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Pituitary Adenoma

A pituitary adenoma is a benign tumor of the brain, meaning it spreads to other areas of the body in only exceedingly rare cases. However, it can still have detrimental effects because of its size and/or the substances it secretes, so your brain tumor surgeon may recommend treatment.

About Pituitary Adenomas

To understand the effects of a pituitary adenoma, it’s important to understand a bit about the anatomy. The pituitary gland is a small, pea-sized gland in the middle of the brain, at an area behind and a little above the inside back of your nose. It sits within a groove of the skull called the sella turcica, and its function is to secrete a variety of hormones that affect the functioning of the body.

Sometimes the cells of the pituitary gland will start to grow abnormally, which is a benign tumor. The sella turcica is a very small space, and if the gland grows too large, it could start to impinge on nearby structures of the brain, blood vessels, nerves or even another area of the pituitary gland itself. If the extra cells are part of the pituitary that secretes hormones, levels of that particular substance could rise and you might see effects throughout your body.

Symptoms of Pituitary Adenomas

The symptoms you experience will depend on the nature of your pituitary adenoma. There could be symptoms related to compression of other structures, or there could be symptoms related to excessive hormones being released.

When a pituitary adenoma does not release extra hormone, it is called a non-functioning pituitary adenoma. Symptoms are related to related to the pressure the tumor is putting on other structures and include:

  • Headache
  • Vision loss or blurring, or changes to peripheral vision
  • Dizziness
  • Facial numbness
  • Effects related to loss of pituitary function, including:
    • Nausea
    • Loss of body hair
    • Reduced sex drive
    • Menstrual changes
    • Erectile dysfunction
    • Fatigue or weakness
    • Intolerance of cold

If your pituitary adenoma is functioning or releasing hormones, you may experience a specific set of symptoms related to an excess of that hormone, in addition to the above symptoms. Some of the hormones are:

  • Corticotropin stimulates cortisol production and release. Symptoms of too much corticotropin (Cushing’s disease) include:
    • Rapid and unexpected weight gain
    • “Buffalo hump,” or fat at the base of the neck
    • Facial swelling and redness
    • Acne
    • Body hair growth
    • High blood sugar and/or blood pressure
    • Easy bruising
    • Skin thickening
  • Growth hormone is what it sounds like: a hormone that stimulates the growth of cells. Symptoms of too much growth hormone (Acromegaly, or Gigantism if before puberty) include:
    • In children:
      • Very tall stature
      • Abnormally rapid growth
      • Joint pain
      • Excessive sweating
    • In adults:
      • Growth of certain bones, including the hands, feet, and face
      • Joint pain
      • Excessive sweating
      • Thickening of the tongue and skin
      • Body hair growth
  • Prolactin mainly helps nursing women produce breast milk. Symptoms of too much prolactin include:
    • Infertility and/or cessation of menstruation in women
    • Impotence in men
    • Breast milk production in non-pregnant or postpartum women or men
  • Thyrotropin stimulates the thyroid gland and can lead to hyperthyroidism. Symptoms include:
    • Irregular, racing heartbeat
    • Weight loss
    • Shakiness
    • Feeling hot and/or sweating
    • Anxiety and/or insomnia
    • Frequent bowel movements

Treatments for Pituitary Adenomas

The treatment your brain tumor surgeon recommends will depend on whether your pituitary adenoma is functioning or nonfunctioning, its size and your individual health history. Sometimes the tumor will be small enough that your physician will not recommend treatment, or there may be medication you can take to counteract the effects of the excess hormones. However, some patients will require direct treatment, which can be accomplished through surgery, radiation therapy or a combination of the two.

Surgical Options

If your brain tumor surgeon recommends surgery, there are a couple of different methods. Sometimes he will be able to access the pituitary adenoma by making an incision below your nose or upper lip, depending on the size and the location of the tumor. However, although effective, this approach isn’t as widely practiced by most surgeons.

Another approach is to use endoscopy to access the area through the back of the nose – a transnasal procedure. The surgeon uses an operative microscope to carefully visualize the surgery area, allowing for a smaller incision site and a less invasive procedure.

Sometimes the tumor is too large or difficult to reach, and your brain tumor surgeon will need to perform a craniotomy to get direct access to the pituitary adenoma. In this procedure, he removes a small section of the skull for better access. After the procedure, the section of skull is replaced and often held in place with small screws or a plate.

Another method of treatment is Gamma Knife radiosurgery, or stereotactic radiosurgery. Despite the name, this procedure does not involve an actual surgery. Rather, it uses a focused beam of radiation energy to destroy the tumor cells. This procedure may be used alone or in addition to surgery, again depending on the circumstances of your condition.

Why Choose Neurosurgeons of New Jersey?

If your physician has recommended you seek treatment for your pituitary adenoma, it is important to find a neurosurgeon experienced in your condition and all the potential treatment options. At Neurosurgeons of New Jersey, the largest subspecialty practice in the Tristate area, there are surgeons who focus only on brain tumors, ensuring you receive state-of-the-art care from an expert. With a patient-centered focus and cutting-edge technology, the surgeons at Neurosurgeons of New Jersey can work with you to develop the treatment plan that suits your condition and your needs.