Most pituitary tumors are benign (noncancerous) and grow slowly. Small tumors are the most common and usually cause symptoms related to endocrine dysfunction (either abnormally high or abnormally low hormone levels). Large tumors can cause symptoms related to pressure on the brain, optic nerves, or other nearby structures.
Treatment for pituitary tumors may involve observation, medication, surgical removal of the tumor, radiation therapy, or a combination of treatments. Treatment is determined by the size and type of tumor, symptoms, previous treatment, the patient's health, and the patient's choice.
Tumor Classification
Pituitary tumors can be classified by size and by whether they produce hormones.
Functioning tumors are tumors that produce excessive amounts of a hormone. Symptoms depend on the type of hormone produced by the tumor. Functioning tumors are usually diagnosed when they are small because of they symptoms they cause related to abnormally high hormone levels.
Nonfunctioning tumors do not produce hormones. They produce symptoms only when they become large enough to cause pressure on normal tissue, typically the optic chiasm, where the optic nerves cross as they enter the brain. Pressure on the optic chiasm can result in loss of vision. Other symptoms of nonfunctioning tumors include headache and changes associated with loss of pituitary function such as impaired sexual function and lack of energy.
Adenomas are benign (noncancerous) tumors in or on the pituitary gland. Adenomas, the most common type of pituitary tumor, compose about 10 to 15% of all intracranial tumors. Adenomas are named based on their size and ability to produce hormones. Microadenomas are tumors that are 1 cm or smaller; macroadenomas are tumors that are larger than 1 cm. Other types of adenomas are macroprolactinomas, microprolactinomas, and thyroid-stimulating hormone-secreting (TSH) tumors. Adenomas can cause acromegaly, Cushing's disease, gigantism, and hyperthyroidism.
Nonpituitary tumors and disorders within, above, or beside the sella turcica can include the following:
- Abscess
- Arachnoid cysts
- Chordomas
- Coccidioidomycosis
- Craniopharyngioma
- Cysticercosis
- Dermoid cysts
- Epidermoid cysts
- Empty sella syndrome
- Germ cell tumors
- Granular cell tumors
- Lymphocytic hypophysitis
- Meningiomas
- Meningoencephaloceles
- Mucoceles
- Pituitary astrocytomas
- Rathke's cleft cyst
- Rhabdomyosarcomas
- Sarcoidosis
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