Pituitary Adenomas

Pituitary adenomas are benign, slow-growing tumors that form in the front portion (anterior lobe) of the pituitary gland. Some pituitary adenomas are endocrine active, which means they secrete excess hormones. Even a relatively small endocrine-active tumor can cause hormonal imbalances that interfere with vital bodily functions and cause disruptive symptoms.

Because pituitary adenomas can potentially invade nearby structures in the skull base, such as the cavernous sinus, clival bone and intracranial space, these tumors can be challenging to treat. Many patients with this complex diagnosis entrust their care to Tampa General Hospital’s Neuroscience Institute, where some of the world’s top neurosurgeons and ear, nose and throat specialists collaboratively practice in our Skull Base Surgery Center. For 2023-24, U.S. News & World Report has designated TGH as a “high performer” for Neurology and Neurosurgery.

What Can Cause a Pituitary Adenoma?

Pituitary adenomas develop after certain cells in the pituitary gland undergo abnormal changes that damage their DNA, which controls their function. As a result, the cells begin to grow and divide rapidly, and the excess cells then build up, bind together and form tumors.

Some pituitary adenomas are believed to run in families due to certain genetic mutations that are passed from parent to child. In most cases, however, the DNA changes that lead to the development of pituitary adenomas are acquired during life, resulting from random events that occur during cell division. There are no known lifestyle-related or environmental causes.

What Are the Symptoms of a Pituitary Adenoma?

In general, pituitary adenomas can cause:

• Headaches
• Double vision
• Easy bleeding and bruising
• Heat intolerance
• Weight gain
• Infertility

Additionally, an endocrine-active tumor can cause:

• Cushing’s disease – Excessive corticosteroids can cause upper body obesity, facial rounding, fatty deposits around the neck, a fatty lump between the shoulders, thin arms and legs, fragile skin, weakness, fatigue and irritability.
• Acromegaly – Excessive growth hormones can cause enlargement of the face, arms, legs and soft tissues.
• Galactorrhea or hyperprolactinemia – Excessive hormones such as prolactin, estrogen or thyrotropin-releasing hormone (TRH) can trigger milk production from the breasts that is unrelated to pregnancy or lactation.  

How Is a Pituitary Adenoma Diagnosed?

If a pituitary adenoma is suspected based on the symptoms, a physician may order a blood or urine test to check for elevated levels of certain hormones, such as:

• Plasma prolactin (PRL)
• Growth hormone (GH)
• Insulin-like growth factor-1 (IGF-1)
• Free thyroxine
• Cortisol
• Testosterone

A high level of any of these hormones in the blood or urine may indicate an endocrine-active tumor.

The physician may also order images created with enhanced, high-resolution magnetic resonance imaging (MRI) technology to look for the unique characteristics of a pituitary adenoma.

What Are the Treatment Options for a Pituitary Adenoma?

Pituitary adenoma treatment is often coordinated by a multidisciplinary team that includes a neurosurgeon, otolaryngologist and endocrinologist. Many patients benefit from a combination of:

• Observation – The tumor is monitored with periodic imaging scans.
• Drug therapy – Medications may be prescribed to prevent the tumor from producing hormones, manage the resulting hormonal imbalances or shrink the tumor to alleviate pressure on the pituitary gland or other vital structures in the skull base.
• Radiation therapy – External beam radiation therapy (EBRT) may be considered to shrink a tumor before surgery or treat a tumor that cannot be surgically removed due to its sensitive location in the skull base.
• Surgery – Endonasal endoscopic surgery is a minimally invasive procedure that involves removing a tumor through the nose. Another surgical approach is an open craniotomy, which is used less frequently to treat pituitary adenomas.

Choose TGH for World-Class Care  

The neurosurgeons and otolaryngologists at TGH are internationally renowned innovators who perform a high volume of endoscopic endonasal procedures to remove complex pituitary adenomas. If you would like to discuss your symptoms or explore your treatment options with a specialist at TGH, contact us at (800) 822-3627 to request an appointment.