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The Neuroendocrine & Pituitary Clinical Center at Massachusetts General Hospital provides multidisciplinary care and specializes in the diagnosis, evaluation and treatment of pituitary tumors and disorders of the hypothalamus and pituitary.Schedule an appointment or referral
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The Neuroendocrine Surgical Service at Massachusetts General Hospital evaluates, treats and manages care for patients with pituitary and hypothalamic tumors and other complex disorders. Treatment for adenomas sometimes includes transsphenoidal surgery.Request an appointment
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The Pediatric Endocrinology Program and Diabetes Center at MassGeneral Hospital for Children is an international referral center for the management of pediatric diabetes and endocrine disorders in children and adolescents.
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The pediatric neuropsychology specialists at Massachusetts General Hospital’s Psychology Assessment Center provide neuropsychological assessments to aid in the diagnosis and treatment of neurological, medical, genetic and developmental disorders.
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Specialists in the Central Nervous System Program in the Department of Radiation Oncology include some of the world's leading experts in using radiation therapies to treat brain tumors and cancers of the spine and peripheral nervous system.
What are pituitary tumors?
The pituitary gland is a small, pea-sized organ in the brain. It is located behind the back of the nose. It makes hormones that affect many other glands in your body. Most pituitary tumors are not cancerous. But because of where the gland is located, many tumors will press against the optic nerves. This can cause vision problems. Also tumors that make a lot of hormone will make the other endocrine glands make more horomes. That will cause symptoms related to the specific hormone.
Most pituitary tumors do not cause symptoms. As a result, they are not diagnosed. Or they are found only during a routine brain imaging test. Up to 1 in 4 people may have small pituitary tumors without knowing it.
Below are the main types of pituitary tumors.
Nonfunctional adenomas (null cell adenomas)
These tumors are the most common type. They do not make extra hormone. Until they become a certain size, you may not have any symptoms. When the tumor is large enough, it may cause headaches and vision problems.
Prolactin-producing tumors (prolactinomas)
These benign tumors are also common. They make too much prolactin. If you are a woman, high prolactin levels can cause your menstrual period to be irregular or to stop. These tumors can also cause you to make breast milk. If you are a man, you may have erectile dysfunction or a lack of interest in sex. You may also have enlarged breasts, infertility, or less body hair. In time, you may have headaches and vision problems.
Adrenocorticotropic hormone-producing tumors
ACTH stimulates the adrenal gland to make glucocorticoids. These are steroids that affect metabolism. They act as anti-inflammatory chemicals. They also suppress your immune system. Too much ACTH can cause Cushing's disease. The disease causes a buildup of fat in your face, neck, back, abdomen, and chest. Also your arms and legs tend to become thin. You may also have purple stretch marks and high blood pressure. These tumors can also weaken bones.
Growth hormone-producing tumors
These tumors make too much growth hormone. In children, too much growth hormone stimulates the growth of almost all the bones in the body. When that occurs, the result is called gigantism. Gigantism can include increased height (over 7 feet), very quick growth, joint pain, and heavy sweating. In adults, an excess of growth hormone causes a condition called acromegaly. It may include:
- Extra growth in the skull, hands, and feet
- Deepened voice
- A change in the facial appearance because of extra growth in the facial bones
- A wide spacing of teeth because of the growth of facial bones
- Pain in the joints
Thyroid-stimulating hormone-producing tumors
Thyroid-stimulating hormone is made by these tumors. They can become large and spread. Symptoms may include:
- Fast heart rate
- Unintended weight loss
- Increased appetite
- Feelings of being warm or hot, or not tolerating heat
- Trouble falling asleep
- Feeling anxious
- Frequent bowel movements
- A lump in the front of the neck, due to an enlarged thyroid gland
Cancerous pituitary tumors are rare. They are usually found in older people. But they can occur at any age. These tumors often make hormones, just like many benign pituitary tumors do. In most cases, the only way to tell a cancerous tumor from a benign one is when the tumor spreads to another part of the body several years later.
What causes pituitary tumors?Doctors do not know what causes these tumors. But a condition called multiple endocrine neoplasia type I (MEN 1) may raise your risk. This condition is passed down through families.
What are the symptoms of pituitary tumors?Symptoms depend on the type of tumor and the affected area of the pituitary gland. These tumors can lead to symptoms caused by too much or too little of the pituitary hormones. Each person also has slightly different symptoms. The symptoms many look like other health problems. Always see your health care provider for a diagnosis.
How are pituitary tumors diagnosed?
Your health care provider will ask about your past health and do a physical exam. You may also need one of these tests:
- Blood and urine tests. These tests see how much of a hormone you have.
- CT scan. This test uses X-rays and a computer to make images of your body.
- MRI. This test uses large magnets, radio waves, and a computer to make detailed images of organs and structures within your body.
- Biopsy. During this test, the doctor removes a sample of tissue with a needle or during surgery. It is then looked at under a microscope. A biopsy can tell if cancer or other abnormal cells are present.
How are pituitary tumors treated?
Your health care provider will figure out the best treatment for you based on:
- How old you are
- Your overall health and past health
- How sick you are
- How well you can handle specific medicines, procedures, or therapies
- How long the condition is expected to last
- Your opinion or preference
Treatment may include:
- Surgery to remove the tumor
- External radiation (external beam therapy). This treatment sends high levels of radiation directly to the cancer cells. Special shields may be used to protect the tissue around the treatment area. These treatments are painless and usually last a few minutes.
- Radiosurgery (stereotactic radiosurgery).This type of radiation therapy uses a single high dose of radiation sent directly into the cancerous tissue. It causes less damage to the surrounding tissues. Radiosurgery is called "surgery" because it is a 1-session treatment that creates a similar result as an actual surgical procedure. Sometimes it’s called "a gamma knife" treatment.
- Medicine. Several types of medicine may be used to control how much growth hormone is made by the tumor.
When should I call my health care provider?Call your health care provider if your symptoms return or you have new ones.
- The pituitary gland is a small, pea-sized organ in the brain. Most pituitary tumors are benign.
- Doctors do not know what causes these tumors.
- Symptoms vary depending on the type of tumor and the affected area of the pituitary gland.
- Your health care provider may order blood and urine tests, CT scan, MRI, or biopsy to diagnose the tumor.
- Treatment may include surgery, radiation therapy, or medicine.
Tips to help you get the most from a visit to your health care provider:
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
Klibanski named first Guthart Professor - 6/26/2009, Research
MGH Hotline 6.26.09 Anne Klibanski, MD, was honored May 29 in a ceremony at Harvard Medical School (HMS) as the first incumbent of the Laurie Carrol Guthart Professorship in Medicine in the Field of Neuroendocrinology.
The Proton Beam Unit at Mass General was founded in 1962 and has the largest experience with stereotactic radiosurgery of any center in the United States. Learn more about these advanced procedures.
Pituitary adenomas are benign tumors which arise from the pituitary gland and can be successfully treated with transsphenoidal (through the sinus) surgery.