News of a pituitary abnormality sounds scary. Helpful information is here from an endocrinologist.
“Pituitary tumor.” Your imaging showed an abnormality and you’re wondering what’s next.
First of all, it’s important to know that these kinds of abnormalities are common and may not require any medical or surgical treatment. In other cases, people who have a pituitary abnormality are referred to a specialist for a detailed evaluation.
The pituitary is a tiny gland under the brain. It controls many of the body’s other glands, so it’s sometimes called the “master gland.”
“One important statistic is that up to 20 percent of people have an abnormality in their pituitary gland,” said Dr. Andrea Utz, an endocrinology specialist with Vanderbilt Health and the director of Vanderbilt’s Pituitary Center. “Almost all of them are small abnormalities, less than 10 millimeters (the size of a pea), that do not make extra hormone or cause gland dysfunction. Most of these do not require any treatment.”
Of course, there are exceptions: Some abnormalities may be large enough to press on important structures around the pituitary, like the nerves to the eyes. Some may affect the levels of pituitary hormones in the body. The specialist’s job is to help determine what kind of abnormality you have, and whether it needs treating.
Here is what you need to know before your first appointment with a pituitary specialist.
A pituitary abnormality is not a brain tumor.
“I devote the first several minutes with any new patient to trying to allay fear,” Utz said. “The first thing that is important to know is that very rarely do abnormalities within the pituitary indicate a cancer — they are almost always benign. Secondly, the pituitary gland is a gland within your head that is below your brain. It is not actually part of your brain, so a patient does not have a brain tumor, they have a gland tumor.”
Most pituitary gland tumors are non-functioning.
This means that the abnormality does not produce extra hormone. Those that are less than 10 millimeters in size are small enough to not cause any symptoms, and do not require any intervention other than possibly some follow-up imaging to be sure there is no significant change in size.
Some large non-functioning pituitary abnormalities cause a decline in vision and can lower some pituitary hormone levels. Many of these will need treatment. Lab testing is used to decide if surgery or medicine is the best treatment.
Pituitary gland tumors are rarely the cause of headaches.
While headaches are a common reason for MRIs to be ordered, pituitary abnormalities are rarely the cause of headaches, especially if they are small.
Blood and other lab testing will be required to evaluate your abnormality.
“I typically have three questions to answer for patients who have been diagnosed with a pituitary tumor,” Utz said:
- Do they have an abnormality large enough to put pressure on the important structures around it, such as the eye nerves?
- Is there any indication that the problem is causing too much pituitary hormone?
- Is there any evidence that the abnormality is preventing the pituitary gland from making its normal hormones?
Specialists usually address these questions through blood testing, though sometimes additional urine or saliva testing is needed. The doctor uses the results of these tests to determine whether to treat someone’s pituitary tumor, and how to treat it.
If your test results indicate need for treatment, you will need a coordinated plan of care.
If yours is a functioning tumor or is a large abnormality, treatment may be necessary. If the abnormality is a prolactinoma (a non-cancerous pituitary tumor that produces too much hormone), it will likely be treated with medication. All other functioning or large tumors are usually treated first with surgery.
If surgery is recommended, it is best to find a pituitary center that coordinates care between endocrinology and neurosurgery, Utz said. “At Vanderbilt Health, a new patient is scheduled to see these specialists usually the same day,” she explained. “We meet and discuss every patient who comes to the pituitary clinic and then together we make a plan to ensure care is as smooth and coordinated as possible.”
Pituitary disorders can disrupt the regulation of many hormone systems in the body, which can affect your health in many ways. Vanderbilt’s Pituitary Center provides comprehensive, long-term treatment and care for adults with pituitary disorders.
