Pituitary Tumours

Pituitary tumours are usually benign (non cancerous) tumours that arise from a small gland located at the base of the brain.

The pituitary gland is involved in hormone production and also sends messages to other glands in the body like the thyroid to release their hormones.

The optic nerves come together a short distance above the tumour in a structure called the optic chiasm.

Pituitary tumours (at least small ones) are not uncommon and presumably many of them never grow enough to cause problems.

Symptoms

These tumours may be discovered incidentally or they may cause symptoms in one of three main ways.

  1. “Mass effect” – this means pressure on nearby structures which can cause visual loss if the optic nerves are affected
  2. Reduced hormone production by the rest of the pituitary gland (“hypopituitarism”)
  3. Over secretion of a hormone- the three most common are:
  • Prolactinoma – oversecretion of prolactin which can cause milk production from the nipples and affects the menstrual cycle
  • Acromegaly – oversecretion of growth hormone
  • Cushing’s Disease – oversecretion of ACTH which causes the adrenal glands to make too much cortisone

Treatments

Observation may be appropriate for small tumours not causing excessive hormone secretion or compressing the optic nerves.

Medical therapy can be given and is usually the first option for ‘prolactinomas’ but is not usually possible or the first choice for other pituitary tumours.

Surgery – see below

Stereotactic radiosurgery or radiotherapy – this involves targeted focal treatment of the pituitary tumour often by a high single dose of radiation, performed only at specialised centres. Dr Jonker is highly experienced at this treatment and does this at the Chris O’Brien Lifehouse at RPAH using the Novalis Tx linear accelerator.

Surgery

Most pituitary operations can successfully be performed through the nose and sinuses with an endocope (camera). This operation is performed by a specialised ENT surgeon and neurosurgeon.

Occasionally the tumour is removed by an opening in the top of the skull (craniotomy)

Complications of treatment

A detailed discussion with the neurosurgeon is necessary as the risks vary from case to case.

  More about Brain Tumour Surgery

 

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