Pituitary tumors can be quite common and are classified by the type of hormones they secrete.
MedStar Washington Hospital Center Pituitary Endocrinology Director Dr. Susmeeta Tewari Sharma says that if 100 people are in a room, 10-15 of them could have a pituitary tumor. And out of that group, five or six people could have a prolactin-secreting pituitary tumor — among the most common pituitary tumors physicians at MedStar Washington Hospital Center see.
“Data shows that among the population, 10 to 20 percent of individuals can have a pituitary tumor, and in some it may be causing hormonal excess or hormonal dysfunction — in others maybe not,” Dr. Sharma said.
When a pituitary tumor produces prolactin, it throws off the body’s natural levels, Dr. Sharma explained, and can manifest differently depending on gender. Women may experience breast pain, breast milk production, infertility or irregular periods. Men may see decreased hair growth, decreased libido, erectile dysfunction or low energy levels.
When people experience these symptoms, they should consult a doctor who can measure hormone levels, order a MRI and see if a pituitary tumor is the cause.
Prolactin-secreting pituitary tumors can be managed through medicine about 80-to-90 percent of the time, Dr. Sharma said. However, several qualifiers may lead a patient to have to undergo surgery: if the tumor has gone undiagnosed for a long period of time and it has become really large and bleeds into itself; if a patient is not able to tolerate medications used to lower prolactin levels; or if, in the rare case, the tumor is resistant to medication.
With prolactin-secreting pituitary tumors, early diagnosis is key, Dr. Sharma said. A growing pituitary tumor can compress the pituitary gland and prevent it from releasing life-sustaining hormones. The prolactin levels itself may not be life threatening, but can cause gonadal hormone deficiency and as the tumor grows, it may cause hormonal deficiencies as well, Dr. Sharma said.
Growth-hormone-secreting tumors are less common than prolactin-secreting pituitary tumors. Growth-hormone-secreting tumors manifest differently: for children, too much growth hormone can result in gigantism; in adults, excessive growth hormone can cause acromegaly — a condition in which patients experience growth in body parts such as the jaw and nose, diabetes, high blood pressure or sleep apnea.
“Most of these changes in facial features in adults are subtle so many times they are overlooked, especially if you are seeing the person every day. There can be a change in ring size or shoe size but the person may attribute this to gaining weight or fluid retention or the aging process and it may not get detected,” Dr. Sharma said.
For most functional tumors, surgery is the best option, she said, adding that medical therapy may be needed in conjunction.
“The goal is to optimize hormone levels and make sure the tumor is either completely gone or residual tumor remains stable over time,” Dr. Sharma said.
It’s not fully clear what causes pituitary tumors, and it’s the focus of much medical research. There are some hereditary disorders that are associated with pituitary tumors; however those can be rare.
As advancements and research are evolving, MedStar Washington Hospital Center’s pituitary center is on the cutting edge of surgical and medical treatment of pituitary disorders and patient care.
“Being evaluated at a pituitary center is really important as we are looking at the patient as a whole and coming up with an individualized, multidisciplinary team approach to these pituitary tumors,” said Dr. Sharma.
For more insights from Dr. Sharma, including her podcast on common pituitary tumors, click here.