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Pituitary Tumors Treatment (PDQ®)
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Description
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What are pituitary tumors?
Pituitary tumors are tumors found in the pituitary gland, a small organ about
the size of a pea in the center of the brain just above the back of the nose.
The pituitary gland makes hormones that affect growth and the functions of
other glands in the body.
Pituitary tumors may be grouped as follows:
-
Benign adenomas, which are noncancer. These grow very slowly and do
not spread from the pituitary gland to other parts of the body.
- Invasive adenomas, which spread to the outer covering of the brain, bones of the skull, or the sinus cavity below the pituitary gland.
-
Carcinomas, which are malignant (cancer). These are pituitary tumors that have spread far from the pituitary gland in the central nervous system (brain and spinal cord) or outside of the central nervous system.
These pituitary tumors may be either functioning or nonfunctioning. Tumors that make
one or more of the pituitary hormones are called functioning tumors, while those that do not make hormones
are called nonfunctioning tumors.
Each type of functioning tumor causes different symptoms, depending on the type of hormone that is being made by the tumor. Symptoms may also be caused if the tumor grows large and presses on nearby parts of the brain. A doctor should be seen if there are symptoms such as these:
- Headaches.
- Trouble
seeing or moving the eyes.
-
Vomiting.
- Any of the symptoms caused by too many hormones, as described under the tumor types in the Stage Explanation section.
Some cancers in other parts of the body may metastasize (spread) to the pituitary gland, but these pituitary tumors usually do not cause symptoms. Breast and lung cancer are the most common types of cancer that spread to the pituitary.
If there are symptoms, a doctor may order laboratory tests to see what the
hormone levels are in the blood. The doctor may also order an MRI (magnetic
resonance imaging) scan, which uses magnetic waves to make a picture of the
inside of the brain. Other special x-rays may also be done.
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Stage Explanation
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Types of pituitary tumors
Pituitary tumors are classified according to size:
- Microadenomas are smaller than 10 millimeters.
- Macroadenomas are 10 millimeters or larger.
Most pituitary adenomas are microadenomas.
Once a pituitary tumor is found, more tests will be done to find out how far
the tumor has spread, the type of tumor, and whether or not it makes hormones. A doctor needs to
know the type of tumor to plan treatment. The following types of pituitary
tumors are found:
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Prolactin-producing tumors
These tumors make prolactin, a hormone that stimulates a woman’s breasts to
make milk during and after pregnancy. Prolactin-secreting tumors can cause the
breasts to make milk and menstrual periods to stop when a woman is not
pregnant. In men, prolactin-producing tumors can cause impotence.
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ACTH-producing tumors
These tumors make a hormone called adrenocorticotropic hormone (ACTH), which
stimulates the adrenal glands to make glucocorticoids. When the body makes too
much ACTH, it causes Cushing disease.
In Cushing disease, fat builds up in the face, back, and chest, and the arms and legs become very thin. Another symptom of ACTH-producing tumors is weakened bones.
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Growth hormone-producing tumors
These tumors make growth hormone. Too much growth hormone can cause acromegaly (the hands, feet, and face are larger than normal) or gigantism (the whole body grows much larger than normal).
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Nonfunctioning pituitary tumors
Nonfunctioning tumors do not produce hormones. Symptoms such as headache or trouble seeing may be caused by the tumor pressing on nearby brain tissue. If the tumor presses on or destroys parts of the pituitary gland, the pituitary gland may stop making one or more of its hormones. Lack of a certain hormone will affect the work of the gland or organ that the hormone controls. For example, if the pituitary gland stops making the hormone that affects the ovaries, the ovaries will not work normally or will not develop normally in a child.
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Thyroid-stimulating hormone-producing tumors
These tumors make thyrotrophin, which stimulates the thyroid gland to make thyroid hormone. The thyroid hormone helps regulate heart rate, body temperature, the level of calcium in the blood, and the rate at which food is changed into energy.
Too much thyroid hormone can cause rapid heartbeat, weight loss, and other symptoms. Thyroid-stimulating hormone-producing tumors may be large and may spread. They sometimes also make growth hormone and/or prolactin.
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Pituitary carcinomas
These tumors usually grow quickly and make hormones, commonly ACTH and prolactin. Symptoms may be caused by the hormone that is made by the tumor and by the tumor pressing on nearby brain tissue.
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Other pituitary tumors
For information about other types of pituitary tumors, refer to the following PDQ summaries:
- Adult Brain Tumors Treatment
- Childhood Brain Tumors Treatment
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Recurrent pituitary tumors
Recurrent disease means that the tumor has come back (recurred) after it has
been treated. It may come back in the pituitary gland or in another part of
the body.
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Treatment Option Overview
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How pituitary tumors are treated
There are treatments for all patients with pituitary tumors. Three kinds of
treatment are used:
Surgery is a common treatment of pituitary tumors. A doctor may remove the
tumor using one of the following operations:
- Transsphenoidal surgery removes the tumor through a cut in the
nasal passage.
- A craniotomy removes the tumor through a cut in the front of the skull.
Radiation therapy uses high-energy x-rays to kill cancer cells and shrink
tumors. Radiation for pituitary tumors usually comes from a machine outside
the body (external radiation therapy). Clinical trials are testing stereotactic radiation surgery, in which radiation is aimed to the tumor only, with less damage to healthy tissue. A CT scan or MRI is used to find the exact location of the tumor. A rigid head frame is attached to the skull and high-dose radiation is directed to the tumor through openings in the head frame, so only a small amount of normal brain tissue is affected. This procedure does not involve surgery. Radiation therapy may be used alone or
in addition to surgery or drug therapy.
Drug therapy is the use of drugs to stop the pituitary gland from making too many hormones.
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Treatment by type
Treatments for pituitary tumors depend on the type of tumor, the symptoms of its hormone activity, how far the tumor
has spread into the brain, and the patient’s age and overall health.
Standard treatment may be considered because of its effectiveness in patients
in past studies, or participation in a clinical trial may be considered. Not
all patients are cured with standard therapy and some standard treatments may
have more side effects than are desired. For these reasons, clinical trials
are designed to find better ways to treat cancer patients and are based on the
most up-to-date information. Clinical trials are ongoing in some parts of the
country for patients with pituitary tumors. Information about ongoing clinical trials is available from the NCI Web site. To learn more about clinical
trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237);
TTY at 1-800-332-8615.
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Prolactin-Producing Pituitary Tumors
Treatment may be one of the following:
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with pituitary tumor.
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ACTH-Producing Pituitary Tumors
Treatment may be one of the following:
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with pituitary tumor.
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Growth Hormone-Producing Pituitary Tumors
Treatment may be one of the following:
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with pituitary tumor.
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Nonfunctioning Pituitary Tumors
Treatment may be one of the following:
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with pituitary tumor.
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Thyroid-Stimulating Hormone-Producing Tumors
Treatment may be one of the following:
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with pituitary tumor.
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Pituitary Carcinomas
Treatment is usually palliative, to relieve symptoms and improve the patient's quality of life. Treatment may be one of the following:
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with pituitary tumor.
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Recurrent Pituitary Tumors
Treatment of recurrent pituitary tumor depends on the type of tumor, the type
of treatment the patient has already had, and other factors such as the
patient’s general condition. Patients may want to take part in a clinical
trial of new treatments. Treatment may be one of the following:
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent pituitary tumor.
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Changes to This Summary (07/19/2007)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Editorial changes were made to this summary.
This information is provided from the PDQ® database in collaboration with the NCI.
