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

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Too much ACTH may cause:

  • Headache.
  • Some loss of vision.
  • Weight gain in the face, neck, and trunk of the body, and thin arms and legs.
  • A lump of fat on the back of the neck.
  • Thin skin that may have purple or pink stretch marks on the chest or abdomen.
  • Easy bruising.
  • Growth of fine hair on the face, upper back, or arms.
  • Bones that break easily.
  • Anxiety, irritability, and depression.

Too much growth hormone may cause:

  • Headache.
  • Some loss of vision.
  • In adults, acromegaly (growth of the bones in the face, hands, and feet). In children, the whole body may grow much taller and larger than normal.
  • Tingling or numbness in the hands and fingers.
  • Snoring or pauses in breathing during sleep.
  • Joint pain.
  • Sweating more than usual.
  • Dysmorphophobia (extreme dislike of or concern about one or more parts of the body).

Too much thyroid-stimulating hormone may cause:

  • Irregular heartbeat.
  • Shakiness.
  • Weight loss.
  • Trouble sleeping.
  • Frequent bowel movements.
  • Sweating.

Other general signs and symptoms of pituitary tumors:

  • Nausea and vomiting.
  • Confusion.
  • Dizziness.
  • Seizures.
  • Runny or "drippy" nose (cerebrospinal fluid that surrounds the brain and spinal cord leaks into the nose).

Imaging studies and tests that examine the blood and urine are used to detect (find) and diagnose a pituitary tumor.

The following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.
  • Eye exam: An exam to check vision and the general health of the eyes.
  • Visual field exam: An exam to check a person's field of vision (the total area in which objects can be seen). This test measures both central vision (how much a person can see when looking straight ahead) and peripheral vision (how much a person can see in all other directions while staring straight ahead). The eyes are tested one at a time. The eye not being tested is covered.
  • Neurological exam: A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a person's mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam.
  • MRI (magnetic resonance imaging) with gadolinium: A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the brain and spinal cord. A substance called gadolinium is injected into a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).
  • Blood chemistry study: A procedure in which a blood sample is checked to measure the amounts of certain substances, such as glucose (sugar), released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.
  • Blood tests: Tests to measure the levels of testosterone or estrogen in the blood. A higher or lower than normal amount of these hormones may be a sign of pituitary tumor.
  • Twenty-four-hour urine test: A test in which urine is collected for 24 hours to measure the amounts of certain substances. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it. A higher than normal amount of the hormone cortisol may be a sign of a pituitary tumor and Cushing syndrome.
  • High-dosedexamethasone suppression test: A test in which one or more high doses of dexamethasone are given. The level of cortisol is checked from a sample of blood or from urine that is collected for three days.
  • Low-dose dexamethasone suppression test: A test in which one or more small doses of dexamethasone are given. The level of cortisol is checked from a sample of blood or from urine that is collected for three days.
  • Venous sampling for pituitary tumors: A procedure in which a sample of blood is taken from veins coming from the pituitary gland. The sample is checked to measure the amount of ACTH released into the blood by the gland. Venous sampling may be done if blood tests show there is a tumor making ACTH, but the pituitary gland looks normal in the imaging tests.
  • Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.

    The following tests may be done on the sample of tissue that is removed:

    • Immunohistochemistry study: A laboratory test in which a substance such as an antibody, dye, or radioisotope is added to a sample of cancer tissue to test for certain antigens. This type of study is used to tell the difference between different types of cancer.
    • Immunocytochemistry study: A laboratory test in which a substance such as an antibody, dye, or radioisotope is added to a sample of cancer cells to test for certain antigens. This type of study is used to tell the difference between different types of cancer.
    • Light and electron microscopy: A laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.
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