Pituitary Adenomas

Overview


Tumour Group: Non-Malignant Brain Tumours
WHO Grade: Grade I or II
Prevalence/Incidence: Pituitary adenomas are low-grade, slow-growing masses that represent about 10% of primary brain tumours, making them the third most common primary brain tumour in adults.
Typical Age Range: They can occur at any age, but they are more common in older people. Women are more affected than men, particularly during childbearing years.

Contents
Description of Tumour
Symptoms
Treatment / Standard of Care
Prognosis
References

Description of Tumour


The pituitary gland is a bean-sized organ located in the midline at the base of the brain, behind the bridge of the nose, in a bony pouch called the “stella turcica.” The pituitary itself is known as the “master gland” because it helps to control other glands and organs in the body. The pituitary gland is involved in the production of several essential hormones.

Pituitary adenomas occur in the pituitary gland, which secretes several crucial hormones including corticotrophin, thyroid stimulating hormone, growth hormone, prolactin, gonadotropins and anti-diuretic hormone.

Stimulation from the hypothalamus may contribute to the growth of a pituitary adenoma.

While certain pituitary tumours secrete abnormally high amounts of one or more of these hormones and cause related symptoms, others are hormonally inactive and do not secrete hormones. Both types of tumours can grow and compress the surrounding tissue, such as the brain and optic nerves.

Most pituitary adenomas grow in the front two-thirds of the pituitary gland. These tumours are classified as “secreting” and “non-secreting.” A secreting tumour produces excessive amounts of hormones. Most pituitary tumours fall into this category; they are further classified by the type(s) of hormone they produce.

Symptoms


Common symptoms include, but are not necessarily limited to:

  • Abnormal growth of hands and feet
  • Abnormal hair growth pattern in women
  • Abnormal weight gain
  • Behavioural and cognitive changes
  • Cessation of menstrual periods (amenorrhea)
  • Depression
  • Headache
  • Impotence in men
  • Morning nausea or vomiting
  • Vision loss

Treatment / Standard of Care


  • For the great majority of patients with symptomatic endocrine-inactive adenomas surgery is the preferred therapy (trans-sphenoidal surgery is preferred to minimize the morbidity associated with an open craniotomy when possible).
  • For recurrent pituitary endocrine-inactive adenomas radiation may be used as either radiosurgery (single fraction) or fractionated daily radiotherapy (using stereotactic techniques), or when significant residual tumour is observed where critical structures are compromised and further surgery not indicated.
  • For hormone-secreting pituitary adenomas surgery may be curative (steroid producing adenomas), or endocrine therapy alone may be sufficient (prolactinomas). Radiation may be required in tumours resistant to surgical and medical management (given as either radiosurgery or fractionated daily radiotherapy).

Treatment options depend on the following:

  • The type and size of the tumour
  • Whether the tumour is making hormones
  • Whether the tumour is causing problems with vision or other symptoms
  • Whether the tumour has spread into the brain around the pituitary gland or to other parts of the body
  • Whether the tumour has just been diagnosed or has recurred

Prognosis  


A prognosis is an estimate of the likely progress of a disease after a diagnosis, based on an average patient group. Since every person is different, please take time to talk with your health care team about how this information applies to you.

By clicking on 'Expand,' a statistic on the prognosis for pituitary adenomas will be shown.

Expand for Prognosis Information

For brain tumour patients, a prognosis depends on several factors, which can include age and other health issues, the size of the tumour, its molecular profile, the type of tumour, how much can be removed and its response to treatments such as chemotherapy and radiation therapy.

Pituitary adenomas that are considered Grade I tend to have the most favourable survival rates compared to other higher grade brain tumours. 

References


Adult Brain Tumour Handbook 6th Edition. Brain Tumour Foundation of Canada. 2012.

Louis, David N. WHO Classification of Tumours of the Central Nervous System. Lyon: International Agency for Research on Cancer, 2007. Print

Non-Malignant Brain Tumour Handbook. Brain Tumour Foundation of Canada. 2011.

"Pituitary Tumours." www.abta.org. American Brain Tumour Association, n.d. Web. 8 July 2013.

Image credited to Philippe Chanson and Sylvie Salenave [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons

 

You can also download this information as a Information Sheet on Pituitary Adenomas (pdf).

 

 

The past four years have been full of joy and excitement for stay-at-home-mom Julia. They have also been filled with new experiences – some she never expected. Almost one year after her initial brain tumour diagnosis, Julia’s operation was scheduled. The non-malignant brain tumour, a pituitary adenoma, was successfully resected. Regular scans since show no regrowth, and today, Julia, once reluctant to tell her story, says she shares her experience in hopes of helping other women facing similar circumstances.

Read Julia's inspiring story >>

 

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