Pituitary Tumors: Symptoms, Causes Diagnosis & Treatment

Overview

The Pituitary Tumors Program at Cleveland Clinic Abu Dhabi provides specialized care and support for people diagnosed with Pituitary Tumors. Our team of highly skilled specialists take a comprehensive, interdisciplinary team approach, with experts from the Neurology, Otolaryngology (ENT), Ophthalmology and Endocrinology departments, and the Cancer Institute, working in close collaboration. We offer a full range of advanced diagnostic and treatment options for adults with pituitary tumors, including innovative surgery, chemotherapy, targeted radiosurgery, and other advanced approaches to tumor treatment.

Why Choose Us?

We offer every patient a dedicated team of medical experts to support them, and their family, throughout their treatment journey. Our integrated approach includes a vast team of endocrinologists, neuro-radiologists, interventional neuro-radiologists, neuro-rehabilitation specialists, ophthalmologists, researchers, clinical care coordinators and nurses, all working together to offer the best personalized science and technology, one patient at a time. The multidisciplinary team meets daily to discuss each patient’s needs, their progress and to decide the best treatment plan.

What We Treat

A pituitary tumor or adenoma is a growth on the pituitary gland, which is located at the base of the brain and is responsible for hormone production that regulates many important functions in the body. Most pituitary tumors are benign (not cancer) and grow slowly. This means they do not spread to other parts of the body. Pituitary adenomas can be classified based on their size into microadenomas (< 1 cm) and macroadenomas (> 1 cm).

Types of Pituitary Adenomas

Non-functioning pituitary tumors

These tumors do not produce hormones. They can still cause problems by compressing nearby structures such as the optic nerves/chiasm causing visual loss or compressing the normal pituitary gland and impair normal hormone production.

Functioning pituitary tumors

These tumors produce hormones in excess, leading to specific symptoms depending on the type of hormone produced. Common types include:
- Prolactinomas: Tumors that produce prolactin, which can cause abnormal milk production (galactorrhea) and irregular menstrual cycles in women, and erectile dysfunction or decreased libido in men.
- Growth hormone-producing tumors (Acromegaly): These tumors cause excessive growth hormone production, leading to enlargement of the hands, feet, and facial features, as well as other health problems.
- ACTH-producing tumors (Cushing's disease): These tumors cause excessive production of adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to produce cortisol. This can result in weight gain, high blood pressure, diabetes, and other symptoms.

Diagnosis & Treatment

Diagnosis of Pituitary Tumors

If a pituitary tumor is suspected by your doctor, they will review all your symptoms and medical history and perform a thorough physical exam. A detailed eye examination including visual acuity and visual field testing may need to be performed. Blood tests will be done to check your hormone levels. Imaging with a pituitary MRI can identify any form of growth on the pituitary gland.

Treatment of Pituitary Tumors

Surgery, medication, radiation or any combination of these treatments are usually offered to people with pituitary tumors.

Surgery: Most pituitary tumors can be removed with endoscopic endonasal transsphenoidal surgery. It is performed through the nose and sphenoid sinus, without making an external incision. The surgeon removes the tumor under endoscopic visualization, while preserving the normal pituitary gland and the surrounding structures. This surgery is typically performed by two surgeons (Neurosurgery and ENT). Occasionally, the tumor cannot be completely removed from the nose and a craniotomy would be required.
Medication: Drugs may be prescribed to control hormone levels and reduce tumor size, especially for functioning pituitary tumors:

Prolactinomas: Dopamine agonists to reduce prolactin secretion and shrink the tumor.
Acromegaly: Somatostatin analogs or growth hormone receptor antagonists to lower growth hormone levels and control symptoms.
Cushing's Disease: Medications such as cabergoline, somatostatin analogs, or adrenal enzyme inhibitors to lower cortisol levels and manage symptoms.

Radiation:

Stereotactic Radiosurgery (SRS): This technique delivers precise, high-dose radiation to the tumor while sparing surrounding tissues. It is often used for small, residual, or recurrent tumors that cannot be completely removed with surgery.
Conventional external beam radiation therapy: This may be used in some cases for larger tumors or when SRS is not feasible.

Observation and monitoring: For small, asymptomatic tumors, especially non-functioning adenomas, periodic monitoring with MRI scans may be recommended to track tumor growth and assess for any development of symptoms.