Pituitary Tumors: Symptoms & Causes | Brigham and Women鈥檚 Hospital

What is a Pituitary Tumor?

A pituitary tumor is an abnormal growth in the pituitary gland. Your pituitary gland is a hormone-producing gland located at the base of the brain. This gland regulates growth, reproduction, metabolism, stress response, and other essential bodily functions.

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Are pituitary tumors cancerous?

Most pituitary gland tumors are noncancerous. About 99% are benign and referred to as pituitary adenomas. Unlike other cancerous tumors, pituitary gland tumors don’t spread throughout your body. However, even benign pituitary tumors can cause issues. They disrupt hormone production and put pressure on structures and nerves near the brain.

Types of pituitary tumors

Pituitary gland tumors are classified by their size, ability to produce hormones, and whether they are cancerous tumors. Most fit into the category of adenomas (benign tumors on the pituitary gland) and include:

Functioning adenomas

Functioning pituitary adenomas produce an excess of hormones, which can lead to various hormone imbalances. Examples include:

Prolactinoma: This tumor produces too much prolactin, a hormone involved in lactation. In women, it can cause irregular or absent periods, infertility, and galactorrhea (an unexpected milky nipple discharge not related to pregnancy or breastfeeding). In men, it may lead to low sex drive, erectile dysfunction, breast enlargement, and infertility.
GH-secreting: This tumor causes too much growth hormone. In adults, it leads to acromegaly, with symptoms like enlarged hands and feet, coarser facial features, joint pain, a deepened voice, and sleep apnea. In children, it causes gigantism, leading to excessive height and growth.
ACTH-secreting: This tumor produces excess ACTH, which signals the body to make more cortisol. The result is Cushing’s disease, which may include weight gain (especially in the abdomen), a round face, a fat pad between the shoulders, skin that bruises easily, purple stretch marks, high blood pressure, diabetes, and mood changes.
TSH-secreting: This tumor makes too much thyroid-stimulating hormone (TSH), causing the thyroid gland to overproduce hormones and leading to hyperthyroidism. Symptoms include weight loss, palpitations, anxiety, heat intolerance, tremors, and frequent bowel movements.
Gonadotropin-secreting: This rare tumor produces luteinizing hormone (LH) and/or follicle-stimulating hormone (FSH). It often causes no symptoms but can occasionally lead to menstrual irregularities, infertility, or enlarged ovaries or testicles.

Nonfunctioning adenomas

These pituitary tumors don’t produce excess hormones like functioning adenomas do. However, their size can put pressure on structures surrounding the pituitary gland, including the brain and optic nerves. That compression can result in headaches, vision problems, and hormonal deficiencies. Nonfunctioning tumors comprise about 30% of all pituitary adenomas.

Microadenomas and macroadenomas

These tumors are classified based on their size. Microadenomas are pituitary tumors smaller than one centimeter. Macroadenomas are greater than one centimeter. Most pituitary adenomas are microadenomas. These tumors often don’t grow large enough to cause any significant symptoms. Macroadenomas can cause symptoms because they tend to grow and add pressure to nearby brain structures.

Pituitary carcinomas

Although rare, pituitary tumors can be cancerous. Pituitary carcinomas can spread to the brain, spinal cord, or other areas outside the central nervous system. Symptoms are more aggressive, including high blood pressure and muscle or bone weakness. Because malignant pituitary tumors typically resemble noncancerous tumors, they can be hard to differentiate. If your physician suspects a malignant pituitary gland tumor, they’ll monitor its growth rate and check that it doesn’t spread to other areas.

What are the symptoms of a pituitary tumor?

Pituitary tumor symptoms may vary depending on the size and type of tumor and its location.

Common symptoms of pituitary adenomas

When pressure gets put on the pituitary gland, problems that may occur include:

Headaches
Eye issues such as double vision or loss of peripheral eyesight
Fatigue and muscle weakness
Seizures
Nausea and vomiting
Sinus pain

Symptoms due to hormonal changes

A pituitary gland tumor can interrupt the normal production of hormones. When that occurs, symptoms may include:

Excessive thirst and urination
Infertility or changes in menstrual cycles for women
Erectile dysfunction or decreased libido in men
Cushing syndrome (where the body has higher than normal levels of the hormone cortisol)

What causes pituitary tumors?

The exact cause of pituitary tumors is unknown. However, specific factors can potentially lead to signs of a pituitary tumor.

Genetics

Pituitary tumors may be hereditary. If certain genetic conditions run in your family, your risk of developing a pituitary tumor could increase. These conditions include:

Carney complex: A rare disorder that affects skin pigments and can cause tumors in the heart, endocrine system, and other areas of the body
Multiple endocrine neoplasia, type 1 (MEN1): Development of tumors in multiple endocrine glands
McCune-Albright syndrome: Causes brown patches on the skin, atypical bone tissue development, and abnormal hormone production
Von Hippel-Landau disease: Characterized by tumors and cysts throughout the body

Hormone imbalances

You could be at greater risk of developing a pituitary tumor when your hormone levels are off. If you have an excess production of growth hormones , prolactin, or other pituitary hormones, that can stimulate pituitary cell growth.

Specific medical conditions

Some disorders are associated with excessive hormone production that could lead to a pituitary tumor. These rare conditions include:

Acromegaly: A disorder where the pituitary gland produces too much growth hormone in adulthood
Hyperprolactinemia: Characterized by high levels of prolactin, which stimulates milk production during and after pregnancy
Gigantism: An overabundance of growth hormone during childhood that causes abnormal growth and excessive height

What happens if a pituitary tumor goes untreated?

Depending on its size, type, and location, an untreated pituitary tumor could lead to complications, such as disruption of your hormone balance, compression of the brain and nerves, vision impairment, and other neurological issues.

Learn how pituitary tumors are diagnosed and treated

At the Pituitary Center at Brigham and Women’s Hospital, our experienced neurosurgeons care for hundreds of patients with pituitary tumors each year. We take a multidisciplinary, patient-focused approach, working closely with you and your family to create a treatment plan tailored to your specific needs. Our team offers advanced, comprehensive care using the latest surgical techniques and treatment options.

FAQs about pituitary tumors

Can I prevent the development of a pituitary tumor?

Since the exact cause of pituitary tumors is unknown, there are no specific measures to prevent them. The best way to minimize your risk is to get regular medical checkups that can help detect early signs of a pituitary tumor. If you have a specific condition that could increase your chances of developing a pituitary tumor, monitoring and managing your disorder can reduce the risk.

Where is your pituitary gland located?

The pituitary gland is a pea-sized gland located at the base of your brain, below the hypothalamus and behind the bridge of your nose.

Are there foods I should avoid with a pituitary tumor?

There’s no specific recommended diet if you have a pituitary tumor. However, limiting your intake of sugar, sodium, and unhealthy fats can help manage weight and reduce the risk of conditions that could exacerbate pituitary tumor symptoms.

How fast do pituitary tumors grow?

Most pituitary tumors, especially benign ones, grow slowly over time and don’t spread. Malignant pituitary tumors grow more aggressively but are extremely rare.

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The Pituitary Center brings together a team of neurosurgeons, endocrinologists, otolaryngologists, neuro-ophthalmologists, and other specialists, including world leaders in the treatment of pituitary tumors. In addition to their surgical expertise, our neurosurgeons are known for their clear communication, compassion, and the time and personal attention they give each patient.