Guzy przysadki mózgowej
Objawy
Guzy przysadki mózgowej, w tym mikro- i makrogruczolaki (>10 mm), mogą powodować objawy wynikające z ucisku na struktury mózgu (np. bóle głowy, zaburzenia widzenia typu ślepota połowicza dwuskroniowa) oraz zaburzenia hormonalne. Niedobory hormonów przysadkowych (LH, FSH, TSH, ACTH, GH, ADH) manifestują się m.in. zmęczeniem, zaburzeniami cyklu miesiączkowego, hipogonadyzmem, niedoczynnością tarczycy, niskim ciśnieniem krwi czy moczówką prostą. Guzy czynne hormonalnie, takie jak prolaktynoma (40% przypadków), somatotropinoma (akromegalia u dorosłych, gigantyzm u dzieci), guzy wydzielające ACTH (zespół Cushinga) oraz rzadkie guzy TSH, powodują charakterystyczne zespoły kliniczne związane z nadprodukcją odpowiednich hormonów. Apopleksja przysadki to nagłe, zagrażające życiu powikłanie wymagające pilnej interwencji.
Objawy guzów przysadki mózgowej
Guzy przysadki mózgowej to nietypowe zmiany rozwijające się w przysadce mózgowej. Mogą one powodować nadmierną produkcję określonych hormonów kontrolujących ważne funkcje organizmu lub prowadzić do zmniejszenia ich wydzielania. Nie wszystkie guzy przysadki powodują objawy – niektóre są wykrywane przypadkowo podczas badań obrazowych, takich jak rezonans magnetyczny (MRI) czy tomografia komputerowa (CT), wykonywanych z innych powodów. Jeśli nie powodują objawów, często nie wymagają leczenia1.
Mechanizmy powstawania objawów
Objawy guzów przysadki mózgowej mogą być powodowane przez kilka czynników. Pierwszy z nich to ucisk guza na przysadkę, nerwy lub inne okoliczne struktury mózgu. Drugim czynnikiem jest zaburzenie równowagi hormonalnej. Poziomy hormonów mogą wzrastać, gdy guz przysadki produkuje zbyt dużo jednego lub więcej hormonów. Z kolei gdy duży guz zakłóca prawidłowe funkcjonowanie przysadki, poziomy hormonów mogą spadać12.
Generalnie objawy guzów przysadki mózgowej mogą wystąpić w trzech przypadkach34:
- Gdy guz wywiera ucisk na okoliczne struktury mózgu
- Gdy guz zaburza funkcję wydzielniczą przysadki, powodując niedobór hormonów
- Gdy guz jest czynny hormonalnie i nadmiernie produkuje określone hormony
Objawy związane z uciskiem guza
Makrogruczolaki (guzy o średnicy większej niż 10 mm) mogą wywierać nacisk na przysadkę mózgową, nerwy, mózg i inne okoliczne tkanki. To może powodować różnorodne objawy1.
Bóle głowy
Bóle głowy są jednym z najczęstszych objawów guzów przysadki mózgowej. Zazwyczaj są zlokalizowane w okolicy czołowej lub skroniowej i mogą nasilać się rano. Pojawienie się nagłego, bardzo silnego bólu głowy może świadczyć o apopleksji przysadki, czyli krwotoku do guza przysadki56. Bóle te mogą występować niezależnie od wielkości guza, ale są częstsze przy większych zmianach7.
Zaburzenia widzenia
Zaburzenia widzenia są powszechnym objawem makrogruczolaków przysadki, które uciskają nerw wzrokowy lub skrzyżowanie nerwów wzrokowych (chiazma optyczna). Do najczęstszych problemów należą85:
- Utrata widzenia obwodowego (pola widzenia)
- Nieostre lub podwójne widzenie
- Postępująca ślepota
- Opadanie powieki
- Ślepota połowicza dwuskroniowa (utrata widzenia w zewnętrznych polach widzenia obu oczu)
Inne objawy związane z uciskiem
Oprócz bólów głowy i zaburzeń widzenia, guzy przysadki mózgowej wywierające ucisk na okoliczne struktury mogą powodować810:
- Drętwienie lub ból twarzy
- Zawroty głowy
- Utratę przytomności
- Nudności i wymioty
- Wyciek płynu mózgowo-rdzeniowego z nosa
- Drgawki
- Zaburzenia węchu
Objawy niedoboru hormonów przysadkowych
Makrogruczolaki mogą ograniczać zdolność przysadki do produkcji hormonów. Gdy tak się dzieje, mogą pojawić się objawy niedoboru hormonów przysadkowych, czyli hypopituitaryzmu18.
Objawy ogólne niedoboru hormonów
Niedobór hormonów przysadkowych może powodować szereg ogólnych objawów813:
- Zmęczenie lub osłabienie
- Brak energii
- Niezamierzona utrata lub przyrost masy ciała
- Uczucie zimna
- Nudności
- Zaparcia
- Bóle stawów
- Niskie ciśnienie krwi
Objawy niedoboru hormonów płciowych
Niedobór gonadotropin (LH i FSH) prowadzi do niedoboru hormonów płciowych (testosteronu u mężczyzn i estrogenów u kobiet), co może powodować113:
- U kobiet:
- Zmiany w cyklu miesiączkowym lub brak miesiączki
- Brak wydzielania mleka z piersi
- Suchość pochwy
- Problemy z płodnością
- U mężczyzn:
- Problemy z erekcją (zaburzenia erekcji)
- Zmniejszenie owłosienia twarzy i ciała
- Rozrost tkanki piersiowej (ginekomastia)
- Bezpłodność
- U obu płci:
- Zmniejszenie popędu seksualnego
- Uderzenia gorąca
- Wahania nastroju
- Zmęczenie
Objawy niedoboru innych hormonów
Niedobór innych hormonów przysadkowych również może powodować charakterystyczne objawy1318:
- Niedobór TSH:
- Zmęczenie
- Zaparcia
- Zwolniona czynność serca
- Sucha skóra
- Obrzęk kończyn
- Osłabione odruchy
- Niedobór ACTH:
- Niskie ciśnienie krwi
- Nudności, wymioty
- Bóle brzucha
- Słaby apetyt
- Niedobór hormonu wzrostu (GH):
- U dorosłych: zmęczenie i zmniejszenie masy mięśniowej
- U dzieci: spowolniony wzrost
- Niedobór wazopresyny (ADH):
- Częste oddawanie moczu
- Nadmierne pragnienie
- Moczówka prosta
Objawy nadmiaru hormonów przysadkowych
Guzy czynne hormonalnie (wydzielające) zazwyczaj produkują nadmiar jednego hormonu. To naraża organizm na wysokie poziomy tego hormonu, co prowadzi do różnych objawów w zależności od rodzaju hormonu1.
Objawy nadmiaru prolaktyny
Guzy wydzielające prolaktynę (prolaktynoma) stanowią około 40% wszystkich guzów przysadki mózgowej. Objawy nadmiaru prolaktyny różnią się u kobiet i mężczyzn1920:
- U kobiet:
- Nieregularne lub brak miesiączki
- Wydzielanie mleka z piersi u kobiet niebędących w ciąży ani niekarmiących (mlekotok)
- Suchość pochwy
- Bezpłodność
- U mężczyzn:
- Zaburzenia erekcji
- Zmniejszenie popędu seksualnego
- Bezpłodność
- Ginekomastia (rzadko)
Guzy te mogą również rosnąć na tyle duże, że uciskają nerwy wzrokowe i struktury mózgu, powodując bóle głowy i problemy ze wzrokiem19.
Objawy nadmiaru hormonu wzrostu
Guzy wydzielające hormon wzrostu (somatotropowe) mogą powodować różne objawy w zależności od wieku pacjenta2223:
- U dzieci:
- Bardzo szybki wzrost
- Abnormalnie wysoki wzrost (gigantyzm)
- Zwiększone pocenie się
- Bóle stawów
- U dorosłych (akromegalia):
- Powiększenie dłoni i stóp
- Zmiany w wyglądzie twarzy (z powodu wzrostu kości twarzy)
- Powiększenie żuchwy i wysunięcie jej do przodu
- Szersze rozstawienie zębów
- Pogłębienie głosu
- Pogrubienie języka i podniebienia, prowadzące do chrapania i bezdechu sennego
- Pogrubienie skóry
- Zwiększony wzrost owłosienia na ciele
- Drętwienie lub mrowienie w dłoniach lub stopach
- Zespół cieśni nadgarstka
- Bóle stawów
- Zwiększone pocenie się
- Wysoki poziom cukru we krwi lub cukrzyca
- Nadciśnienie tętnicze
- Choroby serca
Objawy nadmiaru ACTH
Guzy wydzielające ACTH powodują nadmierną produkcję kortyzolu przez nadnercza, co prowadzi do zespołu Cushinga. Objawy tego zespołu obejmują119:
- Przyrost masy ciała, szczególnie w okolicy brzucha, klatki piersiowej i twarzy, przy jednoczesnym ścieńczeniu ramion i nóg
- Okrągła, zaczerwieniona twarz (tzw. „twarz księżycowata”)
- Fioletowe rozstępy na brzuchu i klatce piersiowej
- Garbek tłuszczowy na karku (tzw. „byczy kark”)
- Cienka skóra, która łatwo sinieje
- Zwiększony wzrost owłosienia na twarzy i ciele (u kobiet)
- Trądzik
- Wolniejsze gojenie się ran, ukąszeń owadów i infekcji
- Obszary ciemniejszej skóry
- Wysokie ciśnienie krwi
- Wysoki poziom cukru we krwi lub cukrzyca
- Zmiany w cyklach miesiączkowych
- Problemy seksualne, w tym problemy z erekcją i zmniejszenie zainteresowania seksem
- Osłabienie mięśni
- Zmiany nastroju lub depresja
- Łatwe siniaczenie
- Osteoporoza (osłabienie kości)
Objawy nadmiaru TSH
Guzy wydzielające hormon tyreotropowy (TSH) są rzadkie. Powodują one nadmierną produkcję hormonów tarczycy, co prowadzi do nadczynności tarczycy. Objawy mogą obejmować125:
- Utratę wagi
- Szybkie lub nieregularne bicie serca (kołatanie serca)
- Drżenie (trzęsienie się)
- Nerwowość, niepokój
- Trudności z zasypianiem
- Zwiększony apetyt
- Uczucie ciepła lub gorąca
- Nadmierne pocenie się
- Częste wypróżnianie
- Guzek na przedniej części szyi (z powodu powiększonej tarczycy)
Poprzez ucisk na resztę przysadki, guzy te mogą również czasami prowadzić do obniżenia poziomu hormonów płciowych, takich jak estrogen, progesteron i testosteron, co może powodować nieregularne miesiączki u kobiet lub zaburzenia erekcji i zmniejszenie zainteresowania seksem u mężczyzn25.
Objawy nadmiaru gonadotropin
Guzy wydzielające gonadotropiny zwykle nie produkują wystarczającej ilości hormonów, aby powodować objawy. Jednak niektóre z nich mogą powodować26:
- Nieregularne miesiączki
- Bezpłodność
- U mężczyzn, zmniejszenie zainteresowania seksem
Apopleksja przysadki
Apopleksja przysadki to rzadkie, ale poważne powikłanie guza przysadki mózgowej, polegające na krwotoku do guza przysadki. Jest to stan nagły, który może prowadzić do nagłego rozwoju objawów2218.
Objawy apopleksji przysadki
Objawy apopleksji przysadki obejmują2728:
- Nagły, silny ból głowy
- Utrata widzenia obwodowego lub całkowita utrata wzroku w jednym lub obu oczach
- Porażenie mięśni oka
- Niskie ciśnienie krwi, nudności i wymioty
- Zmiany osobowości
Apopleksja przysadki wymaga natychmiastowego leczenia, zwykle kortykosteroidami, a często również operacji. Może również prowadzić do ciężkiej niewydolności przysadki, której objawy mogą pojawić się w ciągu dni lub tygodni3031.
Progresja guzów przysadki mózgowej
Guzy przysadki mózgowej zazwyczaj rosną powoli w ciągu wielu lat. Wiele osób żyje z guzami przysadki przez lata, zanim zostaną one wykryte. Objawy często rozwijają się powoli i mogą przypominać inne problemy zdrowotne10.
Czynniki wpływające na progresję
Progresja guzów przysadki mózgowej zależy od kilku czynników3233:
- Rodzaj guza (czynny hormonalnie czy nieczynny)
- Wielkość guza (mikrogruczolak czy makrogruczolak)
- Lokalizacja guza w przysadce
- Szybkość wzrostu guza
Mikrogruczolaki (guzy o średnicy mniejszej niż 10 mm) zazwyczaj rosną wolniej i rzadziej powodują objawy związane z uciskiem. Makrogruczolaki (guzy o średnicy większej niż 10 mm) częściej powodują objawy związane z uciskiem i mogą szybciej rosnąć3410.
Potencjalne powikłania nieleczonych guzów
Nieleczone guzy przysadki mózgowej mogą prowadzić do różnych powikłań3536:
- Trwałe uszkodzenie nerwu wzrokowego, które może prowadzić do ślepoty
- Trwałe zaburzenia hormonalne, w zależności od rodzaju guza czynnego hormonalnie
- Zwiększone ryzyko rozwoju chorób serca, cukrzycy i nadciśnienia tętniczego
- Apopleksja przysadki
- Panhipopituitaryzm (niewydolność wszystkich funkcji przysadki)
Powikłania zależą głównie od rodzaju guza i jego wpływu na produkcję hormonów. Guzy czynne hormonalnie, które wydzielają nadmiar hormonów, mogą powodować poważniejsze powikłania niż guzy nieczynne hormonalnie38.
Różnice w objawach u dzieci i dorosłych
Objawy guzów przysadki mózgowej mogą się różnić między dziećmi a dorosłymi, szczególnie w przypadku guzów wydzielających hormon wzrostu14.
Objawy u dzieci
U dzieci, guzy przysadki wydzielające hormon wzrostu mogą powodować1439:
- Szybki wzrost
- Bóle stawów
- Nadmierne pocenie się
- Abnormalnie wysoki wzrost (gigantyzm)
Inne objawy guzów przysadki u dzieci mogą obejmować3940:
- Spowolniony wzrost
- Opóźniony rozwój płciowy
- Bóle głowy
- Problemy ze wzrokiem
- Zmęczenie
Objawy u dorosłych
U dorosłych, guzy przysadki wydzielające hormon wzrostu powodują akromegalię zamiast gigantyzmu. W przeciwieństwie do dzieci, u dorosłych kości długie nie mogą już rosnąć, więc nadmiar hormonu wzrostu prowadzi do pogrubienia kości dłoni, stóp i czaszki, a także do innych zmian w wyglądzie2217.
Dorośli częściej doświadczają również objawów związanych z zaburzeniami hormonalnymi, takich jak zmniejszenie popędu seksualnego, zaburzenia miesiączkowania, bezpłodność i zaburzenia erekcji2041.
Diagnoza i monitorowanie objawów
Ze względu na różnorodność objawów, guzy przysadki mózgowej mogą być trudne do zdiagnozowania. Często objawy rozwijają się powoli i mogą być podobne do objawów innych schorzeń32.
Kiedy należy skontaktować się z lekarzem
Należy skontaktować się z lekarzem, jeśli występują następujące objawy4243:
- Nagła zmiana neurologiczna, taka jak utrata wzroku, silne bóle głowy lub utrata energii
- Zaburzenia widzenia, szczególnie utrata widzenia obwodowego
- Uporczywe bóle głowy
- Niewyjaśnione zmiany w cyklu miesiączkowym u kobiet
- Wydzielanie mleka z piersi u kobiet niebędących w ciąży ani niekarmiących
- Zaburzenia erekcji u mężczyzn
- Niewyjaśniony przyrost lub utrata masy ciała
- Nadmierne pragnienie i częste oddawanie moczu
Metody diagnostyczne
Do diagnozowania guzów przysadki mózgowej wykorzystuje się różne metody3244:
- Badania obrazowe:
- Rezonans magnetyczny (MRI)
- Tomografia komputerowa (CT)
- Badania laboratoryjne:
- Badania poziomu hormonów we krwi
- Pobieranie krwi z zatok skalistych (w przypadku guzów wydzielających ACTH)
- Badania okulistyczne:
- Badanie pola widzenia
- Badanie dna oka
Rozmiar guza ma znaczenie dla diagnozy. Guzy większe niż 1 centymetr nazywane są makrogruczolakami i częściej powodują objawy, takie jak bóle głowy, problemy ze wzrokiem i spadek poziomu hormonów. Małe guzy o średnicy mniejszej niż 1 centymetr nazywane są mikrogruczolakami i rzadziej uciskają normalną tkankę przysadki lub mózgu, ale nadal mogą produkować nadmiar hormonów przysadkowych4434.
Opcje leczenia i rokowanie
Leczenie guzów przysadki mózgowej zależy od rodzaju guza, jego wielkości, lokalizacji oraz objawów, które powoduje45.
Metody leczenia
Do głównych metod leczenia guzów przysadki mózgowej należą4542:
- Chirurgiczne usunięcie guza:
- Zalecane, gdy guz uciska nerwy wzrokowe i ogranicza widzenie
- Gdy guz powoduje inne objawy, takie jak ból głowy lub ból twarzy
- Gdy guz obniża poziom hormonów z powodu nacisku na przysadkę
- Gdy guz powoduje nadmierną produkcję hormonów
- Farmakoterapia:
- Może obniżyć ilość hormonów produkowanych przez organizm z powodu guza
- Niektóre leki mogą zmniejszyć rozmiar pewnych typów guzów przysadki
- Radioterapia:
- Pomocna, gdy guz nie został całkowicie usunięty podczas operacji
- Gdy guz powraca po operacji
- Gdy objawy nie ustępują po leczeniu farmakologicznym
Rokowanie
Rokowanie dla pacjentów z guzami przysadki mózgowej jest zazwyczaj dobre3847:
- Prawie wszystkie guzy przysadki są łagodne (niezłośliwe)
- Dla większości osób leczenie pozwala kontrolować lub usunąć guz, dając normalną długość życia
- Jednak pacjenci mogą musieć radzić sobie z konsekwencjami, takimi jak problemy ze wzrokiem lub zaburzenia hormonalne
- Guzy czynne hormonalnie, takie jak choroba Cushinga i akromegalia, wiążą się z różnymi współistniejącymi chorobami i powikłaniami
- Istnieje zwiększona śmiertelność, szczególnie u pacjentów z chorobą Cushinga, przy opóźnieniu leczenia medycznego lub chirurgicznego
Po zakończeniu leczenia pacjenci zazwyczaj przechodzą regularne kontrole w poradni endokrynologicznej. Mogą one trwać przez wiele lat. Podczas wizyt kontrolnych wykonywane są badania krwi w celu monitorowania poziomów hormonów. Pacjenci mogą również mieć dalsze badania obrazowe i badania wzroku46.
Podsumowanie
Guzy przysadki mózgowej powodują różnorodne objawy, które można podzielić na trzy główne kategorie: objawy związane z uciskiem guza, objawy niedoboru hormonów przysadkowych oraz objawy nadmiaru hormonów wydzielanych przez guz. Objawy te mogą rozwijać się powoli i często przypominają objawy innych schorzeń, co może utrudniać diagnozę18.
Ważne jest, aby być świadomym objawów, które mogą wskazywać na guz przysadki mózgowej, takich jak zaburzenia widzenia, uporczywe bóle głowy, niewyjaśnione zmiany w cyklu miesiączkowym, wydzielanie mleka z piersi, zaburzenia erekcji czy niewyjaśniony przyrost lub utrata masy ciała. Wczesne rozpoznanie i leczenie może zapobiec poważnym powikłaniom i poprawić rokowanie4350.
Nowoczesne metody diagnostyczne i terapeutyczne, takie jak dokładne badania obrazowe, analizy hormonalne, zabiegi chirurgiczne, farmakoterapia oraz radioterapia, umożliwiają skuteczne leczenie większości guzów przysadki mózgowej. Dla wielu pacjentów oznacza to możliwość prowadzenia normalnego życia, choć mogą oni wymagać długotrwałej opieki medycznej i monitorowania stanu zdrowia4546.
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Materiały źródłowe
- #1 Pituitary tumors – Symptoms and causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/pituitary-tumors/symptoms-causes/syc-20350548
Pituitary tumors are unusual growths that develop in the pituitary gland. Some of these tumors cause the pituitary gland to make too much of certain hormones that control important body functions. Others can cause the pituitary gland to make too little of those hormones. […] Not all pituitary tumors cause symptoms. Sometimes these tumors are found during an imaging test, such as an MRI or a CT scan, that is done for another reason. If they don’t cause symptoms, pituitary tumors usually don’t need treatment. […] Pituitary tumor symptoms may be caused by a tumor putting pressure on the brain or on other parts of the body nearby. Symptoms also can be caused by a hormone imbalance. Hormone levels can rise when a pituitary tumor makes too much of one or more hormones. Or a large tumor that disrupts the way the pituitary gland works may cause hormone levels to fall.
- #1 Pituitary tumors – Symptoms and causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/pituitary-tumors/symptoms-causes/syc-20350548
Macroadenomas can put pressure on the pituitary gland, on nerves, on the brain and on other parts of the body nearby. That can cause symptoms such as headache, eye problems due to pressure on the optic nerve, especially loss of side vision, also called peripheral vision, and double vision, pain in the face, sometimes including sinus pain or ear pain, drooping eyelid, seizures, nausea and vomiting. […] Macroadenomas can limit the pituitary gland’s ability to make hormones. When that happens, symptoms may include tiredness or weakness, lack of energy, sexual problems, such as problems with erections and less interest in sex, changes in menstrual cycles, nausea, feeling cold, losing or gaining weight without trying. […] Functioning pituitary adenomas typically make a large amount of one hormone. That exposes the body to high levels of that hormone.
- #1 Pituitary tumors – Symptoms and causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/pituitary-tumors/symptoms-causes/syc-20350548
Cushing disease symptoms include weight gain and fatty tissue deposits around the midsection and upper back, rounded face, stretch marks, thin skin that bruises easily, thinning of the arms and legs with muscle weakness, thicker or more visible body hair, slow healing of cuts, insect bites and infections, areas of darkened skin, acne, changes in menstrual cycles, sexual problems, including problems with erections and less interest in sex. […] Symptoms of acromegaly include an enlarged face and hands. Changes to the face may cause the brow bone and lower jaw to jut out, and the nose and lips to get larger. […] Pituitary tumors that make thyroid-stimulating hormone cause the thyroid gland to make too much of the hormone thyroxine, also called T-4. That leads to a condition called hyperthyroidism, also known as overactive thyroid disease. Hyperthyroidism can speed up the body’s metabolism causing many symptoms. Some of the most common include weight loss, rapid or irregular heartbeat, nervousness, anxiety or irritability, frequent bowel movements, sweating, tremor, sleep problems.
- #2 Symptoms of pituitary gland tumours | Canadian Cancer Societyhttps://cancer.ca/en/cancer-information/cancer-types/pituitary-gland-tumours/signs-and-symptoms
Signs and symptoms of pituitary gland tumours often appear as the tumour grows and when it makes too many hormones. Other health conditions can cause the same symptoms as pituitary gland tumours. […] The signs or symptoms of pituitary gland tumours may vary depending on: if the tumour is pressing on nearby areas, such as nerves or parts of the brain; if the tumour is pressing on parts of the pituitary gland or damaging the tissue of the pituitary gland; if the tumour is making too many hormones (functioning) or not (non-functioning); which hormones are being made in large amounts. […] As a pituitary gland tumour grows, it can press on nearby areas and cause symptoms. A tumour can also affect how well the pituitary gland works and cause lower levels of hormones than normal. The signs or symptoms of pituitary gland tumours may include: vision problems, such as blurred vision or loss of side vision (peripheral vision); headache; dizziness; numbness or pain in the face; sleep problems; fatigue; weakness; nausea; extreme thirst and urinating often (called diabetes insipidus).
- #3 Symptoms of a Pituitary Tumor | Neurological Surgeryhttps://neurosurgery.weillcornell.org/condition/pituitary-tumors/symptoms-pituitary-tumor
Many pituitary tumors never cause any symptoms. When they do, the symptoms can be attributed to three different causes: […] A tumor that grows large enough to press against adjacent brain structures may cause: […] When the tumor disrupts the pituitary’s ability to produce hormones, symptoms may include: […] When a functioning tumor produces hormones, the extra hormones can cause symptoms based on which hormone is being produced in excess: […] Since the symptoms of a pituitary tumor can easily be confused with those of other conditions, an accurate diagnosis is important. Many people with pituitary tumors have them for years because the symptoms come on so slowly that they don’t recognize them in others, a severe and sudden headache are the first signs of a tumor.
- #4 Diagnosing Pituitary Tumors | NYU Langone Healthhttps://nyulangone.org/conditions/pituitary-tumors/diagnosis
Functional pituitary tumors, or adenomas, produce excess levels of hormones, causing a person to develop certain hormonal conditions. They can lead to a variety of symptoms, depending on which hormones are affected. A premenopausal woman who has not given birth may produce breast milk or have irregular or absent menstrual periods, and a man might have sexual problems. People may experience increased growth of soft tissues and bones, high blood pressure, weight gain, and fat deposits on the face, upper back, shoulders, and midsection. […] Nonfunctional pituitary tumors dont cause hormone levels to rise. However, both functional and nonfunctional tumors can grow large enough to cause headaches and vision problems. Large tumors may also press on the pituitary gland and interfere with its ability to secrete hormones, causing hormone levels to drop. Symptoms can include low blood pressure, low blood sugar, fatigue, fertility problems, and decreased sex drive.
- #5 Pituitary Adenomas: Types, Symptoms, and Treatment | PNIhttps://www.pacificneuroscienceinstitute.org/pituitary-disorders/conditions/pituitary-adenomas/
Larger pituitary macroadenomas often cause loss of visual acuity or peripheral vision (termed bitemporal hemianopsia) from pressure on the optic nerves and optic chiasm which is directly above the pituitary gland. Larger macroadenomas especially those that have hemorrhaged (apoplexy) may also cause double vision. […] Patients with macroadenomas often have frontal, forehead and temporal area headaches. Pituitary adenoma removal often results in headache resolution. […] Most of these tumors remain small and do not cause significant harm or symptoms; however many do progress and grow to cause hormonal and neurological problems. […] This problem typically occurs only in larger tumors (macroadenomas) and results from compression and damage to the normal pituitary gland from the enlarging adenoma.
- #6 Pituitary Tumours: Causes, Symptoms, Treatment | Doctorhttps://patient.info/doctor/pituitary-tumours
Pituitary tumour symptoms depend on the hormone secreted by the tumour as well as the pattern of growth of the tumour within the sella turcica. […] Local effects resulting from an expanding pituitary mass may give rise to headache, neuro-ophthalmological defects or facial pain according to the size and direction of expansion: […] Headaches are classically retro-orbital or bitemporal. They tend to be worse on waking. Sudden catastrophic headaches may result from pituitary apoplexy. Very large pituitary tumours may cause obstruction of CSF, resulting in hydrocephalus and expansion of the lateral ventricles. […] Visual field defects are common but often asymptomatic. Bitemporal hemianopia is the classic abnormality but any unilateral or bilateral visual field defect may occur. […] Anterior pituitary hormonal deficiency: Panhypopituitarism or varying degrees of loss of any of the six hormones may occur.
- #7 Pituitary Tumor – Brigham and Women’s Hospitalhttps://www.brighamandwomens.org/surgery/otolaryngology/nose-and-sinus/pituitary-tumors
Pituitary tumors are common, but most are benign (noncancerous) and are almost never fatal. […] However, because the pituitary gland is located at the base of the skull, many pituitary tumors press against the optic nerves and thus cause vision problems. […] Common symptoms of a pituitary tumor include: Blurred vision, Persistent headaches, Loss of peripheral vision, Sudden loss of sight, Numbness or pain in the face, Weakness, Nausea, Unwanted weight gain or loss, Loss of menstrual periods, Impotence, Loss of interest in sex, Problems caused by the production of too many hormones. […] Each individual experiences symptoms differently, and symptoms can be similar to those of other conditions or medical problems.
- #8 Signs & Symptoms of Pituitary Tumors | American Cancer Societyhttps://www.cancer.org/cancer/types/pituitary-tumors/detection-diagnosis-staging/signs-and-symptoms.html
Not all pituitary tumors (pituitary adenomas) cause symptoms. But when they do, they can cause symptoms in these ways: […] Some tumors cause symptoms when they make too much of one or more pituitary hormones. These are called functional (or functioning) pituitary adenomas, and the symptoms they cause depend on which hormone(s) they make. These tumors tend to cause symptoms while they are still small. […] Tumors that grow large enough can press on or grow into nearby parts of the brain, nerves involved with vision, or other important structures. This can lead to symptoms such as: Trouble with eye movement, which can lead to blurred or double vision, Visual field defects (especially loss of peripheral vision), Progressive blindness, Headaches, Facial numbness or pain, Dizziness, Loss of consciousness (passing out).
- #8 Signs & Symptoms of Pituitary Tumors | American Cancer Societyhttps://www.cancer.org/cancer/types/pituitary-tumors/detection-diagnosis-staging/signs-and-symptoms.html
Tumors that grow large enough can also press on and destroy the normal parts of the pituitary gland. This can lead to low levels of one or more pituitary hormones, which can in turn lead to low levels of some body hormones such as cortisol, thyroid hormone, and sex hormones. Depending on which hormones are affected, symptoms might include: Feeling tired or weak, Unexplained weight loss or weight gain, Low blood pressure, Loss of body hair, Feeling cold, Menstrual changes or loss of menstrual periods in women, Erectile dysfunction (trouble with erections) in men, Growth of breast tissue in men, Decreased interest in sex. […] Large tumors can sometimes press on the posterior (back) part of the pituitary, causing a shortage of the hormone vasopressin (also called anti-diuretic hormone or ADH). This can lead to diabetes insipidus.
- #9 Pituitary Tumor | North American Neuro-Ophthalmology Societyhttps://www.nanosweb.org/pituitarytumor/
Pituitary tumors may present with vision changes, headaches, weight gain, menstrual irregularities, lactation, impotence, and change in the bone structure in your face and hands. Other uncommon symptoms like double vision, abnormal eye movements, a large pupil or droopy eyelids may rarely occur. Many pituitary tumors do not cause any symptoms and are found incidentally on MRI. […] Because the optic chiasm sits on top of the pituitary gland, a large pituitary tumor can push on the optic nerves or chiasm and cause vision loss. Your peripheral vision is typically affected, but you may also lose central vision and color vision in one eye (if the optic nerve is compressed). Unfortunately, the vision loss can become permanent and this may limit your ability to drive or do other daily activities.
- #10 8 Top Pituitary Tumor Symptoms & Signs | MD Anderson Cancer Centerhttps://www.mdanderson.org/cancer-types/pituitary-tumors/pituitary-tumor-symptoms.html
Pituitary gland tumors often do not have symptoms in the early stages. When they do have symptoms, they vary from person to person. Many patients live with pituitary tumors for years before the tumors are found. Symptoms often are slow to develop and often are like those of other medical problems. […] If a pituitary tumor grows too large, it may press on normal pituitary gland tissue. This may cause the pituitary gland not to work correctly and decrease levels of pituitary hormones. If the tumor presses against other parts of the body, symptoms may include headaches, double vision and loss of vision due to pressure on the optic nerves. When a pituitary tumor causes other glands to make too much hormone, symptoms depend on the gland(s) involved. […] Pituitary tumor symptoms may include the following:
- #10 8 Top Pituitary Tumor Symptoms & Signs | MD Anderson Cancer Centerhttps://www.mdanderson.org/cancer-types/pituitary-tumors/pituitary-tumor-symptoms.html
Too much ACTH leads to Cushing’s disease. Symptoms of Cushing’s disease may include: Rounded „moon” face, Weight gain, particularly in the trunk and abdomen, Thinning of the skin, Wide purple-red stretch marks, Diabetes, High blood pressure, Muscle weakness, Slowing of growth (in children). […] In children, too much GH causes gigantism (abnormally large growth). In adults, too much GH causes acromegaly. The symptoms of acromegaly are: Hands, feet, jaw and/or forehead gradually grow larger, Coarse facial features, such as thickened skin and enlarged nose or lips, Heart problems, High blood pressure, Excessive sweating. […] Too much TSH may cause: Weight loss, Nervousness, Rapid or irregular heartbeat. […] Too much prolactin causes different symptoms in men and women. […] In women: Milky discharge from the nipples, Irregular or absent menstrual periods, Infertility. […] In men: Erectile dysfunction and/or impotence, Infertility, Loss of body hair, Decreased sex drive, Rarely, increased breast growth (gynecomastia).
- #11 Pituitary Tumors Treatment – NCIhttps://www.cancer.gov/types/pituitary/patient/pituitary-treatment-pdq
A pituitary tumor is a growth of abnormal cells in the tissues of the pituitary gland. […] Signs of a pituitary tumor include problems with vision and certain physical changes. […] Signs and symptoms can be caused by the growth of the tumor and/or by hormones the tumor makes or by other conditions. Some tumors may not cause signs or symptoms. Check with your doctor if you have any of these problems. […] Signs and symptoms of a nonfunctioning pituitary tumor […] The following signs and symptoms may occur: Headache. Some loss of vision. Loss of body hair. In women, less frequent or no menstrual periods or no milk from the breasts. In men, loss of facial hair, growth of breast tissue, and impotence. In women and men, lower sex drive. In children, slowed growth and sexual development. […] Signs and symptoms of a functioning pituitary tumor
- #12 Pituitary Tumors Treatment – NCIhttps://www.cancer.gov/types/pituitary/patient/pituitary-treatment-pdq
When a functioning pituitary tumor makes extra hormones, the signs and symptoms will depend on the type of hormone being made. […] Other general signs and symptoms of pituitary tumors: Nausea and vomiting. Confusion. Dizziness. Seizures. Runny or „drippy” nose (cerebrospinal fluid that surrounds the brain and spinal cord leaks into the nose). […] The prognosis depends on the type of tumor and whether the tumor has spread into other areas of the central nervous system (brain and spinal cord) or outside of the central nervous system to other parts of the body. […] Pituitary tumors can recur (come back) after they have been treated.
- #13 Pituitary Adenomas: Definition, Symptoms & Treatmenthttps://my.clevelandclinic.org/health/diseases/15328-pituitary-adenomas
Pituitary macroadenomas can cause one or more pituitary hormone deficiencies due to damage to your pituitary gland tissue. This can result in an underactive pituitary gland, also known as hypopituitarism. […] Each pituitary hormone deficiency causes different symptoms. […] A deficiency of LH and FSH hormones leads to low testosterone (LH) and estrogen (FSH), a condition known as hypogonadism. Symptoms of hypogonadism include hot flashes and vaginal dryness, erectile dysfunction and decreased facial/body hair growth in men, mood swings, decreased libido/sex drive and fatigue. […] A deficiency of TSH results in low thyroid hormone production, a condition known as hypothyroidism. Symptoms of hypothyroidism include fatigue, constipation, slow heart rate, dry skin, swelling of extremities and diminished reflexes.
- #14 Content – Health Encyclopedia – University of Rochester Medical Centerhttps://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=34&contentid=18823-1
Not all pituitary tumors cause symptoms. But those that do can cause different kinds of symptoms. […] Pituitary tumors that make too many hormones (called functional tumors) cause symptoms linked to the hormone they produce. […] Pituitary tumors that dont make too many hormones (called nonfunctional tumors) can grow large (macroadenomas). They cause symptoms because they press on nearby nerves and other areas. […] Noncancerous and cancerous pituitary tumors may press on the optic nerves or nearby parts of the brain. This can cause these symptoms: Double or blurred vision, Loss of side (peripheral) vision, Sudden loss of sight, Headaches, Dizziness, Numbness or pain in the face, Fainting. […] Pituitary growths may also press on and damage the pituitary gland. This can lead to decreased release of important pituitary hormones. Depending on the hormone levels affected, you may have some of the following symptoms: Upset stomach (nausea and vomiting), Weakness and tiredness, Unwanted weight loss or gain, Feeling cold, Menstrual periods change or stop, Having problems keeping an erection (impotence), Less interest in sex, Breast tissue growth in men, Loss of body hair, Excessive thirst and frequent peeing.
- #14 Content – Health Encyclopedia – University of Rochester Medical Centerhttps://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=34&contentid=18823-1
Functional pituitary tumors cause different symptoms, based on the excess hormone they make. […] Symptoms caused by having too much GH are different in children than in adults. For children, symptoms include: Rapid growth, Pain in joints, Too much sweating, Being abnormally tall (gigantism). […] Over time, adults with tumors that cause high GH levels may have these symptoms: Increase in hat, shoe, or ring size caused by growth of head, hands, or feet, Deeper voice, Change in facial structure, Tongue thickening, Snoring or pauses in breathing while sleeping, Joint pain, Too much sweating, Headaches, Heart disease, High blood sugar levels or diabetes, High blood pressure, Kidney stones, Increased body hair growth. […] Pituitary tumors that make the hormone ACTH cause the adrenal glands to make too many steroid hormones. This is called Cushing disease and may lead to: Weight gain, often in the belly, chest, and face, Purple stretch marks on the belly and chest, A hump of fat on the back of the neck, Abnormal growth of body hair, A round, red, swollen face, Less interest in sex, Weak, brittle bones (osteoporosis), Acne, High blood pressure, High blood sugar levels, Irregular or absent menstrual periods in women, Headaches, Vision changes, Moodiness or depression, Easy bruising, Muscle weakness. […] Many of these symptoms may be caused by other health problems. It’s important to see a healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have a pituitary tumor or pituitary cancer.
- #15 Pituitary Tumors/Adenomas: Symptoms, Causes, & Treatments | University of Utah Health | University of Utah Healthhttps://healthcare.utah.edu/skull-base-tumors/pituitary-tumors
Signs of too few hormones range, but can include: increased urine volume, exhaustion, reduction in menstrual periods, unexplained weight gain or loss, nausea, and feeling cold. […] Tumors that cause an increase in the hormone called prolactin affect the sex hormones differently for men and women. […] Your pituitary tumor may cause you to experience headaches, particularly in your forehead, when it puts pressure on your nerves on brain. […] Your pituitary tumor may cause symptoms with your eyes, including loss of peripheral (side) vision, when it presses on the optic nerve. You may also experience double vision, blurring, or sudden blindness.
- #16 Pituitary Tumor: FREQUENTLY ASKED QUESTIONS – Neurosurgeryhttps://med.virginia.edu/neurosurgery/services/pituitary-tumor-program/pituitary-tumor-frequently-asked-questions/
What are the symptoms of a pituitary tumor? […] This depends on the type of tumor and the size of the tumor. A large tumor may cause loss of vision, particularly peripheral vision, if it compresses the optic chiasm (where the optic [eye] nerves come together, located above the pituitary gland). Headache may also occur; the type of headache varies from patient to patient. Headache may occur with a large or a small tumor. A tumor may interfere with normal pituitary function causing hypothyroidism (low thyroid hormone level), adrenal insufficiency (low cortisol level), hypogonadism (loss of sexual function and fertility in men, loss of menstrual periods or fertility problems in women). Occasionally a pituitary tumor causes diabetes insipidus, which results in frequent urination and excessive thirst. Diabetes insipidus is not high blood sugar levels; it is a problem with the ability of the kidney to retain fluid because of a deficiency of the pituitary hormone, vasopressin (also called antidieuretic hormone) that regulates water balance.
- #17 Pituitary Tumor: FREQUENTLY ASKED QUESTIONS – Neurosurgeryhttps://med.virginia.edu/neurosurgery/services/pituitary-tumor-program/pituitary-tumor-frequently-asked-questions/
Non Secretory Tumor: This is a tumor that does not produce an excessive amount of a pituitary hormone that can be measured in the blood. This type of tumor most commonly causes sexual dysfunction in men and loss of regular menses and infertility in premenopausal women. This type of tumor is usually detected after it has become a large, causing loss of vision and/or headache and/or hypogonadism (loss of sexual function in men, loss of menses in premenopausal women), hypothyroidism (low thyroid hormone level) or adrenal insufficiency (low cortisol level). […] Craniopharyngioma/Rathkes Cleft Cyst: These tumors are congenital a problem in the development of the pituitary gland which begins during fetal (in the womb) development, it is present at birth but may not cause a problem until childhood or adulthood until growth causes a problem. This is not a malignant (cancerous) tumor but it often interferes with normal pituitary function causing hypopituitarism (loss of pituitary function) or cause headache or loss of vision. This type of tumor may also cause diabetes insipidus: frequent urination and excessive thirst (not diabetes mellitus [high blood sugar]).
- #17 Pituitary Tumor: FREQUENTLY ASKED QUESTIONS – Neurosurgeryhttps://med.virginia.edu/neurosurgery/services/pituitary-tumor-program/pituitary-tumor-frequently-asked-questions/
Specific types of tumors cause various symptoms and changes in body function. […] Prolactinoma: most commonly causes loss of sexual function and infertility in men. Men may also have enlargement of the breasts, called gynecomastia. In women of reproductive age a prolactin-producing tumor may cause milk in the breasts, a change in menstrual periods or loss of menses or problems becoming pregnant. Women who have gone through menopause do not have a change in menstrual periods to signal the problem; in this situation, headache and loss of vision may be the first indicator of a prolactinoma. […] Acromegaly: Enlargement of the hands, feet and face and excessive sweating are the most common features of excessive growth hormone production. Other problems include joint pains (osteoarthritis), sleep apnea (excessive snoring, stopping breathing during sleep), hypertension (high blood pressure), diabetes mellitus (high blood sugar), colon polyps, change in teeth spacing, oily skin and acne.
- #17 Pituitary Tumor: FREQUENTLY ASKED QUESTIONS – Neurosurgeryhttps://med.virginia.edu/neurosurgery/services/pituitary-tumor-program/pituitary-tumor-frequently-asked-questions/
Cushings: The term Cushings Disease refers to the overproduction of cortisol by the adrenal glands caused by a pituitary tumor producing too much of the pituitary hormone, ACTH. Excessive cortisol production causes weight gain (particularly in the abdomen and neck), loss of muscle mass (legs, arms) and muscle weakness, depression, difficulty with concentration and memory, sleep disturbance, irritability, thinning of the skin with easy bruising, hypertension, diabetes mellitus, loss of bone mass (osteoporosis) with a risk for bone fractures and weakening of the immune system with a higher risk of developing infections. […] TSH Secreting Tumor: This is the least common type of hormone producing pituitary tumor. Excessive TSH stimulates the thyroid gland to produce too much thyroid hormone (hyperthyroidism). Symptoms of hyperthyroidism include weight loss, nervousness, rapid heartbeat, difficulty sleeping, frequent bowel movements and in women, less menstrual flow or loss of menstrual periods.
- #18 Pituitary Adenomas: Definition, Symptoms & Treatmenthttps://my.clevelandclinic.org/health/diseases/15328-pituitary-adenomas
A deficiency of ACTH means you don’t produce as much cortisol, a condition known as adrenal insufficiency. Symptoms of adrenal insufficiency include low blood pressure, nausea, vomiting, abdominal pain and poor appetite. […] A deficiency of GH results in low growth hormone production, also known as growth hormone deficiency. You’ll have different symptoms depending on how old you are. In adults, a lack of GH results in fatigue and decreased muscle mass. […] If left untreated, some pituitary adenomas mainly macroadenomas and functioning (secreting) adenomas can cause serious health issues. The health issues largely depend on which hormone the adenoma secretes. […] A very rare complication of untreated pituitary adenomas is pituitary apoplexy. This is a medical emergency that’s caused by bleeding either into or out of your pituitary gland.
- #19 Signs & Symptoms of Pituitary Tumors | American Cancer Societyhttps://www.cancer.org/cancer/types/pituitary-tumors/detection-diagnosis-staging/signs-and-symptoms.html
High ACTH levels cause the adrenal glands to make excess steroid hormones such as cortisol. This causes symptoms that doctors group together as Cushing’s disease. In adults, the symptoms can include: Unexplained weight gain (mostly in the face, chest, and belly), Purple stretch marks on the chest or belly, New or increased hair growth (on the face, chest, and/or belly), Swelling and redness of the face, Acne, Extra fat on the back of the neck, Moodiness or depression, Easy bruising, High blood sugar levels or even diabetes mellitus, High blood pressure, Decreased interest in sex, Changes in menstrual periods in women, Weakening of the bones, which can lead to osteoporosis or even fractures. […] Prolactinomas are most common in young women and older men. In women before menopause, high prolactin levels cause menstrual periods to become less frequent or to stop. High prolactin levels can also cause abnormal breast milk production, called galactorrhea.
- #20 Pituitary Tumors | Endocrine Societyhttps://www.endocrine.org/patient-engagement/endocrine-library/pituitary-tumors
Symptoms of tumor mass pressure can include headaches and trouble seeing, especially problems with peripheral vision. Symptoms of low pituitary hormones include fatigue, dizziness, dry skin, irregular periods in women, and sexual dysfunction in men. Other symptoms depend on the hormone that is affected. […] A prolactinoma is the most common secretory tumor, accounting for about 40% of pituitary tumors. This tumor produces too much prolactin, the hormone that causes milk production, also called hyperprolactinemia. […] Symptoms include: Changes in menstrual cycle (skipping periods or complete loss of periods) Headaches Infertility in women and men Vaginal dryness or pain during intercourse Reduced sex drive in women and men Erectile dysfunction the inability to get or maintain an erection Osteoporosis or bone loss Peripheral vision problems that make it hard to see well at the edges of your vision Symptoms of hypopituitarism when the tumor is large.
- #21 Symptoms of pituitary gland tumours | Canadian Cancer Societyhttps://cancer.ca/en/cancer-information/cancer-types/pituitary-gland-tumours/signs-and-symptoms
Most pituitary gland tumours make too much of certain hormones. These tumours are referred to as functioning. Tumours that do not make extra hormones are called non-functioning. […] Prolactin-producing tumours may have these signs or symptoms: menstrual periods stop (called amenorrhea); making breast milk without being pregnant or giving birth; decreased interest in sex (libido); erectile dysfunction; breast growth in men. […] Growth hormone-producing tumours can cause the following signs or symptoms: in adults, increased growth of the skull, bones of the face, jaw, hands and feet (called acromegaly); in children, very fast growth and becoming very tall (called gigantism); joint pain; high blood sugar (glucose) levels; increased sweating; increased growth of body hair. […] Adrenocorticotropic hormone (ACTH)-producing tumours cause too much cortisol in the body. This leads to a group of symptoms called Cushing disease. The signs or symptoms of Cushing disease include: weight gain; a red, round and full face; muscle weakness; increased hair growth on the face and body; a buildup of fat between the shoulders or above the collar bone; purple lines on the skin; high blood pressure; high blood sugar (glucose) levels; changes in mood and behaviour.
- #22 Signs & Symptoms of Pituitary Tumors | American Cancer Societyhttps://www.cancer.org/cancer/types/pituitary-tumors/detection-diagnosis-staging/signs-and-symptoms.html
Another way that a pituitary tumor (especially a larger one) can cause many of the symptoms above is if it leads to bleeding or a blockage in a blood vessel, reducing the blood supply to the pituitary. This condition, known as pituitary apoplexy, isn’t common, but it can result in symptoms developing quickly, and it’s often a medical emergency. […] Symptoms from excess pituitary hormones depend on which hormone(s) the tumor is making. […] In adults, the arm and leg bones can’t grow any more, even when GH levels are very high, so people don’t grow taller. But the bones in an adult’s hands, feet, and skull can grow throughout life. Making too much GH as an adult causes a condition called acromegaly. Signs and symptoms can include: Growth of the hands and feet, Changes in how the face looks (due to growth of facial bones), Wider spacing of the teeth and protruding jaw (due to jawbone growth), Deepening of the voice, Thickening of the tongue and roof of mouth, leading to sleep disturbances such as snoring and sleep apnea (pauses in breathing), Thickened skin, Increased growth of body hair, Numbness or tingling in the hands or feet, Carpal tunnel syndrome, Joint pain, Increased sweating, High blood sugar or even diabetes mellitus, High blood pressure, Heart disease.
- #23 What are some symptoms of pituitary tumors?https://www.medicalnewstoday.com/articles/symptoms-of-pituitary-tumors
Pituitary tumors that produce growth hormones (somatotroph adenomas) account for about 2 in 10 pituitary tumors. Too much growth hormone can lead to acromegaly, resulting in symptoms such as swelling in the hands and feet, gradual changes in facial features, such as the brow, jaw, and nose becoming larger and the spacing between teeth widening, weakness or tingling in the hands and fingers, increased sweating, skin changes such as skin tags, oily skin, and skin thickening, joint pain, fatigue, and vision problems. […] TSH-producing tumors (thyrotroph adenomas) are rare and may cause the thyroid gland to be overactive. This can lead to symptoms such as weight loss, rapid or irregular heartbeat, irritability or nervousness, trouble sleeping and fatigue, muscle weakness, shaking, increased sweating, and frequent bowel movements.
- #24 What are the symptoms of pituitary tumors? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Developmenthttp://www.nichd.nih.gov/health/topics/pituitarytumors/conditioninfo/symptoms
The symptoms of functioning tumors depend on the particular hormone the tumor is overproducing. […] A pituitary tumor that produces too much prolactin may cause: Headache, Some loss of vision, Less frequent or no menstrual periods or menstrual periods with a very light flow, Difficulty getting pregnant, Impotence in men, Lower sex drive, The flow of breast milk in a woman who is not pregnant or breastfeeding. […] A pituitary tumor that produces too much adrenocorticotropic hormone (ACTH) may cause: Headache, Some loss of vision, Weight gain reflected in the face, neck, and trunk of the body, but thin arms and legs, A lump of fat on the back of the neck, Thin skin that may include purple or pink stretch marks on the chest or abdomen, Easy bruising, Growth of fine hair on the face, upper back, or arms, Bones that break easily, Anxiety, irritability, depression, Growth deceleration with weight gain in children, Irregular menses.
- #24 What are the symptoms of pituitary tumors? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Developmenthttp://www.nichd.nih.gov/health/topics/pituitarytumors/conditioninfo/symptoms
A pituitary tumor that produces too much growth hormone may cause: Headache, Some loss of vision, In adults, growth of the bones in the face, hands, and feet, In children, excessive growth of the whole body, Tingling or numbness in the hands and fingers, Snoring or pauses in breathing during sleep, Joint pain, Sweating more than usual, Extreme dislike of or concern about one or more parts of the body. […] A pituitary tumor that produces too much TSH (through high T4) may cause: Irregular heartbeat, Shakiness, Weight loss, Trouble sleeping, Frequent bowel movements, Sweating. […] Nonfunctioning tumors press on or damage the pituitary and prevent it from secreting enough hormones. If there is too little of a particular hormone, the gland or organ it normally controls will not function correctly. Symptoms of nonfunctioning pituitary tumors are: Headache, Some loss of vision, Loss of body hair, In women, less frequent menstrual periods or no periods at all, or no milk from the breasts, In men, loss of facial hair, growth of breast tissue, and impotence, In women and men, lower sex drive, In children, slowed growth and sexual development. […] Other General Symptoms of Pituitary Tumors: Nausea and vomiting, Confusion, Dizziness, Seizure, Runny or drippy nose.
- #25 Signs & Symptoms of Pituitary Tumors | American Cancer Societyhttps://www.cancer.org/cancer/types/pituitary-tumors/detection-diagnosis-staging/signs-and-symptoms.html
These tumors can also sometimes grow large enough to press on nearby nerves and parts of the brain, which can cause headaches and vision problems. […] These rare tumors make too much thyroid-stimulating hormone (TSH), which then causes the thyroid gland to make excess amounts of thyroid hormones. This can cause symptoms of hyperthyroidism (overactive thyroid), such as: Rapid or irregular heartbeat, Tremors (shaking), Weight loss, Increased appetite, Feeling warm or hot, Sweating, Trouble falling asleep, Anxiety, Frequent bowel movements, A lump in the front of the neck (from an enlarged thyroid). […] By pressing on the rest of the pituitary, these tumors can also sometimes result in lower levels of sex hormones such as estrogen, progesterone, and testosterone. This can lead to irregular menstrual periods in women or erectile dysfunction and decreased interest in sex in men.
- #26 Symptoms of pituitary gland tumours | Canadian Cancer Societyhttps://cancer.ca/en/cancer-information/cancer-types/pituitary-gland-tumours/signs-and-symptoms
Thyroid-stimulating hormone (TSH)-producing tumours can cause an overactive thyroid (hyperthyroidism) with symptoms such as: nervousness; anxiety; feeling shaky; sleep problems; increased appetite; weight loss; feeling hot; frequent bowel movements; a rapid or irregular heartbeat. […] Gonadotropin-producing tumours usually don’t make enough hormones to cause symptoms. But they may cause: irregular menstrual periods; infertility; in men, less interest in sex.
- #27 Pituitary Tumors – Neurologic Disorders – Merck Manual Professional Editionhttps://www.merckmanuals.com/professional/neurologic-disorders/intracranial-and-spinal-tumors/pituitary-tumors
Sometimes pituitary tumors that compress tissue throughout the anterior lobe of the pituitary reduce production of multiple pituitary hormones, causing generalized hypopituitarism. […] Rarely, hemorrhage into a pituitary tumor causes pituitary apoplexy, with sudden headache, ophthalmoplegia, and visual loss. […] Any pituitary tumor may compress optic nerve tracts, causing bitemporal hemianopia, unilateral optic atrophy, or contralateral hemianopia, or it may compress pituitary tissue, causing a deficiency of pituitary hormones.
- #28 Pituitary Adenomas: Definition, Symptoms & Treatmenthttps://my.clevelandclinic.org/health/diseases/15328-pituitary-adenomas
Symptoms often include: Severe headache. […] Loss of peripheral vision or loss of all vision in one or both eyes. […] If you have a large and/or functioning pituitary adenoma, you’ll likely need treatment as some pituitary adenomas can cause symptoms that greatly impact your health and quality of life.
- #29https://www.advocatehealth.com/health-services/brain-spine-institute/brain-spine-tumors/pituitary-tumor
The symptoms of functioning pituitary tumors vary according to the hormone secreted by the tumor. If a tumor secretes excess human growth hormones in a child, they may grow to be exceptionally tall and have large hands and feet. […] Its important to identify and treat functioning pituitary tumors promptly before they cause complications such as: Blindness, Cardiovascular disease, Diabetes, High blood pressure, Hormone deficiencies, Kidney stones, Weakened bones (osteoporosis). […] Pituitary apoplexy is a rare, but very serious complication of a pituitary adenoma. It means there is bleeding either into or out of your pituitary gland and it can be life-threatening. Symptoms of pituitary apoplexy are: Loss of peripheral vision or of all vision in one or both eyes, Low blood pressure, nausea and vomiting, Paralysis of the eye muscles, Personality changes, Severe headache.
- #30 Pituitary tumors, diagnosis and treatment options | Mayfield Brain & Spinehttps://mayfieldclinic.com/pe-pit.htm
Pituitary apoplexy. In rare instances, a pituitary tumor can suddenly bleed (hemorrhage). Symptoms include sudden onset of a severe headache and vision changes, including vision loss, double vision, or drooping of an eyelid. Pituitary apoplexy requires emergency treatment, usually with corticosteroids and often surgery.
- #31 Pituitary Adenomas – Pituitary & Skull Base Tumor | UCLA Healthhttps://www.uclahealth.org/medical-services/neurosurgery/pituitary-skull-base-tumor/conditions/pituitary-adenomas
Hormone-producing pituitary tumors can also grow to large sizes, causing the same problems described above in addition to the hormone-related effects. […] When the tumor compresses the normal pituitary gland, it can cause it to fail leading to pituitary insufficiency (hypopituitarism). The symptoms will depend upon which hormone is involved. […] Pituitary adenomas can suddenly bleed internally (hemorrhage), leading to an abrupt increase in size. […] Patients with pituitary apoplexy generally experience a sudden headache. If accompanied by acute vision loss, this is a surgical emergency. Pituitary apoplexy can also lead to severe pituitary insufficiency, the symptoms of which can occur days to weeks later.
- #32 Pituitary tumors – Diagnosis and treatment – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/pituitary-tumors/diagnosis-treatment/drc-20350553
Pituitary tumors often aren’t noticed or aren’t detected. In many cases, that’s because the symptoms caused by pituitary tumors that make hormones, called functioning adenomas, and large tumors, called macroadenomas, are similar to those of other medical conditions. It’s also because they grow very slowly over time. Small pituitary tumors that don’t make hormones, called nonfunctioning microadenomas, often don’t cause symptoms. If they are detected, it’s typically because of an imaging exam, such as an MRI or a CT scan, that’s done for another reason. […] A pituitary tumor can affect eyesight, especially side vision, also called peripheral vision. Testing your eyes to check how well you can see may help your health care provider decide if other tests may be needed to detect a pituitary tumor.
- #33 Pituitary tumours | Brain tumours (primary) | Cancer Research UKhttps://www.cancerresearchuk.org/about-cancer/brain-tumours/types/pituitary-tumours
You can get symptoms of an overactive thyroid gland (hyperthyroidism) such as: weight loss, sweating, tremor (shaking), a fast heart beat (palpitations). […] Pituitary tumours usually grow slowly over some years. So for a small tumour that isnt causing symptoms, your doctor might monitor you with regular MRI scans. This is called active monitoring. You then have treatment if there are signs that the tumour is growing or starts to cause symptoms.
- #34 Pituitary Adenomas – AANShttps://www.aans.org/patients/conditions-treatments/pituitary-adenomas/
Pituitary adenomas are the fourth most common intracranial tumor after gliomas, meningiomas and schwannomas. A large majority of pituitary adenomas are benign and are relatively slow growing. Adenomas are by far the most common disease affecting the pituitary gland. These tumors most commonly affect people in their 30s or 40s, although they can be diagnosed in children as well. Most of these tumors can be successfully treated. […] Tumors smaller than 10 millimeters are called microadenomas and often secrete anterior pituitary hormones. These smaller, functional adenomas are usually detected earlier because the increased levels of hormones cause abnormal changes in the body. Approximately 50 percent of pituitary adenomas are diagnosed when they are smaller than 5 millimeters in size. Adenomas larger than 10 millimeters (the size of a dime) are called macroadenomas and usually do not secrete hormones. These tumors are often discovered because they produce symptoms by mass effect, compressing nearby brain or cranial nerve structures.
- #35 Pituitary Tumors Symptoms | Expert Surgeon | Aaron Cohen-Gadol, MDhttps://www.aaroncohen-gadol.com/en/patients/pituitary-tumor/pituitary-tumors/symptoms
Patients may initially experience a few or many symptoms of pituitary tumor growth. These include: […] Common pituitary tumor symptoms are headaches, nausea, fatigue, anxiety, vision problems, weight gain, easy bleeding or bruising, menstrual irregularities, lactation, erectile dysfunction, and heat or cold intolerance. […] Non-functional pituitary tumors often do not produce any hormone. They are more common than functional pituitary tumors and cause symptoms due to the enlarged pituitary gland pushing on other structures in the brain, including the optic (vision) nerves. […] When left untreated, pituitary tumors can lead to optic nerve damage, which could result in blindness. It could also cause hormonal imbalances, depending on the type of functional pituitary tumor. This could increase the risk of developing conditions such as heart disease, diabetes, and high blood pressure, which could lead to additional complications.
- #36 Pituitary Tumors: Background, Pathophysiology, Epidemiologyhttps://emedicine.medscape.com/article/1157189-overview
Pituitary macroadenomas can also cause distinct visual field defects. Bitemporal hemianopia, a typical pattern in these cases, arises from compression of the optic chiasm. […] Panhypopituitarism – Refers to deficiency of several anterior pituitary hormones; may occur in a slowly progressive fashion (eg, pituitary adenomas). […] Growth hormone deficiency […] Adults – Increased rate of cardiovascular disease, obesity, reduced muscle strength and exercise capacity, and increased cholesterol. […] Cushing disease […] Weight gain, centripetal obesity, moon facies, violet striae, easy bruisability, proximal myopathy, and psychiatric changes. […] Mortality rate related to pituitary tumors is low. Advances in medical and surgical management of these lesions and the availability of hormonal replacement therapies have contributed to successful management. Nevertheless, pituitary apoplexy is a life-threatening complication. […] Approximately 30% of resected adenomas have persistent progressive growth in the next 4 years after surgery.
- #37 Pituitary Tumor Symptoms, Diagnosis, & Treatment | UPMChttps://www.upmc.com/services/neurosurgery/brain/conditions/pituitary-and-skull-base-tumors/conditions/pituitary-tumor
Pituitary adenomas can create significant problems, including persistent headaches, feeling of pressure behind the eyes, nausea, and vision problems, such as double or blurred vision, loss of peripheral vision, or sudden blindness. […] Many pituitary adenomas secrete one or more hormones. When hormone levels rise too high, you may develop hormone-specific symptoms. […] Because the pituitary gland controls most of the glands and systems in the body, complications can be serious and widespread. Left untreated, pituitary tumor complications can include cardiovascular disease, diabetes, high blood pressure, kidney stones, osteoporosis, mental disorders, seizures, thyroid disease, and shortened lifespan. […] If you have any pituitary tumor symptoms, see your doctor promptly. Your doctor will ask you about your symptoms and medical history and will perform a physical exam. This will include a neurological exam to check your mental status and how well your nerves work.
- #38 How Serious Are Pituitary Tumors?: Joseph Watson, MD: Board Certified Neurosurgeonhttps://www.cerebrummd.com/blog/how-serious-are-pituitary-tumors
No one wants to learn they have a tumor. But, when it comes to your pituitary gland, 99% of these growths are benign, or noncancerous. And pituitary tumors usually dont spread or grow extensively. Still, they can negatively impact your health. […] As a result, pituitary tumors can interfere with the hormonal balance in your body, which can trigger a variety of symptoms. […] The signs of a pituitary tumor can vary depending on whether you have hormonal changes or pressure from a large tumor. As a result, you might experience: Unexplained weight loss or gain, Fatigue, muscle weakness, or aching joints, Irregular menstrual periods, Low blood pressure or low blood sugar, Osteoporosis, Sexual dysfunction or infertility, Depression or irritability, Changes in vision, Headaches. […] Not all pituitary tumors require treatment. However, depending on the type, size, and location of your growth, it could put you at risk of permanent hormone deficiency or vision loss from the pressure on your optic nerve. In very rare cases, a pituitary tumor can also begin bleeding and require immediate treatment.
- #39 Pituitary Tumors in Children | Symptoms, Diagnosis and Treatmenthttps://www.cincinnatichildrens.org/health/p/pituitary-tumors
A pituitary tumor is an abnormal growth on the pituitary gland, a pea-size structure located at the skull base (where skull meets the neck). […] When a pituitary tumor develops, the pituitary gland may make too much or too little of a certain hormone. […] Pituitary tumor symptoms vary based on the type of cells involved. For example, a pituitary tumor made up of prolactin cells may make too much prolactin hormone. This can cause: Breast milk production, Menstrual cycle changes, Infertility (which can be corrected with treatment). […] A pituitary tumor involving the cells that produce growth hormones may cause faster-than-normal growth. […] Pituitary tumors involving cortisol-producing cells can lead to a condition called Cushings disease, or Cushings syndrome. Symptoms of Cushings syndrome include: Abnormal marks on the skin, Excessive weight gain, High blood pressure, Muscle weakness, Weakened bones (osteoporosis).
- #40 Pituitary Tumors in Children | Symptoms, Diagnosis and Treatmenthttps://www.cincinnatichildrens.org/health/p/pituitary-tumors
Some pituitary tumors don’t produce excess hormones. These tumors, called null cell adenomas, can go undetected. They can grow large enough to affect nearby cells or push on nearby structures. Symptoms of null cell adenoma include: Hypopituitarism (hormone deficiencies), Vision problems. […] Nearly all types of pituitary tumors can cause headaches. Other common symptoms of pituitary tumors include: Confusion, Dizziness, Nausea and vomiting, Runny or drippy nose. […] Large pituitary tumors that put pressure on the brain can lead to seizures. […] A child’s prognosis (long-term health) after a pituitary tumor diagnosis is quite good. The right treatment and follow-up care can get rid of the tumor and its associated symptoms. […] Cortisol-producing pituitary tumors can be more difficult to treat. These types of tumors may require close follow-up care and additional therapy, such as medications or radiation.
- #41 How common pituitary tumors can have huge health effectshttps://www.medstarhealth.org/blog/common-pituitary-tumors
When a pituitary tumor produces prolactin, it throws off the bodys natural levels. In women, this can lead to a number of symptoms, including: Breast pain, Feeling of breast fullness, Infertility, Irregular periods, Unnecessary breast milk production. […] Mens symptoms can include: Decreased hair growth, Decreased sex drive, Erectile dysfunction, Infertility, Low energy levels. […] Early diagnosis is key. Without treatment, a growing pituitary tumor can compress the pituitary gland and prevent it from releasing life-sustaining hormones, including cortisol (which affects metabolism and immune response) and thyroid-stimulating hormone (TSH, which affects the thyroid, metabolism, heart, digestive system, muscle control and other areas). A large pituitary tumor also can cause vision problems as it compresses the optic nerves, which relay information from the eyes to the brain.
- #42 Pituitary Tumors: Causes, Symptoms & Treatment | UW MedicineStethascopeHearthttps://www.uwmedicine.org/conditions-symptoms/endocrine-diabetes/pituitary-tumor
In time, you may have headaches and vision problems. […] ACTH-producing tumors […] Too much ACTH can cause Cushing disease. This disease causes fat buildup in your face, neck, back, belly (abdomen), and chest. […] Growth hormone-producing tumors […] In children, too much growth hormone stimulates the growth of almost all the bones in the body. […] The symptoms may also look like other health problems. Always see your healthcare provider for a diagnosis. […] Seek care immediately if: You experience a neurological change of any kind. This includes: Vision loss, Severe headaches, Loss of energy or stamina. […] Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is. […] Treatment may include: Surgery to remove the tumor. Surgery is often a better option for smaller tumors.
- #43 Pituitary tumor: MedlinePlus Medical EncyclopediaLockhttps://medlineplus.gov/ency/article/000704.htm
Symptoms caused by pressure from a larger pituitary tumor may include: Changes in vision such as double vision, visual field loss (loss of peripheral vision), drooping eyelids or changes in color vision, Headache, Lack of energy, Nasal drainage of clear, salty fluid, Nausea and vomiting, Problems with the sense of smell, In rare cases, these symptoms occur suddenly and can be severe (pituitary apoplexy). […] If the tumor can be surgically removed, the outlook is fair to good, depending on whether the entire tumor is removed. […] The most serious complication is blindness. This can occur if the optic nerve is seriously damaged. The tumor or its removal may cause lifelong hormone imbalances. The affected hormones may need to be replaced, and you may need to take medicine for the rest of your life. Tumors and surgery can sometimes damage the posterior pituitary (back part of the gland). This can lead to diabetes insipidus, a condition with symptoms of frequent urination and extreme thirst. […] Contact your provider if you develop any symptoms of a pituitary tumor.
- #44 Diagnosing Pituitary Tumors | NYU Langone Healthhttps://nyulangone.org/conditions/pituitary-tumors/diagnosis
Some pituitary tumors can press on nerves that lead from the eyes to the brain, causing vision problems. If youre having problems with your eyesight or if your doctor suspects a pituitary tumor based on your symptoms and laboratory tests, he or she may order vision tests. […] MRI scans can help doctors determine the size of a pituitary tumor. Tumors greater than one centimeter are called macroadenomas and are more likely to cause symptoms such as headaches, vision problems, and a drop in hormone levels (hypopituitarism). Small tumors less than one centimeter in diameter are called microadenomas. These tumors are less likely to compress normal pituitary or brain tissue, but still may produce excess pituitary hormones. […] Very small, functional pituitary tumors that produce excessive amounts of adrenocorticotropic hormone, or ACTH, can be difficult to detect on an MRI scan. Sometimes ACTH levels may be high due to a tumor located somewhere else in the body. For these reasons, doctors may order a pituitary venous blood sampling test, also called petrosal sinus sampling.
- #45 Pituitary tumors – Diagnosis and treatment – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/pituitary-tumors/diagnosis-treatment/drc-20350553
If a pituitary adenoma needs treatment, it may include surgery to remove the tumor. Medication or radiation therapy also might be used to treat a pituitary adenoma. […] Surgery to treat a pituitary tumor involves removing the tumor. This is sometimes called a tumor resection. A surgeon may suggest surgery if a pituitary adenoma: Presses on the optic nerves and limits eyesight. Causes other symptoms, such as headache or facial pain. Lowers hormone levels in the body due to pressure on the pituitary gland. Causes the body to make too much of some hormones. […] Surgery to remove a pituitary tumor might damage the pituitary gland. That can limit its ability to make hormones, leading to other medical problems including diabetes insipidus. […] Radiation therapy can be helpful if a pituitary tumor: Isn’t completely removed with surgery. Comes back after surgery. Causes symptoms that medications don’t relieve. […] Treatment with medications can be useful for the management of pituitary adenomas. They can help lower the amount of hormones the body makes due to a tumor. Some medications also can shrink certain types of pituitary tumors.
- #46 Pituitary gland tumours – symptoms, diagnosis, treatment | Macmillan Cancer Supporthttps://www.macmillan.org.uk/cancer-information-and-support/brain-tumour/pituitary-gland-tumours
Treatment of pituitary tumours is usually very successful, although many people will have to take hormone replacements, sometimes for the rest of their lives. After your treatment has finished, you will probably have regular check-ups at an endocrinology clinic. These may continue for several years. You will have blood tests to monitor your hormone levels. You may also have further scans and eye tests.
- #47 Pituitary Adenoma – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK554451/
The prognosis of pituitary adenomas depends on its being functioning or non-functioning. The non-functioning adenomas and prolactinomas have an excellent prognosis if treated promptly with surgery and/or medical therapy. Functioning adenomas like Cushing’s disease and acromegaly are associated with several other co-morbidities and complications. There is increased mortality especially in patients with Cushing’s disease with delays in medical or surgical treatment.
- #48 Pituitary Tumor Symptoms & Treatment | Florida Neurosurgeonhttps://themorrisonclinic.com/conditions/pituitary-tumor-symptoms-treatments
Signs and symptoms of pressure from a pituitary tumor may include: Headache, Vision loss, particularly loss of peripheral vision. […] Large tumors could cause hormonal deficiencies. Signs and symptoms include: Nausea and vomiting, Weakness, Feeling cold, Less frequent or no menstrual periods, Sexual dysfunction, Increased amount of urine, Unintended weight loss or gain. […] Functioning pituitary tumors cause an overproduction of hormones. Different types of functioning tumors in your pituitary gland cause specific signs and symptoms and sometimes a combination of them. […] Survival rates depend on the type of tumor, the personâs age, and other factors. It is important to remember that statistics on survival rates for people with a pituitary gland tumor are an estimate. […] For most people, treatment removes or controls the tumor. It may help to know that many pituitary tumor survivors have learned to live with this uncertainty and are living full lives. […] For other people, the tumor might never go away completely.
- #49 Pituitary Tumors > Fact Sheets > Yale Medicinehttps://www.yalemedicine.org/conditions/pituitary-tumors
Symptoms are varied, ranging from high blood pressure to headaches to irregular periods for women […] Symptoms of functioning pituitary tumors vary based on the hormone or hormones that are overproduced: […] Pituitary tumors, whether nonfunctioning or functioning, can also cause symptoms if they grow large enough to press against nearby tissues. For instance, tumors that press against the pituitary gland can impair its ability to produce hormones. This results in low levels of one or more hormones. Depending on their size and where they are located, pituitary tumors can press against the optic nerves or other parts of the brain, resulting in vision problems and headaches. […] The outlook depends on a number of factors including the type of tumor and its size. Most pituitary tumors, though, are treatable and many can be cured. Tumors that grow large enough to press against the optic nerves or parts of the brain can cause lasting damage and symptoms. […] Similarly, the hormones secreted by functioning tumors may result in long-term and potentially serious symptoms. In general, outcomes are best when tumors are detected and treated early.
- #50 When Do You Need Surgery for a Pituitary Tumor? | Nuvance Healthhttps://www.nuvancehealth.org/health-tips-and-news/when-do-you-need-surgery-for-a-pituitary-tumor
A growing pituitary tumor can press on the optic nerves, leading to blurred or double vision, or even loss of peripheral vision. […] Some pituitary tumors produce excess hormones, causing conditions like Cushing’s disease and acromegaly. […] If these medications fail to control the tumor’s growth or hormone production, surgery may be the best next option. […] Recognizing these symptoms early can lead to a quicker diagnosis and treatment. If you’re experiencing any of these symptoms, especially in combination, it’s important to consult a healthcare provider for a thorough evaluation.