Pituitary Tumors Surgery

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Pituitary Tumors: Types, Signs & Symptoms

Pituitary Gland Tumors are abnormal growths which develop inside the pituitary gland. Some pituitary gland tumors result in secreting too much of hormones which regulate important functions of the body. Some of these pituitary gland tumors can also cause pituitary glands to produce lower levels of hormones as well. Most pituitary tumors are benign (noncancerous) growths which are called adenomas. Adenomas remain inside pituitary gland or within the surrounding tissues & generally do not spread to other parts of the body. Various options are available for treating pituitary tumors, including surgical removal of tumors, controlling its growth & also management of hormone levels with help of medications. Moreover, doctors often recommend observation or a ‘wait & watch’ approach while treating pituitary tumors.

Signs & Symptoms of Pituitary Gland Tumors

Not all pituitary gland tumors are found to cause signs & symptoms. Pituitary gland tumors which are functioning & making hormones can cause a variety of signs & symptoms depending upon the hormones they produce. Signs & symptoms of pituitary gland tumors which are nonfunctioning & do not make hormones are related to the size of their growth & the amount of pressure they are able to put on other nearby structures. Large pituitary gland tumors which measure little less than half-inch (1 centimeter) or larger are medically termed macroadenomas, while smaller tumors are known as microadenomas. Merely because of the size of macroadenomas, they are able to put pressure on normal pituitary gland & structures located nearby.

  • Signs & Symptoms Relating to Tumor Pressure – Signs & symptoms of pressure from large pituitary tumors can include the following.
    • Headache
    • Loss of vision, particularly peripheral vision loss
  • Signs & Symptoms Relating to Hormone Level Changes
    • Over-Functioning – Functional pituitary gland tumors can cause overproduction of hormones. Different types of functional tumors within the pituitary gland can cause specific signs & symptoms & quite often a combination of them.
    • Deficiency – Large pituitary gland tumors can cause hormonal deficiencies whose signs & symptoms may include the following.
      • Weakness
      • Nausea & Vomiting
      • Feeling Cold
      • Sexual Dysfunction
      • Less Frequent or No Menstrual Cycles
      • Unintended Weight Loss or Weight Gain
      • Increased Amounts of Urine

Types of Pituitary Gland Tumors

  • Adrenocoticotropic Hormone-Secreting (ACTH) Pituitary Tumors – ACTH pituitary tumors produce adrenocorticotropin hormone which stimulates the adrenal gland so as to make hormone cortisol. Adrenal glands producing too much cortisol eventually results in Cushing’s syndrome. Signs & symptoms which are possible due to Cushing’s syndrome include the following.
    1. Accumulation of fat in midsection & upper back region
    2. Exaggerated roundness of face
    3. Thinning of arms & legs
    4. Bone weakening
    5. Acne
    6. High Blood Sugar
    7. High Blood Pressure
    8. Anxiety, Irritability or Depression
    9. Stretch Marks
    10. Bruising
  • Growth Hormone-Secreting Pituitary Tumors – This type of pituitary tumors produce excessive growth hormones (acromegaly) & which can cause the following signs & symptoms.
    1. Joint Pain
    2. Heart Problems
    3. High Blood Sugar
    4. Excessive Sweating
    5. Enlarged Hands & Feet
    6. Coarsened Facial Features
    7. Increased Hair on Body
    8. Misaligned Teeth
    9. Children & Adolescents may grow too fast and/or too tall
  • Prolactin-Secreting Pituitary Tumors – Overproduction of prolactin hormone from pituitary tumor (prolactinoma) can cause decrease in normal levels of sex hormones like estrogen in women & testosterone among men. Excessive prolactin within blood affects differently for men & women.
Pituitary tumor type and symptoms

Prolactinoma in women can cause the following.

  • Milky discharge from breasts
  • Lack of menstrual periods
  • Irregular menstrual cycles

Prolactin-producing pituitary gland tumors in men can cause male hypogonadism. Signs & symptoms of this condition include the following.

  • Breast growth in males
  • Loss of sex drive
  • Lower sperm count
  • Erectile Dysfunction
  • Thyroid-Stimulating Hormone-Secreting Pituitary Tumors – When pituitary gland tumors overproduce thyroid-stimulating hormone, thyroid gland will end up making too much of hormone thyroxine hormone. This is a rare cause called overactive thyroid disease or hyperthyroidism. Hyperthyroidism can eventually accelerate body’s metabolism to cause the following symptoms.
  • Excessive sweating
  • Frequent bowel movements
  • Irritability or nervousness
  • Irregular or rapid heartbeat
  • Weight loss

Right Time to See a Doctor for Pituitary Gland Tumors

The right time to see a doctor is when people develop signs & symptoms which are associated with pituitary gland tumors. Most often pituitary gland tumors can be treated so as to return hormone levels back to normal & which will effectively alleviate signs & symptoms of patients. Moreover, in case people know that multiple endocrine neoplasia like type I (MEN I) runs in their family, they should talk to their doctors about conducting periodical tests which may also help detect pituitary gland tumors in early stages.

Causes of Pituitary Gland & Hypothalamus Tumors

Cause of uncontrolled cell growth within the pituitary gland creating a tumor, however, remains unknown. Pituitary gland basically is a small bean-shaped gland which is situated at the base of the brain. It is located somewhat behind the nose & between the ears. Despite small size of the pituitary gland, it is able to influence nearly every part of the body. Hormones produced by the pituitary gland help regulate important functions like reproduction, growth & blood pressure. Although, most pituitary gland tumors bear no apparent hereditary factor, small percentage of these tumor cases are found to run in families. Nevertheless, scientists strongly suspect that genetic alterations play a key role in the development of pituitary gland tumors.

Risk Factors Associated with Pituitary Gland Tumors

People having a family history of certain hereditary conditions like type I MEN I (multiple endocrine neoplasia) pose increased risk of developing pituitary gland tumors. Multiple tumors are found to occur in various glands of the endocrine system in MEN I patients. Nevertheless, genetic testing is available for this particular disorder.

Complications Associated with Pituitary Gland Tumors

Pituitary gland tumors normally do not grow or extensively spread. However, they can affect the health of the patient by causing following conditions.

  • Loss of Vision – Pituitary gland tumors can exert pressure on the optic nerves so as to cause loss of vision.
  • Permanent Hormone Deficiency – Presence of pituitary gland tumors or removal of one can permanently alter supply of hormones & which may eventually be required to be replaced with hormone medications.

Rare but potentially serious complication associated with pituitary gland tumor is pituitary apoplexy which is caused when sudden bleeding occurs within the tumor. This feels like the most severe headache the patient has ever experienced. Usually treated with corticosteroids & possibly surgery, pituitary apoplexy invariably requires emergency treatment.

Diagnosing Pituitary Gland Tumors

Pituitary gland tumors most often go undiagnosed due to the reason that their symptoms largely resemble those of other conditions. Moreover, quite a few pituitary gland tumors are also found by medical tests which were conducted for other conditions. However, doctors will most likely take detailed history of patients & perform a physical examination in diagnosis of pituitary gland tumor. They may also order the patients to undergo the following tests.

  • Blood & Urine Tests – These tests can determine whether the patient is having overproduction or deficiency of hormones in the system.
  • Brain Imaging Tests – MRI scan or CT scan of brain can eventually help doctors judge the size & location of pituitary gland tumors.
  • Vision Testing – This test is done so as to determine if pituitary gland tumor has impaired sight or peripheral vision of the patient.
  • Additional Tests – Additionally, doctors may refer patients to endocrinologists for more extensive testing procedures.

Treatment Options for Pituitary Gland Tumors

Quite a few pituitary gland tumors do not require any type of treatment. Tumors which require pituitary tumor treatment are determined by the type & size of the tumor & how far has it grown into the brain. Age & overall health of the patient are also important factors which are considered before deciding upon the kind of treatment. Treatments generally involve a team of medical experts which possibly include a radiation oncologist, endocrine system specialist (endocrinologist) & a brain surgeon (neurosurgeon). Doctors treating pituitary gland tumors normally use medications, radiation therapy & surgery, either alone or in combinations to treat tumor patients & eventually help their hormone production return to normal levels.

  • Endoscopic Transnasal Transsphenoidal Surgery – Surgical removal of pituitary gland tumor is usually necessary when the tumor is found to be pressing upon the optic nerves or in case the tumor is overproducing certain hormones. Success of surgery however depends upon factors like the type of tumor, its size & location & whether it has invaded the surrounding tissues. Two main surgical techniques which are adopted in treatment of pituitary gland tumors include the following.
    • Endoscopic Transnasal Transsphenoidal Approach – This approach usually enables the surgeon remove the pituitary gland tumor through the nose & sinuses without making an external incision. Moreover, no other part of the brain gets affected & the procedure is completed without any visible scars. However, large tumors may be difficult to remove through this approach, especially when the tumor has invaded nearby brain tissue & nerves.
    • Craniotomy or Transcranial Approach – Pituitary gland tumor is removed through the upper part of the patient’s skull through an incision made in the scalp in transcranial approach for surgery. However, it is easier to reach large and/or more complicated tumors while using this procedure.
  • Radiation Therapy – Radiation therapy utilizes high-energy X-rays in order to destroy pituitary gland tumors. This therapy can either be used after surgery or even alone in case surgery cannot be an option. However, radiation therapy can be extremely beneficial in case tumors are found to persist or return following surgical intervention so as to cause signs & symptoms which medications are unable to relieve. Main methods of radiation therapy treatment for pituitary gland tumors include the following.
    • GammaKnife Stereotactic RadiosurgeryThis radiation procedure is often delivered as a single high dose treatment for pituitary gland tumor. It focuses radiation beams upon the tumor without making any incision. While delivering radiation beams specific to the size & shape of the tumor to the pituitary gland tumor with aid of specialized brain imaging techniques, minimal radiation comes into contact with the healthy surrounding tissue & thereby immensely decreases damage to normal healthy tissue.
    • External Beam Radiation Therapy – This procedure delivers radiation in small increments over a period of time. This is a series of treatment sessions which are usually given about 5 times a week for over 4 – 6 week period. Usually performed as an outpatient procedure, this therapy is most often effective but may however take years to fully control the pituitary gland tumor growth & production of hormone. Moreover, this external beam radiation therapy can also damage the remaining pituitary cells & the surrounding normal brain tissue which are particularly located near the pituitary gland.
    • Proton Beam Therapy – This is another radiation therapy option which uses positively charged ions or protons rather than X-rays to treat pituitary gland tumors. Unlike X-rays, proton beams effectively stop after releasing energy within the targeted area of the brain. Moreover, proton beams can be finely controlled & can be effectively used upon pituitary gland tumors with lesser risk of damaging the healthy surrounding tissue. However, proton beam therapy requires special equipment which is not currently widely available.

Benefits of most of these types of radiation therapy are most often not immediately visible & may in many cases take months or even years to prove fully effective. Radiation oncologists will evaluate the patient’s condition & discuss pros & cons of every option which is available to patients.

  • Medications – Pituitary gland tumor treatment with help of medications can help block excess hormone secretions & quite often also shrink certain types of tumors.
  • Prolactinomas – Prolactin-Secreting Pituitary Gland Tumors – Drugs like bromocriptine (Parlodel) & cabergoline decrease secretion of prolactin & quite often also reduce the size of pituitary gland tumors. However, possible side effects of these drugs include depression, confusion, diarrhea or constipation. Vomiting, nausea, dizziness & drowsiness. Moreover, some people are also found to develop compulsive behaviors like gambling while taking these medications.
  • Growth Hormone-Secreting Tumors – There are two types of drugs which are available as treatment for these types of pituitary gland tumors. They are especially very useful, especially in cases where surgery has failed in normalizing production of growth hormone. One such type of drug is known as somatostatin analogs (Somatuline Depot, Sandostatin) which are effectively found to cause decrease in growth hormone production & which may also be able to shrink the pituitary gland tumor. These drugs are delivered through injections & which are usually given to patients after every 4 weeks. Common side effects caused by these drugs include pain at injection site, headache, dizziness, stomach pain, diarrhea, vomiting & nausea. These drugs can also cause gallstones in patients & may even worsen diabetes mellitus. The second type of drug is pegvisomant (Somavert) & which blocks the effect of excessive growth hormone in the body. This drug is delivered through injections daily, but may cause damage to liver, in some patients.

Replacement of Pituitary Hormones

Pituitary gland tumor patients are most likely to need taking replacement hormones in order to maintain normal levels of hormone in case the tumor or surgery to remove tumor decreases production of hormones. Quite a few people who undergo radiation therapy treatment for pituitary tumors also need to undergo pituitary gland hormone replacement.

Watchful Waiting with Pituitary Gland Tumors

Watchful waiting with pituitary gland tumors is also known as observation, deferred therapy or expectant therapy. Patients might in such a case need regular follow-up evaluation tests in order to determine if the tumor is growing. This is usually an option when pituitary tumors are not causing any signs or symptoms. Several people with pituitary gland tumors are found to function normally without any treatment when the tumor is not causing any problems. Watchful waiting can be an ideal option for younger patients as long as they are able to accept the possibility of tumors growing or changing during the observation period & which would also possibly require treatment in future. For this purpose, the doctor & the patient can sit together & discuss risk of developing symptoms versus treatment options.

Affordable Treatment for Pituitary Gland Tumors in India

Over the past many years India has emerged as one of the most favorite healthcare tourism destinations providing a wide spectrum of affordable medical procedures to international patients. While quality of healthcare services in the country is excellent when compared to the best treatment procedures around the world, most nationally & internationally accredited hospital facilities are equipped with the state-of-the-art latest technologies in order to deliver successful outcomes. Moreover, India features a large pool of skilled doctors & surgeons & many of whom are globally reputed & initially trained & experienced for decades in developed countries like UK, Canada & United States before returning to their homeland. Another convenient feature for the international patient is that professional staff & well trained nurses in the country are able to speak English & therefore quite capable of understanding what patients coming from a foreign country are experiencing.

Low Cost Travcure Treatment Packages for Pituitary Tumors

Travcure is one of the fastest growing healthcare companies in South Asia & has ever since inception been an essential part of the Indian success story. Associated with the best doctors & surgeons in the country, they are ideally placed to deliver the most successful outcomes for international patients for a wide spectrum of ailments without any waiting period. Travcure is also tied up with top nationally & internationally accredited hospitals & which enables them pass on the low cost benefits to patients as well. Taking care of each & every detail which an international patient may face in a diverse situation like the Indian subcontinent, seamless Travcure services which begin with the first conversation with the patient moves on to identifying the best surgeon & hospital for treatment, assisting in obtaining medical visas, receiving the patient at the airport on arrival for treatment to arrangement for local travel, accommodation as per the patient’s choice, medical procedures at reasonable costs & exotic recuperative holidays in case the patient desires so as to make his journey a memorable experience.

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