What Are Pituitary Tumors
The pituitary is a small, bean-sized gland that is below the hypothalamus, a structure at the base of the brain, by a thread-like stalk that contains both blood vessels and nerves. It controls a system of hormones in the body that regulate growth, metabolism, the stress response, and functions of the sex organs via the thyroid gland, adrenal gland, ovaries, and testes. A pituitary tumor is an abnormal growth of cells within the pituitary gland. Most pituitary tumors are benign, which means they are non-cancerous, grow slowly and do not spread to other parts of the body; however they can make the pituitary gland produce either too many or too few hormones, which can cause problems in the body. Tumors that make hormones are called functioning tumors, and they can cause a wide array of symptoms depending upon the hormone affected. Tumors that don’t make hormones are called non-functioning tumors. Their symptoms are directly related to their growth in size and include headaches, vision problems, nausea, and vomiting. Diseases related to hormone abnormalities include Cushing’s disease, in which fat builds up in the face, back and chest, and the arms and legs become very thin; and acromegaly, a condition in which the hands, feet, and face are larger than normal. Pituitary hormones that impact the sex hormones, such as estrogen and testosterone, can make a woman produce breast milk even though she is not pregnant or nursing, or cause a man to lose his sex drive or lower his sperm count. Pituitary tumors often go undiagnosed because their symptoms resemble those of so many other more common diseases.Types of Menigiomas
- Cavernous Sinus Meningioma: Occurs near the area that drains deoxygenated blood to the heart from the brain.
- Cerebellopontine Angle Meningioma: Located near the margin of the cerebellum; acoustic neuromas (vestibular schwannoma) typically are found in this area.
- Cerebral Convexity Meningioma: Located on the upper surface of the brain cerebral convexity.
- Foramen Magnum Meningioma: Located near the opening at the base of the skull through which the lower portion of the brainstem passes.
- Intraorbital Meningioma: Located in or around eye sockets.
- Intraventricular Meningioma: Located in the chambers through which cerebrospinal fluid is carried throughout the brain.
- Olfactory Groove Meningioma: Located along the nerves connecting the nose to the brain.
- Parasagittal/Falx Meningioma: Located adjacent to the dural fold that separates the two brain hemispheres
- Petrous Ridge Meningioma: Portion of the temporal bone (which supports the temple) that contain sections of the organs that facilitate hearing.
- Posterior Fossa Meningioma: Occurs near the back of the brain.
- Sphenoid Meningioma: Located near the sphenoid bone behind the eyes.
- Spinal Meningioma: Located in the spine, in some cases against the spinal cord.
- Suprasellar Meningioma: Located near the area of the skull where the pituitary gland is found.
- Tentorium Meningioma: Located near where the brain connects to the brainstem, an area known as the tentorium cerebelli.
Pituitary Tumors – Is there any treatment?
Generally, treatment depends on the type of tumor, the size of the tumor, whether the tumor has invaded or pressed on surrounding structures, such as the brain and visual pathways, and the individual’s age and overall health. Three types of treatment are used: surgical removal of the tumor; radiation therapy, in which high-dose x-rays are used to kill the tumor cells; and drug therapy to shrink or destroy the tumor. Medications are also sometimes used to block the tumor from overproducing hormones. For some people, removing the tumor will also stop the pituitary’s ability to produce a specific hormone. These individuals will have to take synthetic hormones to replace the ones their pituitary gland no longer produces.
Pituitary Tumors – What is the prognosis?
If diagnosed early enough, the prognosis is usually excellent. If diagnosis is delayed, even a non-functioning tumor can cause problems if it grows large enough to press on the optic nerves, the brain, or the carotid arteries (the vessels that bring blood to the brain). Early diagnosis and treatment is the key to a good prognosis.
Pituitary Tumors – Surgical treatment of pituitary tumors
Transnasal (endoscopic and microsurgical approach) – A type of surgery in which micro instruments are inserted through the nose, through the sphenoid bone at the base of the skull and into part of the brain. Transsphenoidal surgery is generally used to remove tumors of the pituitary gland, or anterior skull base. Orange County Neurosurgical Associates utilize a multidisciplinary team approach of treating pituitary tumors in conjunction with Ear Nose and Throat surgeons, and Endocrinologists.