08/09/2022
See a doctor if you have sudden vision changes or persistent headaches.
By Dr. David Penn, Neurosurgery, Nuvance Health
Pituitary tumors are common. In fact, about 10,000 pituitary tumors are diagnosed each year in the United States. However, the actual number of people living with pituitary tumors is likely higher because these benign tumors are usually small and do not cause symptoms.
Pituitary tumors may become worrisome if they cause symptoms and health concerns such as vision problems and headaches. They can also cause over secretion of hormones, such as Cushing’s disease or acromegaly.
Here are facts about pituitary tumors.
What is a pituitary tumor?
A pituitary tumor, also called a pituitary adenoma, forms in the pituitary gland. The small, pea-sized gland is located at the base of the brain and behind the nose. The pituitary gland is part of the endocrine system. It produces hormones that control important bodily functions such as growth, metabolism and reproduction.
Pituitary tumors can occur at any age but are most common in older adults. Pituitary tumors usually grow slowly.
What are pituitary tumor symptoms?
Sometimes people can live with pituitary tumors and never know it because they are small and do not cause symptoms. Also, pituitary tumors are not cancerous and they do not spread beyond the skull.
Pituitary tumors can affect how the pituitary gland functions, causing it to either produce too much or not enough hormones. Symptoms vary depending on what hormones are affected and what bodily functions they control.
Pituitary tumors can also press on the optic nerves and cause vision loss. They can particularly affect peripheral vision. They can also cause headaches.
How is a pituitary tumor diagnosed?
An MRI scan is required to diagnose a pituitary tumor. Someone may also have blood tests and eye exams depending on their symptoms.
Most people will start by seeing a primary care doctor if they consistently feel fatigued, have unexplained weight gain or loss, or reproductive or sexual health concerns. Blood tests may reveal hormonal abnormalities that might indicate a problem with the pituitary gland.
Some people may also see an eye doctor. Vision problems associated with pituitary tumors include:
- Loss of peripheral vision
- Blurred or double vision
- Eye muscle weakness
- Sudden blindness
Some people may also see a neurologist or go to the emergency department if they have neurological symptoms associated with pituitary tumors such as:
- Headaches
- Facial numbness or pain
- Dizziness
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How are pituitary tumors treated?
Medication
An endocrinologist may recommend medication to treat pituitary tumors that cause hormonal or metabolic fluctuations. Pituitary tumors can decrease endocrine function, which can result in abnormally low levels of certain hormones. Some medications can help to replace these hormones.
One particular type of pituitary tumor called a prolactinoma can over secrete a hormone called prolactin. A medication that can eliminate the tumor is usually the best treatment for prolactinoma.
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Surgery
A neurosurgeon may recommend surgery to remove a pituitary tumor if it is causing concerning symptoms such as vision loss, debilitating headaches or severe hormone abnormalities. A symptomatic pituitary tumor can cause permanent optic nerve damage and complete vision loss if it is not removed.
Traditional pituitary tumor surgery required neurosurgeons to perform a craniotomy; they had to make a large incision and temporarily remove a piece of the skull to access the tumor.
Now, some neurosurgeons perform minimally invasive surgery to remove pituitary tumors.
At Nuvance Health’s Vassar Brothers Medical Center, neurosurgeons and ear, nose and throat (ENT) specialists perform an innovative surgery together.
The surgery requires no incisions at all. Working as a team and using an endoscope, the ENT specialist moves the structures in the nose to access the pituitary gland and tumor. An endoscope is a thin tube with a video camera and light at the end of it. The high definition camera gives the surgical team clear visualization so they preserve all the important structures while completely removing the tumor.
The neurosurgeon then removes the tumor in pieces through the nose.
Before and after surgery, the endocrinologist helps monitor and regulate the patient’s hormones so they feel better.
Patients usually get their vision back after surgery if the optic nerve damage was not too extensive. We are usually able to reverse about six months of vision damage.
Compared to traditional surgery, the endoscopic pituitary tumor surgery is much quicker. Patients feel like they had surgery on their nose and not their brain, they leave the hospital sooner and heal much faster.
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The bottom line: Pituitary tumors are common. If you have sudden, worsening vision changes or other neurological concerns such as headaches and dizziness, see a primary care doctor, eye doctor or neurologist. If an MRI scan shows a pituitary tumor that should be removed, rest assured knowing Nuvance Health neurosurgeons offer a minimally invasive, endoscopic surgical option so patients can heal faster.
Dr. David Penn is fellowship-trained in both endoscopic skull base and cerebrovascular neurosurgery. He has expertise in treating pituitary tumors and complex brain tumors such as acoustic neuromas and meningiomas. Dr. Penn’s specialty skills also include minimally invasive treatment of brain tumors and open neurovascular surgery. Book an appointment directly online with Dr. Penn.
David Penn, MD, Neurosurgery, Nuvance Health