An adenoma is an abnormal growth or tumor in glandular tissue, such as the pituitary or adrenal gland. Pituitary adenomas are adenomas that grow in the pituitary gland. Pituitary adenomas can lead to changes in hormonal balance, growth problems, and nerve damage.
Macroadenomas are growths that are larger than 10 millimeters. Microadenomas are growths that are smaller than 10 millimeters.
Symptoms of pituitary adenomas can vary considerably, depending on whether the tumor is secreting one or more of a variety of hormones. Even if the tumor is not producing any hormones, its location at the base of the brain can cause significant symptoms. Adenomas are not cancerous and do not spread to other parts of the body.
The preferred surgical treatment at UPMC for pituitary adenoma is the Endoscopic Endonasal Approach (EEA) to remove the pituitary tumor. This innovative, minimally invasive technique uses the nose and nasal cavities as natural corridors to access hard-to-reach or previously inoperable tumors. EEA offers the benefits of no incisions to heal, no disfigurement to the patient, and a faster recovery time.
Your doctor will ask you about your symptoms and medical history, and will perform a physical exam.
Symptoms of pituitary tumor may include:
- headache
- dizziness
- nausea
- weakness
- unexplained changes in weight
- growth of skull, hands, and feet
- changes in facial appearance, including wider spacing of teeth
- anxiety, nervousness, moodiness or depression
- problems with eyesight, such as double or blurred vision, loss of peripheral vision, or sudden blindness
- irregular menstrual cycles (women)
- erectile dysfunction (men)
Complications may include:
- diabetes
- kidney stones
- cardiovascular disease
- high blood pressure
- osteoporosis
- thyroid disease
To make the diagnosis, your doctor may order various types of tests and procedures.
Blood and urine tests will measure your hormone levels and blood sugar values. These tests can identify other conditions that might cause your symptoms, and therefore rule out a pituitary adenoma.
Inferior petrosal sinus sampling may be performed.
In this test, small tubes are guided in the veins from your groin to the pituitary to collect blood on each side. These samples then are tested to confirm whether the pituitary gland is the source of the hormonal disease.
Your doctor may want you to receive an MRI or CT scan of your head. The scan will look for a tumor in your pituitary gland.
You also may be referred to an endocrinologist, a doctor who specializes in diseases of the endocrine glands and the hormones that those glands produce.
Treatment for a pituitary adenoma depends on what hormones the tumor is secreting. Several treatments may be used together to provide the best care for the patient.
Surgery
For most patients, the best treatment is to remove the pituitary adenoma (tumor). At UPMC, the preferred method for this surgery is the Endoscopic Endonasal Approach (EEA). This approach allows surgeons to see the pituitary gland well without making an open incision. The pituitary tumor is removed through the nose and nasal cavities, and recovery time is faster than with a traditional approach. The remaining pituitary gland is explored carefully to check for other lesions, and all abnormal tissue is removed.
Stereotactic Radiosurgery (Gamma Knife, CyberKnife) uses highly focused beams of radiation to shrink the tumor. This method is used in patients whose tumors do not respond to surgery or to medication.
Medication
Medications may be used to reduce the level of hormones that the pituitary produces. You may receive medication after surgery if a large tumor in the pituitary is affecting surrounding structures.
