The pituitary gland is roughly the size of a pea, but is the control center for most of the hormonal functions in the human body. Located in the center of the skull, the pituitary gland is a vital part of the endocrine system, which regulates the hormones responsible for mood, growth, development, metabolism, and reproduction. It’s often called the “master gland” because it can control the function of other endocrine glands such as the thyroid, ovaries, and testes.
Benign tumors of the pituitary gland, pituitary adenoma, is a non-uncommon disease process encountered in neurosurgery. These tumors are almost always benign (non-cancerous), but may cause headaches, hormonal dysfunction, and sometimes visual impairment. In select cases, surgical treatment is appropriate. Sometimes, non-operative treatment with medication or MRI imaging over time is more appropriate. Dr. Woodall and the team at Georgia Neurological Surgery have the skill and expertise to manage your pituitary tumor.
Causes and Symptoms of Pituitary Tumors
The cause of pituitary tumors is unknown, though certain rare inherited genetic conditions can increase the risk of developing one. You usually won’t know you have one unless it’s large enough to present symptoms, or if it’s found during an MRI or CT scan of the brain for another condition. Overall symptoms can include headaches and visual changes.
The most common kinds of pituitary tumors include:
- Hormone-secreting pituitary tumors that can cause disorders related to the hormone involved. These include:
- Cushing’s disease, due to the production of too much of the hormone cortisol, causing changes to your appearance such as rapid weight gain, purple stretch marks on the chest, and other skin changes, along with other internal complications including high blood pressure, loss of muscle mass, fractures caused by osteoporosis (bone loss), and type 2 diabetes.
- Gigantism, due to excessive growth hormone during childhood or young adulthood, with symptoms related to having a large body stature and enhanced facial features, along with a delay in puberty. In adults, the condition is called acromegaly. Because growth hormone stimulates the growth of muscles, bones, and some internal organs, excessive production can cause weakness, vision problems, and heart failure.
- Prolactinoma, which may lead to inappropriate lactation—in addition to vision and fertility issues—due to the overproduction of the hormone prolactin.
- Nonfunctioning pituitary adenomas, which can cause a hormone deficiency, called hypopituitarism. The symptoms and conditions related to hypopituitarism depend on the deficient hormone, and can include a reduction of sex hormones. This means men can become impotent and women may become infertile. It can also reduce levels of cortisol, known as the “fight or flight” hormone, causing weakness, fatigue, and low blood pressure.
Treatment of Pituitary Tumors with Endoscopic Surgery
Endoscopic surgery, or an endoscopic endonasal approach (EEA), is a surgical procedure to remove all kinds of pituitary tumors. “Endo” means “within,” so the procedure accesses the pituitary gland through the nose and sinuses using an endoscope, a thin, rigid tube with a light and tiny camera designed to show high-quality images in real-time.
The use of the endoscope affords the surgeon a wide view with excellent illumination and visualization of the tumor when compared to traditional microscopic approaches to the pituitary gland. A skin incision is not necessary, which improves the cosmetic outcome of the surgery. The wide view provided by the endoscope simplifies operations which previously would have seemed more challenging using older technology/techniques.
Surgical time depends largely on your anatomy and the size and consistency of your tumor. You will likely spend at least two to three days in the hospital to ensure you’re on the road to recovery. Patients often complain of pressure-type headaches following surgery that get better over time. Monitoring in the hospital is directed at monitoring for endocrine abnormalities (such as high or low sodium levels), and monitoring for cerebrospinal fluid leak. Generally, the procedure is well-tolerated
Contact M. Neil Woodall, MD, Today
If you have a pituitary tumor and are interested in surgical treatment, Dr. Woodall has the skill, care, and experience to ensure you receive the treatment you need—without leaving the Athens area. Contact our office today.