Pituitary Gland Tumors

The pituitary gland is reddish brown, soft, as small as a pea and located at the base of the brain. It is positioned in a bony chamber behind the back of your nose. It is an important endocrine gland (glands that secret hormones directly into the blood) as it controls the functioning of other endocrine glands in the body.

It lies below the hypothalamus and is attached to it by nerve fibers. The hypothalamus communicates with the pituitary gland by sending messages in the form of hormones. The pituitary gland receives these messages and adjusts its own production and release of hormones and also sends messages to other glands and organs in the body. The pituitary gland consists of three sections, the anterior lobe, the intermediate lobe and the posterior lobe. As the pituitary gland has multiple tasks to carry out, each part produces a different hormone.

Anterior Lobe

• Growth hormone
• Prolactin, which stimulate milk production after giving birth
• ACTH (Adrenocorticotropic hormone) which stimulates the adrenal glands
• TSH (Thyroid-stimulating hormone) which stimulates the thyroid gland
• FSH (Follicle-stimulating hormone) which stimulates the ovaries and testes
• LH (Luteinizing hormone) which stimulates the ovaries or testes

Intermediate Lobe

• Melanocyte-stimulating hormone, which controls skin pigmentation

Posterior lobe

• ADH (Antidiuretic hormone), which increases absorption of water into the blood by the kidneys
• Oxytocin, which contracts the uterus during childbirth and stimulate milk production

The most common problem the pituitary gland is likely to face, is the development of a tumor. The abnormal growth of pituitary cells lead to tumors. These tumors are most often benign, i.e. non-cancerous. Quite often, the tumors do not cause symptoms and the condition is never diagnosed during a person's lifetime. However, they sometimes create discomfort and may impede or increase the flow of hormones. The hormones perform critical functions and, almost of any one can wreak havoc in our bodies. Pituitary tumors may be either non-functioning or functioning. Non-functioning pituitary tumors do not make hormones while functioning pituitary tumors make excess of one or more hormone.

When a pituitary tumor produces extra hormones, any of the following symptoms might arise:

• Changes in weight - Weight gain or Weight loss
• Enlarged hands, feet, skin changes
• Facial changes - enlarged jaw, tongue, bones of the face, moon face, puffy eyes
• Hair changes- coarse, thin head hair, loss of body hair, thinning eyebrows
• Headache, constipation, lethargy or weakness
• Low blood pressure
• Nasal drainage
• Nausea and vomiting, seizures
• Personality changes - decreased sexual interest, irritability
• Problems with the sense of smell
• Temperature sensitivity- intolerance to cold or heat
• Visual changes - double vision, drooping eyelids

Symptoms that surface only in women are abnormal nipple discharge, stopping of menstruation or excessive body hair. Symptoms seen exclusively in men can be breast development or impotence.

The condition that arises is in relation to the hormone that is being produced in excess. Central hypothyroidism is caused by excess supply of thyroid-stimulating hormone. Cushing syndrome is a result of excessive production of Adrenocorticotropic hormone. Excess growth hormone manifests into Gigantism or acromegaly and Prolactinoma is the result of an excess of prolactin.

Pituitary tumors can be sub divided into the following three groups:

• Benign pituitary adenomas: Tumors that are not cancerous fall into this category. These tumors grow very slowly and do not spread from the pituitary gland to other parts of the body.
• Invasive pituitary adenomas: These are benign or non-cancerous tumors that may spread to bones of the skull or to the sinus cavity below the pituitary gland.
• Pituitary carcinomas: These deadly tumors are malignant (cancerous). They spread to other areas of the central nervous system (brain and spinal cord) or outside the central nervous system. They occur very rarely.

Detection

Tests are carried out, depending on the symptoms being exhibited. They may include endocrine function tests to measure Cortisol levels (Dexamethasone suppression test or Urine cortisol test), Follicle-stimulating hormone (FSH) levels, Insulin growth factor-1 (IGF-1) levels, Luteinizing hormone (LH) levels, Serum prolactin levels, Testosterone/estradiol levels, Thyroid hormone levels (Free T4 test or TSH test). Other tests include Formal visual field testing and MRI of the head.

Treatment

Treatment depends on the type and size of the tumor. A tumor may be removed through surgery or may be shrunken with the use of medication or radiation. Hormone replacement may also be required.

If you experience any of the symptoms mentioned above (even one), it is best to consult your health care practitioner. Early diagnosis and treatment of a tumor is the key to a good prognosis.