Pituitary Disorders

[Boleslao Drinker]

AnatomyThe pituitary has two parts, an anterior lobe and a posterior lobe. Each lobe releases different hormones. The pituitary gland is attached to the bottom of the hypothalamus, a part of the brain that connects the nervous system and endocrine system. The hypothalamus releases hormones, and it signals the pituitary gland to release hormones.

Rare disorders: Many pituitary disorders are uncommon. At the same time, estimates for the number of people with acromegaly or Cushing disease/syndrome may be too low. Estimates include:

Pituitary tumors are unusual growths that develop in the pituitary gland. This gland is an organ about the size of a pea. It's located behind the nose at the base of the brain. 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.

Most pituitary tumors are benign. That means they are not cancer. Another name for these noncancerous tumors is pituitary adenomas. Most adenomas stay in the pituitary gland or in the tissue around it, and they grow slowly. They typically don't spread to other parts of the body.

Pituitary tumors are different from pituitary cysts. A cyst is a sac that may be filled with air, fluid or other material. A tumor is an unusual mass of cells that may grow over time. Cysts may form on or near the pituitary gland, but they are not tumors or adenomas.

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.

Functioning pituitary adenomas typically make a large amount of one hormone. That exposes the body to high levels of that hormone. Rarely, a pituitary adenoma may make more than one hormone. The following types of functioning pituitary adenomas cause different symptoms depending on the hormones they make.

Pituitary tumors that make adrenocorticotropic hormone are called corticotroph adenomas. Adrenocorticotropic hormone, also called ACTH, causes the adrenal glands to make the hormone cortisol. ACTH tumors trigger the adrenal glands to make too much cortisol. This causes a condition called Cushing disease. Cushing disease is one cause of Cushing syndrome.

Pituitary tumors that make growth hormone also are called growth hormone-secreting tumors or somatotroph adenomas. Too much growth hormone leads to a condition known as acromegaly. Acromegaly can cause:

It's uncommon for these adenomas to make too many hormones that then trigger symptoms. Instead, symptoms from these adenomas usually are due to tumor pressure. If symptoms do happen because of too much LH and FSH, they affect women and men differently.

Pituitary tumors that make thyroid-stimulating hormone are called thyrotroph adenomas. They also may be referred to as thyroid-stimulating hormone-secreting tumors. They 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:

If you develop symptoms that might be associated with a pituitary tumor, see your health care provider. Treatment for pituitary tumors often can bring hormones back to a healthy level and ease symptoms.

Although rare, some pituitary tumors are hereditary. That means they run in families. In particular, the hereditary disorder multiple endocrine neoplasia, type 1 (MEN 1) can cause pituitary tumors. If MEN 1 runs in your family, talk to your health care provider about tests that may help find a pituitary tumor early.

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The pituitary gland is a small organ about the size of a pea. It's located behind the nose at the base of the brain. Despite its small size, the pituitary gland has an effect on nearly every part of the body. The hormones it makes control important body functions, such as growth, blood pressure and reproduction.

The cause of uncontrolled cell growth in the pituitary gland, which creates a tumor, remains unknown. In rare cases, pituitary tumors can be caused by genes you've inherited. But most have no clear hereditary cause. Still, scientists think that changes in genes may play an important role in how pituitary tumors develop.

Most people who get pituitary tumors don't have any factors that put them at higher risk of developing these tumors. Environment and lifestyle choices don't seem to have an effect on a person's risk of pituitary tumors.

If a pituitary tumor presses on part of the brain called the medial temporal lobe, it may lead to a seizure. This type of seizure is known as a focal seizure with impaired awareness. These seizures involve a change in or loss of consciousness or awareness. If you have one of these seizures, you may seem to be awake. But you stare into space and don't respond as you typically would to the environment around you. You may not remember the seizure after it happens.

Because of its location and role in regulating hormones within the body, any abnormality of the pituitary gland can be associated with a wide range of symptoms and disorders. For example, if the pituitary gland grows in size, this can cause pressure on the optic chiasm, a bundle of nerve fibers that communicates information from the eyes to the brain, which can lead to vision issues or headaches.

Pituitary tumors are one of the more common disorders involving the pituitary gland. While these tumors are nearly all benign (noncancerous), they can still lead to hormonal abnormalities, causing increased or decreased hormone production and impacting overall health. Not all tumors will have symptoms, but once they are discovered it is important that the patient undergo a comprehensive evaluation by an expert team to prevent the condition from worsening.

Due to the complex nature of pituitary disorders, most patients require coordinated care by experts in many specialties. At the University of Chicago Medicine, we take an integrated, multidisciplinary approach to the diagnosis, evaluation and treatment of individuals with pituitary disorders. Whether a patient needs hormonal or visual assessment or a neurosurgical procedure, our team of specialists have the resources and expertise to provide advanced and comprehensive care.

Patients with pituitary disorders can have variable symptoms depending on the cause of the disorder. Pituitary tumors, cysts or other growths can cause headaches or problems with vision or in severe cases nausea and vomiting. Low levels of pituitary hormones can cause many symptoms such as fatigue, sexual dysfunction and changes in body composition, appearance or weight.

Diagnosis of pituitary disorders involves a comprehensive approach that includes a hormonal evaluation by an endocrinologist as well as imaging studies such as MRI scans to evaluate for presence of pituitary gland abnormalities. Depending on the abnormality, patients may require formal evaluation of vision by a neuro-ophthalmologist.

Treatment of pituitary disorders often involves collaboration between endocrinologists, neurosurgeons, neuro-ophthalmologists, radiation oncologist and otolaryngologists (ENT). Treatments include surgical intervention, medications, hormone replacement in case of hormone deficiencies and at times radiation therapy. At UChicago Medicine, we are proud to offer minimally invasive, endoscopic surgical approaches.

The pituitary gland is a kidney-bean-sized gland at the base of your brain. It is part of the body's system of glands that make hormones, called the endocrine system. The pituitary gland makes several hormones. They act on nearly every part of the body.

The endocrine system is made up of glands and organs that make hormones. The endocrine system includes the pituitary gland, thyroid gland, parathyroid glands, adrenal glands, pancreas, ovaries and testicles.

Hypopituitarism is when there isn't enough of one or more of the pituitary hormones. This lack of hormones, called a deficiency, can affect how the body works in many ways. These include growth, blood pressure and the ability to have children, among others. Symptoms depend on which hormones are missing.

Symptoms of hypopituitarism vary from person to person. Symptoms depend on what hormones are missing and how little of the hormone is being made. There might be more than one hormone that's low. A second hormone deficiency might increase the symptoms of the first one. Or sometimes, it might hide those symptoms.

Contact your health care provider right away if symptoms of hypopituitarism start suddenly or come with a bad headache, changes in vision, confusion or a drop in blood pressure. These could be symptoms of sudden damage to the pituitary gland tissue. This condition is known as pituitary apoplexy.

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