Diagnosis and Treatment of Pituitary Tumors

Request an Appointment

Please call 617-732-6679 or submit a request through our secure online form.

A pituitary tumor is an abnormal growth in the pituitary gland. Most are benign. Because these tumors typically grow slowly, they are often detected during an imaging test for another condition.

If you experience symptoms of a pituitary tumor, your physician will conduct a series of diagnostic tests. They’ll then decide if treatment for a pituitary gland tumor is needed.

At the Pituitary Center at Brigham and Women’s Hospital, our experienced neurosurgeons care for hundreds of patients with pituitary tumors each year. We take a multidisciplinary, patient-focused approach, working closely with you and your family to create a treatment plan tailored to your specific needs. Our team offers advanced, comprehensive care using the latest surgical techniques and treatment options.

How to diagnose pituitary tumors

Diagnosing a pituitary tumor involves various tests, starting with your family and medical history and a thorough physical exam. Because pituitary gland tumors often disrupt hormone balances, your care team will focus primarily on testing hormone levels.

Family and medical history: Pituitary tumors can be hereditary. Specific disorders like Carney complex and multiple endocrine neoplasia type 1 can be passed down through generations, increasing your risk of developing a pituitary tumor. Your physician will review your family history for potential conditions related to pituitary tumors. They’ll also consider any other medical conditions and medications you take.
Physical exam: Besides reviewing your medical history, your physician will perform a complete physical. They’ll specifically look for hormonal irregularities and indications of neurological issues involving reflexes, coordination, balance, and mobility.
Vision testing: Because eye issues like double vision, loss of peripheral sight, and drooping eyelids are indications of a pituitary tumor, your physician will order a series of eye exams. A visual field test can help determine if there are issues with your peripheral vision. Studies indicate that around 46% of people tested for pituitary tumors exhibited visual field problems.
Blood tests: Hormone imbalances are typical with pituitary tumors. Blood work can detect low or high hormone levels in your body. Your physician will look for excessive levels of hormones such as cortisol, prolactin, TSH (thyroid-stimulating hormone), and gonadotropins.
Urine test: A urine test can detect high levels of ACTH (adrenocorticotropic hormone), which stimulates the stress hormone cortisol. Too much ACTH can lead to Cushing disease. This disorder causes various complications, such as rapid weight gain, headaches, vision problems, and rounding of the face.
Magnetic resonance imaging scan (MRI): An MRI uses magnets and radio waves with a contrast dye to provide clear, precise images of your brain and spinal cord. An MRI can detect the compression of structures surrounding the brain, a potential sign of a pituitary tumor. MRIs are the preferred imaging method because they can identify small tumors that other tests cannot. They also let your neurologist determine the size and location of the tumor.
Computed tomography (CT) scan: Another imaging exam that offers detailed views of the brain, spinal cord, and surrounding structures is a CT scan. Although it’s not as in-depth as an MRI, a CT scan of the pituitary gland can provide additional information if you require surgery for a pituitary tumor.

Pituitary adenoma treatment

Since about 99% of pituitary tumors are noncancerous, many don’t require treatment. If treatment is needed, your physician will discuss your options based on the size, location, and type of tumor.

Watch and wait

If your pituitary tumor isn’t causing any symptoms, your physician may monitor the situation to determine if further steps are necessary. A “watch-and-wait” approach can avoid possible side effects from medication, radiation therapy, or surgery.

Pituitary tumor surgery

There are two primary pituitary tumor surgery methods. Your surgeon will determine the best route based on factors like the type of tumor, its size and location, and your overall health.

Transsphenoidal surgery: This type of pituitary tumor surgery is the most common method. In a transsphenoidal procedure , pituitary tumor removal typically involves entering the nasal passages. The surgeon uses an endoscope to view the tumor and all surrounding structures. They can then safely remove the tumor without affecting other areas.
Craniotomy: Your surgeon may decide a craniotomy is the best option for pituitary tumor removal if it’s larger or complicated. In this procedure, the surgeon removes a small part of the skull to locate the tumor. They then cut through the thin layer of tissue covering your brain, using precision microscopic tools to remove the tumor without damaging surrounding structures and nerves.

Radiation therapy

If your surgeon can’t remove the entire pituitary tumor through surgery or you’re unable to have surgery, your surgical team may treat the tumor using radiation therapy. Standard radiation procedures include:

External beam radiation: Smaller doses of radiation are delivered daily over about four to six weeks.
Stereotactic radiosurgery: This method administers a powerful, high radiation dose in one session.
Proton beam therapy: This procedure directs radioactive protons at the tumor, minimizing damage to the surrounding tissue.
Intensity modulated radiation therapy (IMRT): IMRT is a precise external beam radiation therapy that uses a computer to surround the tumor from various angles.

Drug therapy

If surgery or radiation therapy aren’t options, specific drugs for pituitary tumors may help stop them from growing. Common pituitary tumor medications treat the following conditions:

Overabundance of prolactin: If you have a tumor that’s creating too much prolactin, the hormone that controls lactation, certain medications called dopamine agonists can help stop your body from producing excessive prolactin and shrink the tumor.
Excess of growth hormones: When the body produces too many growth hormones, it can lead to a disorder in adults called acromegaly. This condition causes abnormal growth of bones, usually in the face, hands, and feet. In children, an excess of growth hormones can result in gigantism, causing excessive height. Surgery is often the first course of action in these cases. However, medications such as somatostatin analogs can help reduce the secretion of growth hormones if surgery can’t be performed or the tumor isn’t entirely removed.
Too much cortisol: When your body produces an excess of the adrenocorticotropic hormone (ACTH), the stress hormone cortisol gets released. That can lead to a serious condition called Cushing syndrome, which is marked by weight gain, thinning of the skin, and muscle weakness.

What to expect after pituitary tumor surgery

Your length of stay in the hospital after pituitary gland tumor surgery depends on the type of procedure. If you have transsphenoidal surgery, you’ll typically go home within one to three days. However, your stay may be longer if you have a more complicated procedure like a craniotomy.

FAQs about pituitary tumors

Can bloodwork detect pituitary tumors?

It can help. Blood tests can indicate a variety of hormonal imbalances associated with pituitary tumors.

Can the pituitary gland be removed?

The pituitary gland can be surgically removed if a tumor puts pressure on structures and nerves near your brain. Surgery to remove a pituitary tumor typically doesn’t have complications. However, because the pituitary gland produces hormones that regulate metabolism, growth, and reproduction, you must take hormone replacement medication to regulate your body.

What size pituitary tumor should be removed?

Most pituitary tumors are benign and called pituitary adenomas. The majority of these are microadenomas, which are smaller than one centimeter. These tumors often go undetected for years and don’t produce symptoms. If you begin to experience symptoms or if the tumor grows, surgery may be necessary.

Is there a cure for pituitary tumors?

Prolactinomas can often be cured with medication alone. For other types, surgical removal of the entire tumor may be considered a cure. However, there is still a chance the tumor could grow back over time, so ongoing monitoring is important.

Schedule an appointment

The Pituitary Center brings together a team of neurosurgeons, endocrinologists, otolaryngologists, neuro-ophthalmologists, and other specialists, including world leaders in the treatment of pituitary tumors. In addition to their surgical expertise, our neurosurgeons are known for their clear communication, compassion, and the time and personal attention they give each patient.