Pituitary Tumors – Symptoms and Causes

Understanding Pituitary Tumors

Pituitary tumors grow in the pea-sized pituitary gland located at the base of the brain behind the nose. These growths are grouped into several types based on their size and function.

Functioning vs. Nonfunctioning Tumors

Functioning tumors actively produce hormones, causing various symptoms depending on which hormones they release. These include:

• ACTH-Producing Tumors (Corticotroph Adenomas): Make adrenocorticotropic hormone.
• Growth Hormone Tumors (somatotroph adenomas): Produce excess growth hormone.
• Gonadotroph Adenomas: Release luteinizing hormone and follicle-stimulating hormone.
• Prolactinomas (Lactotroph Adenomas): Create too much prolactin.
• Thyrotroph Adenomas: Produce thyroid-stimulating hormone.

Nonfunctioning tumors don’t make hormones. Their symptoms come from pressing against the pituitary gland, nearby nerves, or brain tissue.

Size-Based Classifications

Type	Size	Characteristics
Microadenomas	Less than 1 cm	Can be functioning or nonfunctioning
Macroadenomas	1 cm or larger	Can be functioning or nonfunctioning

Most pituitary tumors are benign (not cancerous) and are called adenomas. They typically grow slowly and don’t spread to other body parts. These tumors stay in the pituitary gland or nearby tissues.

Pituitary tumors differ from pituitary cysts. Cysts are sacs that may contain air, fluid, or other material. They can form on or near the pituitary gland but are not tumors.

Treatment options for pituitary tumors include:

• Surgical removal
• Medications to control growth
• Radiation therapy
• Hormone management with medicine
• Observation (“wait-and-see” approach)

Healthcare providers may recommend one treatment or a combination based on the tumor type, size, and symptoms.

Signs and Symptoms

Larger pituitary tumors can push against nearby structures, causing several uncomfortable symptoms. These may include:

• Headaches that may not go away with normal pain relief.
• Vision problems, like losing side vision or seeing double.
• Facial pain, which might feel like sinus pressure or ear discomfort.
• Droopy eyelid on one or both sides.
• Seizures in some cases.
• Stomach issues, like feeling sick or throwing up.

These symptoms happen because the tumor is taking up space and putting pressure on important nerves and brain areas near the pituitary gland.

Effects of Hormone Imbalances

Pituitary tumors can cause two types of hormone problems – either too little or too much of certain hormones.

When hormone levels drop too low, you might notice:

• Feeling extremely tired or weak
• Having no energy for daily activities
• Sexual problems (less interest in sex, trouble with erections)
• Changes in periods for women
• Feeling sick to your stomach
• Always feeling cold
• Weight changes without trying to gain or lose

When hormone levels rise too high, symptoms depend on which hormone is affected:

ACTH-Producing Tumors

It causes Cushing’s disease, with symptoms such as:

• Weight gain around the middle and upper back
• Face becoming more round
• Purple stretch marks on skin
• Thin skin that bruises easily
• Muscle weakness
• More body hair
• Slow healing of cuts and wounds
• Darker patches of skin
• Acne breakouts
• Menstrual changes
• Sexual problems

Growth Hormone Tumors

It causes acromegaly, with changes such as:

• Facial features growing larger (lips, nose, tongue)
• Longer jaw and gaps between teeth
• Larger hands and feet
• Thicker skin texture
• Excessive sweating with stronger body odor
• Painful joints
• Voice becoming deeper

In children, too much growth hormone can cause unusually fast growth or extreme height, called gigantism.

Luteinizing Hormone and Follicle-Stimulating Hormone Tumors

It rarely causes hormone symptoms, but when it does:

For women:

• Menstrual cycle changes
• Trouble getting pregnant
• Painful ovary enlargement

For men:

• Enlarged testicles
• Higher testosterone levels

Prolactin-Producing Tumors (Prolactinomas)

In women:

• Irregular or missing periods
• Milky discharge from breasts
• Breast tenderness
• Fertility problems
• Reduced sex drive

In men:

• Erection difficulties
• Less interest in sex
• Breast growth
• Fertility issues
• Reduced facial and body hair

Thyroid-Stimulating Hormone Tumors

It causes an overactive thyroid, with symptoms such as:

• Weight loss despite normal eating
• Fast or irregular heartbeat
• Feeling anxious, nervous or irritable
• Frequent bowel movements
• Excessive sweating
• Shaky hands
• Trouble sleeping

When Medical Care Is Needed

Visit your doctor if you notice any symptoms that might point to a pituitary tumor. Modern treatments can often return hormones to healthy levels and relieve your symptoms.

If you have family members with pituitary tumors, especially if someone has been diagnosed with multiple endocrine neoplasia type 1 (MEN 1), talk to your doctor about early screening tests.

Some pituitary tumors run in families, and early detection is important.

Causes

The exact reason for pituitary tumors remains unclear to medical experts. These tumors form when cells in the pituitary gland grow and multiply abnormally.

The small pituitary gland, about the size of a pea, is located at the base of the brain and produces hormones that impact various bodily functions.

While most pituitary tumors don’t have a clear genetic link, some rare cases run in families due to inherited genes. Scientists believe genetic mutations likely play a significant role in tumor development, even in non-hereditary cases.

The pituitary gland controls crucial functions including:

• Growth and development
• Blood pressure regulation
• Reproductive processes

These small but powerful tumors can disrupt normal hormone production, affecting multiple body systems despite their tiny size.

Risk Factors

Most people who develop pituitary tumors have no clear risk factors. Daily habits, environmental exposure, and lifestyle choices don’t appear to increase your chances of getting these tumors.

Genetics may play a role, but most patients don’t have family members with similar tumors.

The only known risk factors are rare inherited conditions that increase the risk of various health problems, including pituitary tumors:

• Multiple Endocrine Neoplasia Type 1 (MEN 1)
• Multiple Endocrine Neoplasia Type 4 (MEN 4)
• Carney Complex
• McCune-Albright Syndrome

These genetic conditions are uncommon but can significantly raise a person’s chance of developing pituitary tumors along with other health issues.

Health Issues From Pituitary Tumors

Having Seizures

When a pituitary tumor puts pressure on the medial temporal lobe in the brain, it can trigger seizures. These are usually focal seizures characterized by impaired awareness.

During these episodes, a person might seem awake but will stare blankly and not respond normally to their surroundings.

Most people won’t remember having the seizure afterward. These seizures are different from the convulsive type many people think of when they hear the word “seizure.”

Hormone Deficiencies

Both the tumor itself and surgery to remove it can permanently change the body’s hormone production. When this happens, patients often need to take replacement hormones for the rest of their lives.

The pituitary gland controls several important body functions through hormone signals, so these deficiencies can affect many aspects of health, including:

• Energy Levels
• Growth
• Fertility
• Metabolism

Bleeding in the Tumor

Pituitary apoplexy is a rare but dangerous complication. It occurs when sudden bleeding happens inside the tumor. This requires emergency medical attention.

The main symptoms include:

1. Extremely severe headache (often described as the worst headache ever experienced)
2. Vision problems, including double vision or vision loss
3. Nausea with vomiting
4. Mental confusion

Treatment typically involves taking corticosteroid medications to reduce swelling around the tumor. In many cases, surgery is needed to remove the tumor and stop the bleeding.