endocrine neoplasia, type I and type IV (MEN1, MEN4): These conditions can cause tumors to form in the glands of the body.
Symptoms caused by tumor enlargement
The pituitary gland is located in a very small space under the brain, very close to the optic nerves that carry messages between the eyes and the brain. So, when a large tumor grows in this small space, it starts to push on the things around it. This can cause a variety of symptoms.
Simply put, the root of the problem is that as the tumor grows, it squeezes out the vital organs around it, creating less room.
The main symptoms caused by this congestion are:
- Headache: Frequent, sometimes severe headaches.
- Vision problems: Loss of peripheral vision and double vision, especially when looking straight ahead.
Also, if this tumor presses on the pituitary gland itself, the amount of hormones produced by the gland may decrease. Then, symptoms such as these may occur:
- For men: breast development, loss of facial hair, and sexual dysfunction.
- For women: irregular or stopped menstrual periods, cessation of lactation without having a child.
- For children: Delayed growth and sexual maturation.
- Common: decreased sexual desire, vomiting, stomach discomfort, weight change, and feeling cold all the time.
Symptoms caused by hormone-producing tumors
Some tumors (functioning tumors) produce extra hormones that the body doesn't need. The symptoms that occur then depend on which hormone is being produced in excess. Let's see how that works.
| The hormone that is produced the most | Condition and symptoms |
|---|---|
| Adrenocorticotropic hormone (ACTH) | This controls the hormone cortisol. When ACTH increases, a condition called Cushing's syndrome occurs. Symptoms: Easy bruising, high blood pressure, high blood sugar, purple or pink stretch marks, very round face, muscle weakness, thin limbs and enlarged face, neck, and torso. |
| Growth Hormone | This controls body growth, sugar, and fat utilization. If this increases: Children: Growing much taller than normal ( Gigantism ) Adults: Enlargement of the bones of the face, hands, and feet ( Acromegaly ) Other symptoms: heart disease, high blood sugar, joint pain, excessive sweating. |
| Prolactin | This stimulates the production of breast milk in women. If this increases: For women: Breast milk leakage when not pregnant or not having given birth, decreased sexual desire, cessation of menstruation, difficulty getting pregnant. For men: decreased sperm count and sexual dysfunction. |
| Thyroid stimulating hormone (TSH) | This tells the thyroid gland to produce hormones. These control growth, temperature, and heart rate. If TSH is high: Symptoms: Fast or irregular heartbeat, frequent bowel movements, sleep problems, tremors, excessive sweating, weight loss. |
How do you find this, Doctor?
When you go to see a doctor with these symptoms, he or she will first ask you a detailed question about your symptoms and health history. Then, they will perform a physical examination.
In addition, it is possible to perform tests such as:
- Eye exam: Check to see if the tumor has affected your vision.
- Neurological exam: Check how your brain, spinal cord, and nerves are working.
- Blood and urine tests: Check your hormone levels to see exactly what they are.
- Imaging: To confirm whether a tumor is present by looking inside the body. This is usually done with a CT scan , and sometimes an MRI scan may be done.
What are the treatments for this?
Most pituitary tumors do not require treatment. However, if your tumor does require treatment, the method chosen will depend on the type of tumor, its size, and your overall health.
Surgery
This is the most common treatment. Unless it is a prolactin-producing tumor, most other tumors are removed surgically. To perform this surgery, the doctor may make an incision through the nose, through an incision above the upper lip, or through an incision in the skull. Surgery is usually performed through the skull for larger tumors or for tumors that have spread in a complex way.
Radiation Therapy
This treatment uses high-energy X-rays to destroy the tumor. This treatment is useful if the tumor cannot be completely removed by surgery, or if the tumor has come back. There are different types of radiation therapy, ranging from a single high-dose treatment (stereotactic radiosurgery) to a low-dose treatment given several times a week for 4-6 weeks.
Medicine
Depending on the type of tumor you have, your doctor may first try medication. Especially if your tumor is producing prolactin, medication can reduce the production of that hormone and help the tumor shrink. Medications are also useful for tumors that produce growth hormone and for managing conditions like Cushing's syndrome and acromegaly.
Take-Home Message
- Most pituitary tumors are not cancerous, so don't be unnecessarily alarmed.
- Symptoms such as headaches and vision changes may occur depending on the size of the tumor. Symptoms may also occur due to changes in hormones in the body.
- If you have symptoms like these, it is very important to see a qualified doctor as soon as possible.
- There are effective treatments for this, such as surgery, radiation therapy, and medications.
- Discuss any questions you have about your condition and treatment openly with your doctor.
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