Pituitary tumor

What is pituitary tumor?

The pituitary gland is a pea-sized gland at the base of the brain that produces hormones involved in growth, metabolism, reproduction, and the body's response to stress. A pituitary tumour is an abnormal growth arising from the pituitary gland. Most pituitary tumours are benign adenomas rather than cancerous growths. Doctors classify pituitary adenomas according to their size and whether they produce excess hormones:

By size

• Microadenoma (under 10 mm): small tumours that may produce excess hormones, although many cause no symptoms and are discovered incidentally.

• Macroadenoma (10 mm or larger): larger growths that can squeeze the surrounding brain tissue, normal gland parts, or eye nerves.

By hormonal activity

• Non-functioning: does not produce excess pituitary hormones and may cause symptoms mainly when it becomes large enough to affect nearby structures.

• Prolactinoma: the most common type. It leaks excess prolactin, causing low sex drive, erectile dysfunction, or irregular periods.

• Somatotroph: leaks growth hormone, causing parts of the body, like hands, feet, and face features, to enlarge.

• Corticotroph: leaks the stress-signal hormone ACTH, triggering Cushing’s disease (weight gain, high blood pressure, and muscle weakness).

• Thyrotroph and gonadotroph: rare types that leak thyroid-stimulating or reproductive hormones, though they often cause no hormone symptoms at all.

Symptoms of pituitary tumor

Symptoms depend on whether the tumour produces excess hormones and whether it grows large enough to affect nearby structures.

From hormonal excess

• Prolactinoma: irregular or absent periods, milky nipple discharge, reduced libido, infertility, erectile dysfunction, and breast enlargement in men

• Acromegaly (somatotroph adenoma): gradual enlargement of the hands, feet, and facial features, joint pain, excessive sweating, and carpal tunnel syndrome

• Cushing's disease (corticotroph adenoma): produces excess ACTH, which can cause Cushing's disease. Symptoms may include central weight gain, a round face, purple stretch marks, easy bruising, muscle weakness, high blood pressure, and diabetes

• Thyrotroph adenoma: symptoms of hyperthyroidism including weight loss, palpitations, and heat intolerance

From mass effect

• Headaches

• Bitemporal hemianopia, loss of peripheral vision on both sides, from optic chiasm compression

• Double vision from cranial nerve compression in the cavernous sinus

• Hypopituitarism, deficiency of one or more pituitary hormones from compression of normal pituitary tissue

What causes pituitary tumor?

The exact cause is not fully understood in most cases. Contributing factors include:

• Genetic changes and inherited syndromes: acquired genetic changes in pituitary cells may contribute to sporadic adenomas. Inherited conditions such as multiple endocrine neoplasia type 1 (MEN1), familial isolated pituitary adenoma (FIPA), and Carney complex can increase the risk of developing pituitary adenomas. FIPA can be associated with mutations in the AIP gene.

• Age: pituitary adenomas become more common with age, though they can occur at any age.

• Gender: some types, particularly prolactinomas, are more common in women, especially during the reproductive years.

Pituitary tumours are evaluated using a combination of dedicated pituitary MRI, hormonal blood tests, and clinical assessment.

Brain MRI Elfcare’s full-body MRI can visualise the pituitary gland and identify larger pituitary lesions. Dedicated pituitary MRI provides the highest level of detail for characterising small adenomas and their relationship to nearby structures.

Blood tests assess the pituitary hormonal axis, identifying both hormonal excess from functioning adenomas and hormonal deficiency from compression of normal pituitary tissue. Relevant markers in Elfcare's panel include:

• Prolactin: high levels find the most common hormone-leaking tumor, which can impact fertility and sex drive.

• IGF-1: acts as a stable marker to detect hidden growth hormone overproduction.

• Cortisol: helps assess adrenal function when pituitary dysfunction or cortisol excess is suspected.

• Thyroid panel (TSH, Free T3, Free T4): catches thyroid hormone imbalances caused by a direct tumor or gland compression.

• LH, FSH, testosterone and oestradiol: checks for drops in reproductive and sex hormones caused by tumor pressure.

• Sodium: screens for fluid control imbalances caused by pressure on the back part of the gland.

Why early detection matters

Finding a pituitary tumor early opens up the best treatment options and outcomes before permanent damage occurs. Some pituitary tumours, particularly prolactinomas, can be effectively treated with medication. Others may be monitored or require surgery, radiation therapy, or other specialist treatment depending on their size, hormonal activity, growth, and effect on surrounding structures. Prompt treatment of optic chiasm compression can improve the chance of recovering or preserving vision, although recovery depends on the severity and duration of compression.

How Elfcare can help

Elfcare's full body MRI images the pituitary gland directly as part of standard brain imaging, identifying pituitary adenomas and characterising their size, location, and relationship to adjacent structures. Our blood panel covers the pituitary hormonal axis including prolactin, IGF-1, cortisol, TSH, thyroid hormones, LH, FSH, and sex hormones, providing complementary structural and hormonal information that can help identify abnormalities requiring further evaluation.

The combination of imaging and hormonal testing can provide useful information when symptoms or other findings raise concern about pituitary dysfunction. Suspected pituitary abnormalities may require dedicated pituitary MRI and specialist endocrine assessment.