Pituitary Cancer - Causes, Types, Symptoms, Risk Factors, Diagnosis, and Treatment

What Is the Pituitary Gland?

The pituitary gland is a vital gland that is very small in size. It helps in the functioning of all endocrine glands and is known to be the master gland. It is a major part of the system of the endocrine glands. It is located on the back portion of the nostrils. The pituitary gland is involved in reproductive functioning, thyroid disorders, and the functioning of the adrenals.

What Is Pituitary Cancer?

A tumor or cancer occurring in the pituitary gland is referred to as pituitary cancer. It will contribute to severe alterations in the hormones. Most of the tumors occurring in the pituitary gland are not cancerous. These non-cancerous types are referred to as adenoma. The adenomas do not have the tendency to spread to the other tissues. The diagnosis of this tumor requires specialized tools that are recommended by the doctor. The treatment is planned and executed after the results of diagnostic reports.

What Are the Causes of Pituitary Cancer?

In most pituitary cancer patients, the cause is not known. Alterations in the genetic makeup can result in genetic mutations and can result in pituitary cancer.

What Are the Types of Pituitary Cancer?

The benign condition of the pituitary tumor is referred to as pituitary adenoma, and the malignant ones are referred to as pituitary carcinomas.

1. Pituitary Adenoma:

The pituitary adenomas are categorized into two types based on size:

• Microadenoma: Micradenomas are tiny tours that are less than one centimeter. They do not cause great damage to the nearby tissues. But alterations in the hormonal level will be seen.

• Macroadenoma: In macroadenoma, the tumor is more than one centimeter in size. Damages to the optic nerve are seen in this type of tumor.

The pituitary adenomas are further categorized into two types based on the functions. If the pituitary gland still functions by secreting the hormones, then it is known as a functional adenoma. If the complete loss of function of the gland is noted, it is called a non-functional adenoma.

• Functional Adenoma: The excess of hormone levels can be identified in blood examination. A severe change in symptoms are noted in functional adenoma.

• Non-Functional Adenoma: It is a very rare type, and it usually occurs as a macroadenoma.

2. Pituitary Carcinoma: In a microscopic examination, most of the pituitary carcinomas resemble pituitary adenoma. This type of pituitary cancer is very rare. It is usually found in older people. This cancer can spread to the spinal cord, brain, and bones that are found near the pituitary gland.

What Are the Symptoms of Pituitary Cancer?

The symptoms of pituitary cancer can happen due to the altered and increased level of pressure created by the tumor. The common symptoms experienced due to the pressure changes are loss of vision and headache. The symptoms can happen due to the imbalance in the hormonal levels also.

If there is a deficiency of pituitary hormones, the following symptoms could be noted.

• Weakness.

• Nausea and vomiting.

• Unexplained weight gain or weight loss.

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• Irregular menstrual periods.

• Sensitivity to cold.

• Increased urinary output.

• Loss of libido and sexual functions.

If there is excessive production of pituitary hormones, abnormal symptoms could be noted.

Adrenocorticotropic hormones are altered due to the occurrence of tumors. They show the following tumors.

• Exaggerated facial roundness.

• Excessive accumulation of fat.

• High blood pressure.

• Thinning of the legs and arms with muscle weakness.

• Irritability.

• High blood sugar.

• Bone weakening.

• Anxiety and depression.

• Acne.

• Stretch marks.

• Bruising.

If the growth hormones are disturbed, the below symptoms are noted.

• Enlarged hands and feet.

• Abnormal facial features.

• Heart problems.

• Excess sweating.

• Misaligned teeth.

• Joint pain.

• Abnormally fast growth in children and adolescents.

• Increased body hair.

If the thyroid hormones are disturbed, the below symptoms are noted.

• Increase in a heartbeat.

• Weight loss.

• Excessive sweating.

• Abnormal bowel movements.

• Nervousness or irritability.

Symptoms are caused due to changes in the male and female hormones.

In women, the following symptoms are seen.

• Amenorrhea. Lack of menstrual periods

• Oligomenorrhea. Irregular menstrual periods

• Milky white discharge from the breasts

In men, the following symptoms are seen.

• Breast growth in men.

• Loss of sex drive.

• Reduced sperm count.

• Erectile dysfunction.

What Are the Risk Factors of Pituitary Cancer?

The risk factors associated with pituitary cancer are:

• Family history: Having a positive history in the family can elevate the risk for pituitary cancer.

• Multiple endocrine neoplasias, type IV (MEN4).

• Multiple endocrine neoplasias, type I (MEN1).

• Carney complex.

• McCune-Albright syndrome.

How Is Pituitary Cancer Diagnosed?

The problem with pituitary cancer is that in most cases, pituitary cancer are not precisely diagnosed. They are accidentally found on diagnosis for any other illness. A detailed history of the patient is required as the first process of diagnosis. After this, the clinical examination should be carried out by the doctor to find out abnormal symptoms. YOu will require help from an endocrinologist for an accurate diagnosis. The other diagnostic methods for detecting the cancer are:

• Imaging of the Brain: The brain can be diagnosed for any abnormalities such as tumors in the pituitary gland with the help of computer tomography (CT) scan or magnetic resonance imaging (MRI) scan.

• Routine Blood Examination: A blood test will be helpful in identifying the level of hormones present in the blood.

• Urine Test: The deficient level of hormones secreted by the pituitary gland can be identified by analyzing the quantity and composition of the urine.

• Vision Testing: The disturbances in the eyesight can be identified with the help of this test.

What Are the Treatment Options for Pituitary Cancer?

Treatment for pituitary cancer involves both medical and surgical options. Radiotherapy treatment might be recommended along with medications.

• Medications: Medications are given to shrink the tumors and block the excess level of hormones. The size of the tumor is reduced with the help of medications like Bromocriptine and Cabergoline. It also reduces the secretion of prolactin. To decrease the production of cortisol, Osilodrostat is recommended. Mifepristone is recommended for Cushing syndrome patients. Medications can be given in the form of injections to normalize the production of growth hormones. The excess of growth hormones can be controlled by the usage of drugs like pegvisomant.

• Radiation Therapy: There are four types of radiation therapy that can be used for the treatment of pituitary cancer. They are:

  • External beam radiation method.

  • Stereotactic radiosurgery.

  • Intensity-modulated radiation therapy (IMRT).

  • Proton beam therapy.

• Surgery: Different surgical treatment options for pituitary cancer are:

  • Craniotomy.

  • Endoscopic transnasal transsphenoidal approach.

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