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    Pituitary Tumors Treatment (PDQ®): Treatment - Health Professional Information [NCI] - General Information About Pituitary Tumors

    Pituitary tumors represent from 10% to 25% of all intracranial neoplasms. Depending on the study cited, pituitary tumors can be classified into three groups according to their biological behavior:[1,2]

    • Benign adenoma.
    • Invasive adenoma.
    • Carcinoma.

    Adenomas comprise the largest portion of pituitary neoplasms with an overall estimated prevalence of approximately 17%. Only a minority of adenomas are symptomatic.[3] In addition, pituitary adenomas may be distinguished anatomically as intrapituitary, intrasellar, diffuse, and invasive.[4] Invasive adenomas, which account for approximately 35% of all pituitary neoplasms, may invade the dura mater, cranial bone, or sphenoid sinus.[5] Carcinomas account for 0.1% to 0.2% of all pituitary tumors.[6,7]

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    Clinical Presentation

    The most characteristic-presenting features of pituitary adenomas include inappropriate pituitary hormone secretion and visual field deficits.[8]

    Rare signs and symptoms of pituitary disease include:[8]

    • Cranial nerve palsies.
    • Temporal lobe epilepsy.
    • Hydrocephalus.
    • Cerebrospinal fluid rhinorrhea.

    The signs and symptoms commonly associated with pituitary tumors derived from each specific cell type (i.e., prolactinomas, corticotroph adenomas, somatotroph adenomas, thyrotroph adenomas, and nonfunctioning adenomas) are as follows:

    Prolactin-producing pituitary tumors

    Signs and symptoms of prolactin (PRL)-producing pituitary tumors, also known as prolactinomas and lactotroph adenomas, may include:[8]

    • Headache. (Refer to the PDQ summary on Pain for more information.)
    • Visual field deficits.
    • Oligomenorrhea or amenorrhea.
    • Reduced fertility. (Refer to the Fertility Issues section in the PDQ summary on Sexuality and Reproductive Issues for more information.)
    • Loss of libido. (Refer to the Treatment-related Factors Secondary to Radiation section in the Factors Affecting Sexual Function in People With Cancer section and the Selective Serotonin Reuptake Inhibitors section in the Pharmacological Effects of Supportive Care Medications on Sexual Function section of the PDQ summary on Sexuality and Reproductive Issues for more information.)
    • Erectile dysfunction.
    • Galactorrhea in the estrogen-primed female breast.

    Adrenocorticotrophic hormone-producing pituitary tumors

    Signs and symptoms of adrenocorticotrophic hormone (ACTH)-producing pituitary tumors, also known as corticotroph adenomas, may include:[8]

    • Headache. (Refer to the PDQ summary on Pain for more information.)
    • Visual field deficits.
    • Proximal myopathy.
    • Centripetal fat distribution.
    • Neuropsychiatric symptoms. (Refer to the PDQ summary on Adjustment to Cancer: Anxiety and Distress and the Symptoms and Risk Factors section in the Assessment and Diagnosis section of the PDQ summary on Depression for more information.)
    • Striae.
    • Ability to easily bruise.
    • Skin thinning.
    • Hirsutism.
    • Osteopenia.
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