Pituitary Adenomas

What is a pituitary adenoma?

A pituitary adenoma is a tumor (lump) in your pituitary gland. The pituitary gland is an almond-shaped organ found under the middle part of your brain. Your pituitary gland makes and secretes (releases) things called hormones. Hormones are special chemicals which flow through your blood to control functions of your organs and tissues. An area of your brain called the hypothalamus is found above your pituitary gland. It gives signals to your pituitary gland telling it which hormones to release and how much. Pituitary adenomas are not like cancer cells which spread to other parts of your body and grow into tumors. A pituitary adenoma changes your body functions by releasing abnormal hormone amounts or by damaging nearby tissues.

What causes a pituitary adenoma?

Pituitary adenomas are caused by an abnormal growth of pituitary cells. A cell that makes certain hormones may change and make more abnormal cells. These abnormal cells group together and make a tumor. The tumor grows on your pituitary gland and changes how it works. You may have abnormal genes that caused the tumor to grow. Genes are little pieces of information that tell your body what to do or make. The cause of your pituitary adenoma may also be unknown.

What are the types of pituitary adenomas?

You may have any of the following:

• Functional pituitary tumors: These tumors may increase hormones made by your pituitary gland. These hormones include any of the following:
  
  
  • Adrenocorticotropic hormone: This is also called ACTH. ACTH gets your body ready for hard or stressful activities.
    
    
  • Gonadotropin hormones: These are also called sex hormones. They control how much hormone the male and female sex organs make.
    
    
  • Growth hormone: This hormone controls how your body grows and develops.
    
    
  • Prolactin: This hormone controls how much breast milk is made by the body.
    
    
  • Thyroid stimulating hormone: Thyroid hormone controls how your body uses energy.
  
  
• Nonfunctional pituitary tumors: These tumors do not secrete hormones. They can grow big and damage nearby nerves and blood vessels. They can pinch and damage brain tissue and decrease the amount of hormones secreted by your pituitary gland.

What are the signs and symptoms of a pituitary adenoma?

Your pituitary adenoma can grow and push on nearby blood vessels, brain tissue, and nerves. You may have headaches, sleep problems, and trouble seeing or moving your eyes. You may also have signs and symptoms in any of the following body systems:

• Musculoskeletal:
  
  
  • Bones that are weak and may break easily.
    
    
  • You grow very tall very quickly.
    
    
  • Your forehead and chin become thick and stick out.
  
  
• Reproductive:
  
  
  • Decreased desire (need) for sex.
    
    
  • Difficulty getting pregnant or having babies for females.
    
    
  • Infertility (unable to get your partner pregnant) or erection problems in males.
    
    
  • Irregular or absent menstruation (monthly period) in females.
    
    
  • Milk coming out of your breasts even if you are not pregnant or breast feeding.
  
  
• Skin and hair:
  
  
  • Pink or shiny lines on your skin.
    
    
  • Increased hair on your face and body.
    
    
  • Swelling of your face, fingers, or other areas of your body.
    
    
  • Thinning hair or hair that is falling out.
  
  
• Other signs and symptoms:
  
  
  • Diarrhea (loose, watery bowel movements).
    
    
  • Fast heartbeats or body shakes.
    
    
  • Gaining or losing more weight than what your caregiver recommends.
    
    
  • Increased need for food.
    
    
  • Lump on your neck, under your skin.
    
    
  • Sudden changes in mood.
    
    
  • Swelling of your lips and tongue, and your voice becoming deep.

How is a pituitary adenoma diagnosed?

Your caregiver will ask about any medical problems you may have had in the past. He may also ask about your family's health history. He will ask what symptoms you feel and how bad they get. He may do a complete physical exam to check your health. You may need any of the following:

• 24 hour urine test: All of the urine that you pass for one day is collected. Every time you urinate, you put the urine into a jug. The urine is put into a larger container that is kept cold. If you urinate during the night, save this urine also. At the end of 24 hours the urine is sent to a lab to be tested. Your caregiver will be checking your urine for increased amounts of hormone.
  
  
• Blood tests: You may need blood taken for tests. These can tell your caregivers how much of each hormone you have in your body. Blood tests may also give your caregivers information about your health. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. You may need to have blood drawn more than once.
  
  
• Computed tomography scan: This is also called a CT scan. A special x-ray machine with a computer takes pictures of your brain. It can show your brain tissue, blood vessels, and if you have a pituitary adenoma.
  
  
• Magnetic resonance imaging: This is also called an MRI. The MRI shows pictures of the inside of your head. This can show your caregiver any tumors or problems inside. You will need to lay still and relax during a MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury.

How is a pituitary adenoma treated?

Treatment is given to remove the tumor or make it smaller. Treatment is also given to stop the tumor from making too much hormone. Your treatment will depend on the symptoms you feel and the tumor you have. You and your caregiver will work together to learn what treatment is best for you. You may need any of the following:

• Medicines: Certain medicines may be used to decrease the amount of hormone your tumor is making.
  
  
• Radiation therapy or radiosurgery: These treatments use x-rays or gamma rays to treat the tumor. Radiation may help decrease pain, stop tumor cells from growing, and shrink the tumor. Ask your caregiver for more information about radiation therapy and radiosurgery
  
  
• Surgery: This is done to remove or decrease the size of your tumor. Ask your caregiver for more information on surgeries to treat your pituitary adenoma.

When should I call my caregiver?

Call your caregiver if:

• You feel nervous, or you have sudden changes in your mood.
  
  
• You get tired very easily.
  
  
• You see changes in how you look, such as more facial hair or bone growth in your face.
  
  
• Your menstrual period stops or becomes irregular.
  
  
• You have questions about your treatment, condition, and care.

When should I seek immediate help?

Seek care immediately or call 911 if:

• You feel dizzy or confused.
  
  
• You have a very bad headache and a stiff, painful neck.
  
  
• You have suddenly gained or lost weight without trying.
  
  
• You suddenly feel your heart is beating faster and stronger than normal.
  
  
• You suddenly have trouble seeing, or have trouble moving your eyes from side to side.

Where can I find support and more information?

Being diagnosed with a pituitary adenoma can be life changing for you and your family. Talk to your caregiver, family, or friends about your feelings. Contact any of the following for more information:

• Endocrine and Metabolic Diseases Information Service
  National Institutes of Health
  6 Information Way
  Bethesda , MD 20892-3569
  Phone: 1- 888 - 828-0904
  Web Address: http://www.endocrine.niddk.nih.gov
  

• National Institute of Neurological Disorders and Stroke
  P.O. Box 5801
  Bethesda , MD 20824
  Phone: 1- 301 - 496-5751
  Phone: 1- 800 - 352-9424
  Web Address: http://www.ninds.nih.gov
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.