A pituitary tumor is an abnormal growth in the pituitary gland, the part of the brain that regulates the body's balance of hormones.

Tumor - pituitary

The pituitary gland is a pea-sized endocrine gland located at the base of the brain. The pituitary regulates and controls the secretion of hormones from other endocrine glands, which in turn regulate many body processes. These hormones include:

• Growth hormone (GH)
• Thyroid-stimulating hormone (TSH)
• Adrenocorticotropic hormone (ACTH)
• Prolactin

About 75% of pituitary tumors secrete hormones. When a tumor produces excessive amounts of one or more hormones, the following conditions may occur:

• Gigantism or acromegaly (excess growth hormone)
• Hypothyroidism (excess thyroid stimulating hormone)
• Cushing syndrome (excess adrenocorticotropic hormone)
• Prolactinoma (excess prolactin)

As the tumor grows, hormone-secreting cells of the pituitary may be damaged, causing hypopituitarism.

The causes of pituitary tumors are unknown, although some are a part of a hereditary disorder called multiple endocrine neoplasia I (MEN I).

There are other types of tumors that can be found in the same area of the head as a pituitary tumor:

• Craniopharyngiomas
• Germinomas
• Cysts
• Metastatic tumors (tumors that have spread from cancer in another part of the body)

About 15% of tumors located within the skull are pituitary tumors. Most pituitary tumors are located in the anterior pituitary lobe and are usually benign (noncancerous).

Pituitary tumors develop in about 20% of people, although many of the tumors do not cause symptoms and the condition is never diagnosed during the person's lifetime.

Symptoms associated with pituitary tumors include:

• Headache
• Visual changes
  • Double vision
  • Drooping eyelids
• Personality changes
  • Decreased sexual interest
  • Irritability
• Seizures
• Nasal drainage
• Skin changes
• Facial changes
  • Moon face, puffy eyes
  • Enlarged jaw and facial bones
• Hair changes
  • Loss of body hair
  • Coarse, thin head hair
  • Thinning of eyebrows
• Weakness
• Lethargy
• Temperature sensitivity
  • Intolerance to cold
  • Intolerance to heat
• Constipation
• Nausea and vomiting
• Low blood pressure
• Problems with the sense of smell
• Changes in weight
  • Weight loss (unintentional)
  • Weight gain (unintentional)

Symptoms only in women:

• Cessation of menses
• Abnormal nipple discharge
• Excessive body hair

Symptoms only in men:

• Breast development
• Impotence

Your health care provider will perform a physical examination and will note any double vision and visual field deficits, such as loss of peripheral vision or the ability to see in certain areas.

Tests that help confirm the diagnosis include the following:

• MRI of head
• Cranial CT scan
• Formal visual field testing

Endocrine function tests include:

• Cortisol levels:
  • Urine cortisol test
  • Dexamethasone suppression test - serum cortisol levels measured after giving dexamethasone to suppress hormonal secretion
  • Saliva cortisol test
• Insulin growth factor-1 (IGF-1) levels
• Thyroid hormone levels:
  • TSH test
  • Free T4 test
• Serum prolactin levels
• Testosterone/estradiol levels
• Luteinizing hormone (LH) levels
• Follicle-stimulating hormone (FSH) levels