Pituitary Tumor A pituitary tumor is not cancer. This type of tumor is located in the pituitary gland. which is a small, pea- sized gland in the center of the brain. The pituitary gland is also known as “the master gland” because it makes substances that control other glands and parts of the body. This type of tumor grows very slowly and it does not spread to other areas of the body. Symptoms of a Benign Pituitary Tumor Not all benign pituitary tumors cause you to have symptoms. If symptoms do occur, they may be for the following reasons: The size of the tumor (mass effect) on the pituitary gland itself and surround structures. Tumor liberates active hormones (signals that cause changes in the body) What symptoms are caused by the tumor mass effect? The size of the tumor may cause the following symptoms: Headache Changes or loss of vision Double vision Dizziness Nausea and vomiting More on next page  Learn more about your health care. © Copyright April 26, 2012. James Cancer Hospital & Solove Research Institute, The Ohio State University Medical Center Upon request all patient education handouts are available in other formats for people with special hearing, vision and language needs, call (614) 293-3191. Page 2 Loss of body hair Change in a woman’s menstrual period (fewer or no periods) Change or loss in the ability of a woman to make breast milk (lactate) or unexpected production of milk. The penis fails to become or stay erect (male impotence) Breast development in men Loss of male facial hair Lower sex drive for both men and women Slow growth in children Confusion Seizures What are the symptoms if a tumor delivers pituitary gland hormones? The change in pituitary gland hormones may cause the following symptoms: ACTH (Adrenocorticotropin) and Cortisol are two hormones that are made in different glands but work together. Too much of these hormones may cause the following symptoms (known as Cushing’s disease):  Headache  Loss of vision  Weight gain in the face (moon face), in the neck (buffalo hump) and around the stomach  Purple or pink stretch marks on the stomach or chest  Hair growth on the face, upper back, arms  Bruise easily  Bones that are brittle or break easily Page 3  Depression, anxiety, change in mood Prolactin is a hormone made by the pituitary gland that causes a woman’s breasts to make milk (lactate) during and after pregnancy. Too much of this hormone may cause the following symptoms:  Headache  Loss of vision  Change in a woman’s menstrual period (fewer or no periods)  Fertility problems (unable to get pregnant)  The penis fails to become or stay erect (male impotence)  Lower sex drive for both men and women  Women who are not pregnant or breast feeding make breast milk (lactation) Growth hormone (Somatotropin) is a hormone made by the pituitary gland that controls body growth. It also helps control the sugar and fat your body uses to make energy. Too much of this hormone may cause the following symptoms:  Headache  Abnormal or increased growth of the bones in the face, hands and feet (Acromegaly)  Numbness and tingling in the hands / fingers (carpal tunnel)  Snoring a lot  Sleep apnea (stop breathing while sleeping)  Joint pain  Sweating a lot Page 4 Thyroid-Stimulating hormone (Thyrotropin) is a hormone made in the pituitary gland which is sent out in the body to the thyroid gland. Too much of this hormone may cause the following symptoms:  Fast or irregular heart beat  Abnormal shaking  Unplanned weight loss  Trouble sleeping  Many bowel movements  Sweating a lot How will my doctor know if I have a pituitary tumor? Your doctor will ask you questions about your past health and do a physical exam. If your doctor thinks you have a pituitary tumor, other tests may be done. These include: Imaging A CAT scan of the head and/or a MRI (Magnetic Resonance Imaging) of the brain can show if you have a pituitary tumor and its size and location. The pictures also help the doctor see if the tumor is causing problems with other parts of the brain. Blood Tests Blood tests called a “pituitary panel” can help find out if the tumor is causing any abnormal amounts of each hormone. 24 Hour Urine Test This test is done to determine if you have a high amount of Cortisol, which is a sign of a pituitary tumor. Dexamethasone Suppression Testing (For Cushing’s disease investigation) Page 5 You will be given a medicine called Dexamethasone (Decadron) and your Cortisol amounts will be checked from a sample of blood or urine in order to check the way it reacts. IPSS (Inferior Petrosal Sinus Sampling). (For Cushing’s disease investigation) It is an endovascular procedure (performed through insertion of catheters through the groin) for some cases of Cushing’s syndrome to confirm the source of the problem. Eye Exam An exam to check your vision and the general health of your eyes. Treatment for Pituitary Tumors Benign pituitary tumors can be treated with medicine or surgery. Depending on the type of tumor that you have, your doctor will decide what treatment is best for you. The following is a list of treatments for each type of tumor: Prolactinoma Your doctor will treat a pituitary tumor that produces the hormone Prolactin with medicine first in most of the cases. The medicine is used to shrink the tumor and bring the Prolactin amounts back to normal. If the medicine does not work or cause side effects, then surgery to remove the tumor would be done. Cushings The first choice treatment for pituitary tumors that cause Cushings syndrome/disease is surgery. The surgery removes the tumor. Medicine and radiation are secondary options when surgery is not able to completely control the disease. Acromegaly The first choice treatment for pituitary tumors that causes abnormal or increased growth of the bones in the face, hands and feet is surgery. Medicine and radiation are secondary options when surgery is not able to completely control the disease.