2. What is a Pituitary tumor?
The pituitary gland is a pea sized endocrine
gland located at the base of the brain.
A pituitary Tumor is caused by an abnormal
growth in the pituitary gland.
The tumor is benign and most people are
unaware they have it because there are very
little symptoms.
The hormone releasing cells of the pituitary
gland can be damaged.
3. The symptoms can be:
Headache
Lethargy: weariness, lack of energy
Nasal Drainage
Nausea and vomiting
Problems with the sense of smell
Visual changes such as
-Double vision
-Drooping eyelids
-Visual field loss Figure 3
These symptoms may occur suddenly and can be very
severe.
4. The symptoms can lead to:
Hyperthyroidism: a condition in the thyroid gland that
produces to much thyroid hormone.
Crushing syndrome: When your body is exposed to high
levels of the hormone cortisol.
Gigantism: abnormal large growth due to excess of the
growth hormone during childhood.
Nipple discharge: tenderness, skin changes, changes in
shape or discharge from the nipple portion of the breast.
Figure 4 Figure 5
5. Treatments can include:
Surgery especially if the tumor is pressing on the optic
nerves.
Can be removed through the nose or sinuses.
If it doesn’t work through the nose or sinuses it will have to
be removed through the skull.
Radiation therapy can be used to shrink the tumor.
- It can be used for people who cannot be put through
surgery.
Figure 6 Figure 7
6. Medications:
These medications can also shrink the tumors:
• Bromocriptine is the first line therapy for tumors
that release prolactin. With this dug it decreases
the prolactin and shrinks the tumor.
• Octreotide is used for tumors that release growth
hormone but only used when surgery cant be
curable.
Bromocriptine is used to treat symptoms of high levels of a natural
substance called prolactin in the body
8. Complications:
If the optic nerve has serious
damage you can go blind.
The tumor removal may cause
permanent hormone imbalances.
The affected hormones may need to
be removed.
9. Exams and tests:
Physical Examinations and test will include:
Cortisol levels
-Dexamethasone Suppression test: measures the response of the
adrenal glands to the ACTH.
-Urine Cortisol: measures the amount of the steroid hormone
cortisol in the urine
Follicle-stimulating hormone levels: hormones
released by the anterior pituitary gland.
Insulin growth factor-1 levels
Luteinizing hormone levels: measures the amount of
luteinizing hormone
10. Exams and tests continued:
Serum prolactin levels: measures the amount of
prolactin in the blood
Testosterone/estradiol levels
Thyroid hormone levels
-Free T4 test: hormone produced by the thyroid
gland. A laboratory test can be done to measure
the amount of T4 in your blood.
-TSH test: measures the amount of thyroid
stimulating hormone in your blood.
11. Random Facts:
Can occur to people of all ages, most frequent in children and older
adults.
Most common primary brain tumors consist of;
In ages 15-19, pilocytic astrocytomas followed by pituitary tumors.
In ages 20-34, pituitary followed by meningioma tumors.
Pituitary tumors represent 8.4% of all primany brain tumors.
Pituitary adenomas have separate names based on their size.
A microadenoma is less then 1 centimeter in diameter
A macroadenoma is larger then 1 centimeter in size
Pituitary adenomas are relatively common, occurring in 1 out of
every 1000 adults.
12. EXAM METHOD
Tangent screen exam
Here the patient is asked to sit 1 meter (approximately
3 feet) from a screen with a target on the center. The
eye that isn't tested is covered during the exam. While
the patient stares at the target the examiner will move
an object toward the patient's visual field. The patient
signals the examiner when the object comes into view.
This exam allows the patient's visual field to be
mapped.
13. QUIZ TIME!
QUIZ TIME
1. Explain what a pituitary tumor is?
2. Name 3 of the symptoms.
3. How can the tumor be removed?
4. If the _____ ______ has serious damage you can go blind.
5. How large is a macroadenoma?
*BONUS* : Pituitary tumors represent __% of all primary brain
tumors
14. Picture Resources:
FIGURES 1 & 2-
http://www.google.com/imgres?q=pituitary+tumor&hl=en&gbv=2&biw=812&bih=374&tbm=isch&tbnid=jl6Wh-
U2vXNBnM:&imgrefurl=http://www.cedars-sinai.edu/Patients/Programs-and-Services/Pituitary-Center/Diagnostic-
Imaging/Pituitary-MRIs.aspx&docid=XcMDFKUFo8ZZFM&imgurl=http://www.cedars-sinai.edu/Patients/Programs-
and-Services/Pituitary-Center/Diagnostic-Imaging/Images/coronalPit-MRI_rev_web-ready-
37301.jpg&w=466&h=432&ei=4CJJT_6kK5HDsQLuk_TqCA&zoom=1&iact=hc&vpx=69&vpy=21&dur=1529&hovh=216
&hovw=233&tx=133&ty=233&sig=111409954476902108896&page=3&tbnh=111&tbnw=95&start=18&ndsp=15&ved
=1t:429,r:0,s:18
FIGURE 3- http://www.eyeptosis.com/
FIGURE 4- medicinenet.com
FIGURE 5- - http://www.netterimages.com/image/12845.htm
FIGURE 6- http://healthlob.com/2011/05/radiation-therapy/
FIGURE 7- Dizon, M. N. and D. L. Vesely. "Gonadotropin-secreting Pituitary Tumor Associated with Hypersecretion of
Testosterone and Hypogonadism After Hypophysectomy." Endocrinology Practice 3 (May-June 2002): 225–231
FIGURES 8 & 9-http://www.emedicinehealth.com/drug-cabergoline/article_em.htm
FIGURE 10- http://acromegaly.wordpress.com/2009/02/07/started-treatment-for-acromegaly/
15. Resources
1. Melmed S, Kleinberg D. Anterior pituitary. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Williams Textbook of
Endocrinology. 11th ed. Philadelphia, PA: Saunders Elsevier; 2008:chap 8.
2. 1. Biller BMK, Grossman AB, Stewart PM, et al. Treatment of adrenocorticotropin-dependent Cushing's syndrome: a consensus
statement. J Clin Endocrinol Metab. 2008;93:2454-2462.
3. National endocrine and metabolic diseases information service. National Institutes of Health. NIH Publication No. 08-3007.
Cushing's Syndrome. http://endocrine.niddk.nih.gov/pubs/cushings/cushings.htm. Published July 2008. Accessed November 10,
2010.
4. Pituitary tumors information page. National Institute of Neurological Disorders and Stroke.
http://www.ninds.nih.gov/disorders/pituitary_tumors/pituitary_tumors.htm. Accessed April 15, 2010.
5. Pituitary tumors. American Cancer Society. http://documents.cancer.org/6028.00/6028.00.pdf. Accessed April 15, 2010.
6. Pituitary tumors. American Brain Tumor Association. http://www.abta.org/Tumor_&_Treatment_Info/Pituitary_Tumors/233.
Accessed April 15, 2010.
7. Pituitary Tumors Treatment. National Cancer Institute. http://www.cancer.gov/cancerinfo/pdq/treatment/pituitary. Accessed
April 15, 2010
8. Ari S. Eckman, MD, Division of Endocrinology and Metabolism, Johns Hopkins School of Medicine, Baltimore, MD. Review
provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
