Types of Pituitary Tumors

Growth hormone (GH) is necessary for normal child development and helps adults maintain healthy bone and muscle tissue. Overproduction of GH can lead to acromegaly, or enlarged bones in the hands, feet and face.

Additional symptoms include:

• Arthritis
• Carpal tunnel syndrome (due to enlarged wrist tissue)
• Enlarged forehead, jaw, nose, lips and/or tongue
• Fingers and/or toes becoming wider
• Hands feeling soft, like bread dough
• Headaches
• Shoes and rings no longer fit
• Skin changes, including skin tags, oily skin and excessive sweating 
• Sleep apnea
• Spaces between teeth becoming wider
• Voice deepening in males

Diagnosis can take years because the physical changes take place slowly. Long-term or untreated acromegaly is a life-threatening disorder. Although rare in children, GH-secreting tumors can lead to gigantism if a child has not reached puberty.

People aged 45 and older are at double the risk of fatal stroke or heart attack compared with peers. If left untreated, GH-secreting tumors can cause high blood pressure, heart disease, type 2 diabetes, thyroid cancer and colon polyps.

The pituitary gland produces ACTH, which triggers the adrenal glands to produce the steroid cortisol. Cortisol helps regulate blood pressure, cardiovascular function and the metabolism of proteins, carbohydrates and fats. It also reduces the body’s inflammatory response, helps insulin break down sugar for energy and helps the body respond to stress.

Pituitary tumors in cells that make ACTH cause excessive cortisol production, which creates a collection of symptoms known as Cushing’s disease.

Although rare, Cushing’s disease affects women five times more than men. It is most common among adults 20 to 50 years old and is associated with high blood pressure that is hard to control, diabetes, irritability, anxiety and depression. Cushing’s disease is fatal if left untreated.

Symptoms include:

• Bone pain
• Collection of fat between the shoulders (buffalo hump)
• Increased hair growth on the face, neck, chest, abdomen and thighs (in women)
• Increased fat around the neck
• Irregular menstrual cycle or no periods at all
• Lower sex drive and fertility in men
• Mental changes
• Obesity and slow growth in children
• Purple marks on the abdomen, thighs, buttocks, arms and breasts
• Rounded face (sometimes called moon face)
• Severe fatigue
• Thin and fragile skin that bruises easily
• Thin, weakened bones resulting in rib and spine fractures from everyday activities
• Upper-body obesity with thin arms and legs
• Weak muscles 

Tumors that arise in cells that produce the hormone prolactin are called prolactinomas. These tumors cause an overproduction of prolactin (hyperprolactinemia), which decreases estrogen levels in women and testosterone levels in men, leading to infertility.

Men and women may have different symptoms. Men’s symptoms include enlarged breasts and erectile dysfunction. Women’s symptoms include:

• Acne
• Excessive face and body hair
• Irregular menstrual cycle or no periods at all
• Milky discharge from breasts when not pregnant or breastfeeding
• Vaginal dryness, leading to painful sex

General symptoms include:

• Headaches
• Infertility
• Low bone density
• Low levels of other hormones (hypopituitarism) due to pressure from the tumor
• Low sex drive
• Vision problems

Thyroid-stimulating hormone secreting tumors are rare, but people who have them develop symptoms characteristic of an overactive thyroid (hyperthyroidism).

Symptoms of these tumors can include:

• Anxiety
• Enlarged thyroid (lump in the front of the neck)
• Frequent bowel movements
• Increased appetite
• Rapid or irregular heartbeat
• Shaking or tremors
• Sweating or feeling hot
• Unexplained weight loss

These tumors occur near the pituitary stalk (which connects the pituitary gland to the brain) and form as result of deficiencies in normal endocrine development. They are usually benign (noncancerous) and are typically diagnosed when they grow large enough to exert pressure on the brain, optic nerve or pituitary gland.

Symptoms include:

• Delayed growth in children
• Excessive thirst and urination
• Obesity
• Vision problem or swollen optic nerve

Adamantinomatous (ordinary) craniopharyngiomas are less solid (with cysts) tumors that tend to affect children younger than 14 years of age. These tumors account for 5 to 10% of all childhood brain tumors.

Papillary craniopharyngiomas are more solid tumors and typically found in adults over age 45.

Craniopharyngiomas are more common in African Americans.

 
Surgery is usually the first line of treatment, followed by radiation (in adults and children 3 years and older).

These are very rare, cancerous tumors that make up just 0.2% of all pituitary adenomas. They are equally common in women and men, most often occurring in middle age.

Symptoms often mimic those of pituitary adenomas, as most pituitary carcinomas also secrete hormones. Because of this, pituitary carcinomas are sometimes discovered after they have spread to other parts of the body. These tumors often require aggressive treatment, which may include surgery, radiation and chemotherapy.

Cysts occur during fetal development when the pituitary gland does not properly form. During normal development, the pituitary gland forms because of downward growth of the brain into the posterior lobe, and the upward growth of cells that become the secreting part of the gland, called the anterior lobe. There is a little pouch or cavity between the two lobes that seals by birth, and the two parts of the gland become one.

When the pouch does not seal, the cells secrete a mucinous substance that causes progressive enlargement (Rathke’s cleft cysts). Your doctor will monitor these cysts carefully with frequent MRI brain scans to make sure they do not get larger.