A pituitary adenoma is an abnormal growth of tissue present on the pituitary gland. This gland is located in the brain, at its base. It’s not always clear that a pituitary adenoma needs to be removed surgically, and sometimes careful watching and preventative treatment are all that are necessary with these tumors. Many of them grow at a very slow rate, so concern about invading other brain structures might be minimal.
It’s important to understand that the pituitary adenoma can be classified in different ways. Some cause increase production of certain hormones like growth hormone or prolactin. These are usually labeled hormone-producing. In contrast, hormone-inactive adenomas don’t usually create additional hormones, but they tend to be larger and might impair the gland’s ability to produce needed amounts of hormones or they can begin to interfere with other areas of the brain. They are most noted for causing visual problems because a larger tumor can easily reach and impair the optic nerves.
If a pituitary adenoma is suspected, from sudden conditions that cause visual disturbance or rapid changes in hormonal function, doctors might do several examinations to determine presence. They might first evaluate blood hormone levels with blood tests and then conduct magnetic resonance imaging (MRI) to look for presence of tumors. An extremely small tumor may not show up on MRI. In this case, doctors could proceed to more complex testing to better evaluate certain blood hormone levels.
When a person is diagnosed with pituitary adenoma, decisions about treatment can be highly individualized. Very small hormone-producing tumors might not be removed, but medications could be given to neutralize extra hormone amounts that are creating problems. Large adenomas, especially if they appear fast growing and are threatening the optic nerves or other brain structures are usually removed through surgery, that does not involved cutting open the skull. Instead most surgeons can access and remove a tumor through the nose.
Sometimes a very large pituitary adenoma cannot be fully removed in this manner. Doctors might consider an open skull procedure or they might use other tactics, such breaking up the tumor with radiofrequent waves. Another potential is shrinking the tumor with chemotherapy or radiation.
Given the choices in treatment and the different types of adenoma, it’s hard to predict which treatment is best for the individual. Different neurosurgeons might also have differing opinions. People may want to get second or third opinions prior to determining what to do if they’re diagnosed with a pituitary adenoma.
It’s also challenging to discuss treatment and survival rate. A high percentage of people with an adenoma will receive excellent care and live to a ripe age. If a tumor has developed and quickly spread, there can be permanent damage to the optic nerves that is irreversible. Occasionally, adenomas begin to bleed spontaneously, and this might prove life-threatening without surgery. In the main, though, an adenoma is benign and won’t cause cancerous tumors to develop elsewhere, so outlook with treatment is good.
