The pituitary gland, located at the base of the brain, is a small organ about the size of an acorn. The pituitary gland is sometimes referred to as the “master gland” because it releases substances which control the basic functions of growth, metabolism, and reproduction.
Symptoms and Diagnosis
A tumor in the pituitary gland causes symptoms by either releasing too much of a hormone or by pressing on the gland causing it to release too little hormone. The symptoms one experiences from the pituitary tumor are often determined by the type of tumor.
A tumor that secretes hormones produces symptoms by releasing too much of the hormone. Some tumors cause the gland to stop releasing enough hormones. In this case symptoms arise from lack of hormones. A pituitary tumor may also cause symptoms by growing and pressing on critical structures, like the nerves to the eyes, surrounding the gland.
Some pituitary tumors may be observed without treatment because most grow slowly. Pituitary tumors are usually benign. It is rare for them to ever become malignant.
If a decision is made to observe the tumor without treatment, ongoing evaluations by CT or MRI, by an endocrinologist, and by an ophthalmologist should be performed. CT or MRI scans will be performed within 3-6 months after the initial diagnosis and every 6-12 months thereafter. This period of observation without treatment provides information that helps the doctors decide whether other treatments that have more risks are needed.
Observation without treatment may also be recommended if conditions are present that would seriously increase the risk of surgical or other treatments. Because pituitary tumors are slow growing, patients can often be observed without treatment for long periods of time without the tumor causing serious problems. This is often the recommended form of treatment for patients who are age 70 or above or who have a serious medical illness such as heart disease. Close follow-up may be necessary to monitor tumor growth and symptoms.
Surgery is the preferred method of treatment for pituitary tumors that are creating neurological deficits or secreting large amounts of hormones.
The transsphenoidal operation is the most common operation for a pituitary tumor. The surgical approach for this operation is through the nose. There is no incision on the face. This surgical approach provides the best exposure of the tumor at the lowest risk. The operation normally takes two or three hours. Following the operation, most patients spend one day in the intermediate or intensive care unit before returning to their hospital room. Patients usually stay in the hospital for three or four days following the operation.
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