Pituitary Tumors

Tumors may form in the pituitary gland, an organ in the brain that controls the release of hormones in the body. Hormones are chemical messengers that send signals to the body's organs to keep them working properly. Pituitary tumors have various effects on hormones and health, and they can cause many different health complications in adults and children. These tumors can develop on their own or be caused by one of many inherited disorders. NICHD scientists are exploring the causes of pituitary tumors and their related disorders and seeking better ways to diagnose and treat them.

Common Name

  • Pituitary (pronounced pi-TOO-i-ter-ee) tumors

Medical or Scientific Name

  • Pituitary adenoma (pronounced ad-n-OH-muh)

Pituitary Tumors: Condition Information

What are pituitary tumors?

Pituitary tumors are abnormal growths of cells in the tissue of the pituitary gland. The pituitary gland is a bean-shaped organ in the center of the brain, just behind and between the eyes. The pituitary gland causes the release of hormones in the body that control growth, metabolism, response to stress, and sexual and reproductive function.1

Doctors and scientists classify pituitary tumors according to whether or not they spread beyond the pituitary gland:2

  • Pituitary adenomas (pronounced ad-n-OH-muhz) are benign, meaning they are noncancerous and do not spread to other parts of the body. Most pituitary tumors fall into this category. Despite being benign, pituitary adenomas can make the pituitary gland produce too much or too little of certain hormones, causing health problems.
  • Pituitary carcinomas (pronounced kahr-suh-NOH-muhz) are malignant. This means they can spread beyond the pituitary gland into the brain or spinal cord, or into other parts of the body. Very few pituitary tumors are carcinomas.

Because pituitary carcinomas are so rare, this health topic will cover only those pituitary tumors that are adenomas.

  • Their size:
    • Microadenomas are smaller than 1 centimeter. Most pituitary adenomas are microadenomas.
    • Macroadenomas are 1 centimeter or larger.
  • Whether they secrete hormones2:
    • Functioning pituitary tumors (also called secretory tumors) produce levels of hormones that are too high. Most pituitary tumors are functioning tumors. The symptoms they cause are due to the excessive levels of hormones they produce. These hormones play important roles in the healthy functioning of the body:
      • Prolactin (pronounced proh-LAK-tin) causes a woman's breasts to make milk during and after pregnancy.
      • Adrenocorticotropic (pronounced uh-DREE-noh-kawr-ti-koh-TROP-ik) hormone (ACTH) is involved in the body's response to stress.
      • Growth hormone helps control body growth and metabolism.
      • Thyroid-stimulating hormone is involved in growth, body temperature, and heart rate.
    • Nonfunctioning pituitary tumors (also called nonsecretory tumors) do not produce hormones. They can press on or damage the pituitary gland and prevent it from secreting adequate levels of hormones.

Citations

  1. National Institute of Neurological Disorders and Stroke. (2010). NINDS pituitary tumors information page. Retrieved February 28, 2012, from https://www.ninds.nih.gov/Disorders/All-Disorders/Pituitary-Tumors-Information-Page
  2. National Cancer Institute. (2011). Pituitary tumors treatment (PDQ). Retrieved February28, 2012, from http://www.cancer.gov/cancertopics/pdq/treatment/pituitary/Patient/page9/AllPages#7

What are the symptoms of pituitary tumors?

Symptoms of Functioning Tumors

The symptoms of functioning tumors depend on the particular hormone the tumor is overproducing.1

Prolactin

A pituitary tumor that produces too much prolactin may cause:

  • Headache
  • Some loss of vision
  • Less frequent or no menstrual periods or menstrual periods with a very light flow
  • Difficulty getting pregnant
  • Impotence in men
  • Lower sex drive
  • The flow of breast milk in a woman who is not pregnant or breastfeeding

Adrenocorticotropic Hormone (ACTH)

A pituitary tumor that produces too much adrenocorticotropic hormone (ACTH) may cause:

  • Headache
  • Some loss of vision
  • Weight gain reflected in the face, neck, and trunk of the body, but thin arms and legs
  • A lump of fat on the back of the neck
  • Thin skin that may include purple or pink stretch marks on the chest or abdomen
  • Easy bruising
  • Growth of fine hair on the face, upper back, or arms
  • Bones that break easily
  • Anxiety, irritability, depression
  • Growth deceleration with weight gain in children
  • Irregular menses

Growth Hormone

A pituitary tumor that produces too much growth hormone may cause:

  • Headache
  • Some loss of vision
  • In adults, growth of the bones in the face, hands, and feet
  • In children, excessive growth of the whole body
  • Tingling or numbness in the hands and fingers
  • Snoring or pauses in breathing during sleep
  • Joint pain
  • Sweating more than usual
  • Extreme dislike of or concern about one or more parts of the body

Thyroid-Stimulating Hormone (TSH)

A pituitary tumor that produces too much TSH (through high T4) may cause:

  • Irregular heartbeat
  • Shakiness
  • Weight loss
  • Trouble sleeping
  • Frequent bowel movements
  • Sweating

Symptoms of Nonfunctioning Tumors

Nonfunctioning tumors press on or damage the pituitary and prevent it from secreting enough hormones. If there is too little of a particular hormone, the gland or organ it normally controls will not function correctly. Symptoms of nonfunctioning pituitary tumors are1:

  • Headache
  • Some loss of vision
  • Loss of body hair
  • In women, less frequent menstrual periods or no periods at all, or no milk from the breasts
  • In men, loss of facial hair, growth of breast tissue, and impotence
  • In women and men, lower sex drive
  • In children, slowed growth and sexual development

Other General Symptoms of Pituitary Tumors

  • Nausea and vomiting
  • Confusion
  • Dizziness
  • Seizure
  • Runny or drippy nose

Citations

  1. National Cancer Institute. (2011). Pituitary tumors treatment (PDQ). Retrieved February 28, 2012, from http://www.cancer.gov/cancertopics/pdq/treatment/pituitary/Patient/page9/AllPages#7

What causes pituitary tumors?

The exact cause of pituitary tumors is unknown.

In rare cases, inherited disorders may cause pituitary tumors. These diseases include multiple endocrine neoplasia (pronounced nee-oh-PLEY-zhuh) type 1 (MEN 1) syndrome, Carney complex, and isolated familial acromegaly (pronounced ak-ruh-MEG-uh-lee).1

For more information about these conditions, read the section Are there disorders associated with pituitary tumors?

It is likely that pituitary tumors are caused by abnormalities in one or more genes, by hormonal abnormalities, or by a combination of these factors.2 Scientists, including NICHD researchers, are still working to figure out what causes pituitary tumors.

Citations

  1. Asa, S. L., & Ezzat, S. (2002). The pathogenesis of pituitary tumours. Nature Reviews Cancer, 2, 836−849.
  2. Melmed, S. (2011). Pathogenesis of pituitary tumors. Nature Reviews Endocrinology, 7, 257−266.

How do health care providers diagnose pituitary tumors?

A doctor will usually begin by giving you a physical exam and asking about your medical history. She or he will check your general health and examine your body for unusual things like lumps.

You might be given tests or procedures such as:1

  • Eye and visual field exam
  • Neurological exam: During this exam, the doctor gives you a series of tests and questions to check your coordination, mental status, reflexes, and muscle function.
  • Magnetic resonance imaging (MRI) or computed tomography (CT) scan: MRI uses magnetic waves to produce detailed images of the inside of the body, while a CT scan uses X-rays to produce these pictures. These machines create images of the inside of the brain and spinal cord.
  • Blood tests to check levels of hormones, blood sugar, and other substances
  • Urine tests to determine levels of certain hormones
  • Venous sampling: In this type of test, a sample of blood is taken from veins coming from the pituitary gland. Levels of certain hormones are measured in the blood sample.
  • Biopsy: Cells or tissues are removed from the pituitary gland. They are then examined under a microscope to check for signs of cancer.

To find out more about diagnosis of pituitary tumors, visit the National Cancer Institute's General Information section on pituitary tumors.

Citations

  1. National Cancer Institute. (2011). Pituitary Tumors Treatment (PDQ), Retrieved February 28, 2012, from http://www.cancer.gov/cancertopics/pdq/treatment/pituitary/Patient/page9/AllPages#7

What are the treatments for pituitary tumors?

The most common treatments for pituitary tumors are1:

  • Drug therapy. Drugs can be given to treat the abnormal hormone levels caused by functioning pituitary tumors. The drug given depends on the hormone that is affected by the tumor.
  • Surgery. The tumor is removed by performing an operation. The surgeon may reach the pituitary gland through a cut made under the upper lip or at the bottom of the nose between the nostrils. In other cases, the surgeon may cut through the skull to reach the pituitary tumor. Even if the tumor is completely removed, patients are commonly given radiation and chemotherapy after surgery to kill any tumor cells that might be present.
  • Radiation therapy. Radiation therapy involves targeting a tumor with high-energy X-rays that kill tumor cells or keep them from growing.
  • Chemotherapy. Chemotherapy uses drugs that kill tumor cells or keep them from growing. Chemotherapy can be taken by mouth or injected.

The primary approach for treatment will depend on the type of pituitary tumor.

To find out more about treatments for pituitary tumors, visit the National Cancer Institute's Treatment Option Overview section on pituitary tumors.

Citations

  1. National Cancer Institute. (2011). Pituitary tumors treatment (PDQ). Retrieved February 28, 2012, from http://www.cancer.gov/cancertopics/pdq/treatment/pituitary/Patient/page9/AllPages#7

Is there a cure for pituitary tumors?

Most pituitary tumors are curable.1 If a pituitary tumor is diagnosed early, the outlook for recovery is usually excellent. However, if tumors grow large enough, or grow rapidly, they are more likely to cause problems and will be more difficult to treat.2 Lifelong treatment or follow-up is often required, however, to make sure the tumor has not returned.3

Citations

  1. Shimon, I., & Melmed, S. (1998). Management of pituitary tumors. Annals of Internal Medicine, 129, 472−483.
  2. National Institute of Neurological Disorders and Stroke. (2010). NINDS pituitary tumors information page. Retrieved February 28, 2012, from https://www.ninds.nih.gov/Disorders/All-Disorders/Pituitary-Tumors-Information-Page
  3. Melmed, S. (2011). Pathogenesis of pituitary tumors. Nature Reviews Endocrinology, 7, 257−266.

Pituitary Tumors: NICHD Research Goals

NICHD research efforts related to pituitary tumors address the development of the pituitary gland itself as well as the development of pituitary tumors. Studies include efforts to understand:

  • Basic science of pituitary gland development. Studies have identified transcription factors and signaling molecules involved in pituitary development; efforts have also involved the characterization of pituitary stem cells.
  • Mechanisms of tumor development. Research has involved the development of mouse models of pituitary adenomas, examination of mutations that lead to the absence or underdevelopment of the pituitary gland or to tumors, and discovery of genes involved in pituitary dysfunction.
  • Clinical characterization of childhood pituitary tumors and related disorders. Goals of clinical research involve training young physicians in childhood endocrine disease, developing methods for the diagnosis and treatment of tumors, and identifying genes involved in tumor development.

Pituitary Tumors: Research Activities and Scientific Advances

Pituitary tumors and other endocrine tumors lead to a variety of health problems in adults and children. NICHD research efforts aim to uncover the genetic abnormalities and molecular mechanisms that contribute to the development of pituitary tumors and related syndromes. Clinical studies aim to uncover methods of diagnosing, managing, and treating pituitary tumors in children.

The Institute also supports professional training and the development of research infrastructure that will facilitate investigations into childhood pituitary tumors.

Institute Activities and Advances

NICHD research efforts related to pituitary tumors address the development of the pituitary gland itself as well as the development of pituitary tumors. Studies include efforts to understand the genetic, molecular, and cellular mechanisms of pituitary gland development. Using animal models, the Institute aims to document the gene mutations that lead to pituitary tumors. Studies in humans focus on genetic variations as well as diagnostic and therapeutic approaches to treating children and adults with pituitary tumors.

This research is supported in part through the NICHD's Developmental Biology and Structural Variation Branch (DBSVB), which focuses on the causes and prevention of congenital and genetic defects. Branch-supported research includes studies of:

  • Genes and signaling molecules that lead to abnormal growth of pituitary cells
  • Animal models to determine the role of particular genes and molecules in both normal pituitary development and the development of pituitary tumors
  • Approaches relying on bioinformatics and on genomics to find novel genes involved in the development of pituitary tumors

Additionally, the Pediatric Growth and Nutrition Branch (PGNB) supports research on nutritional science, childhood antecedents of adult disease, developmental endocrinology, developmental neuroendocrinology, and physical growth and body composition, including bone health and obesity. The PGNB has supported research on the function and genetics of stem cells in the pituitary gland. Elucidating the dynamics of pituitary stem cells may lead to a better understanding of how pituitary tumors develop.

The Fertility and Infertility (FI) Branch supports scientific research aimed at alleviating human infertility, uncovering new leads on contraceptives, and expanding fundamental knowledge of the processes that underlie human reproduction. Research supported by the FI Branch has examined molecular and genetic mechanisms underlying the abnormal production of reproductive hormones as well as signaling in pathways involving the pituitary gland that affect male and female fertility.

Further research is being conducted within the Section on Endocrinology and Genetics (SEGEN), which is part of the Program on Developmental Endocrinology and Genetics (PDEGEN) in the NICHD's Division of Intramural Research. Researchers are investigating the genetics of rare endocrine disorders, including diseases that can lead to pituitary tumors. SEGEN scientists discovered how a mutation in the PRKAR1A gene can contribute to the development of Carney complex, a rare disorder characterized by tumors in the adrenal glands, heart, connective tissue, pituitary, and other glands.

Other Activities and Advances

The NICHD supports a number of research and clinical training programs for physicians. These programs are part of NIH-wide or collaborative efforts in which the NICHD participates. The training programs for pituitary research are listed below.

  • The NICHD-NIDDK Interinstitute Endocrine Training Program (IETP) seeks to train internal medicine physicians to become first-rate endocrinologists who seek investigative careers. The fellowship is ideal for physicians who seek a broad education in both research and clinical endocrinology. The National Institute of Diabetes and Digestive and Kidney Diseases, through its Diabetes Branch, Metabolic Diseases Branch, Clinical Endocrinology Branch, and Islet Autoimmunity Branch; NICHD (PDEGEN and the Program in Reproductive and Adult Endocrinology); and National Institute of Dental and Craniofacial Research participate in this program, with faculty from all three Institutes.
  • The NICHD Medical Genetics Training Fellowship Program is a clinical fellowship training in medical and/or pediatric genetics as a single program or in conjunction with training in pediatric endocrinology (and/or internal medicine and endocrinology) is offered through the PDEGEN. Training in genetics is offered through PDEGEN's participation in the medical genetics fellowship programs of the NIH led by the National Human Genome Research Institute.
  • The Pediatric Endocrinology Interinstitute Training Program is a 3-year program accredited by the Accreditation Council for Graduate Medical Education that provides comprehensive training in clinical patient management as well as guidance in the development of research skills. The fellowship is at the NICHD and based at the NIH Clinical Center. The Clinical Center maintains clinical research protocols investigating the treatment of adrenal and pituitary tumors, congenital adrenal hyperplasia, Turner syndrome, McCune-Albright syndrome, Cushing's syndrome, obesity, and other important disorders.
top of pageBACK TO TOP