Pituitary Disorders - Overview

The pituitary is a small, bean-sized gland that sits at the base of brain, below the nerves to the eyes. It is connected by a thread-like stalk to the hypothalamus. It controls a system of hormones in the body that regulate growth, metabolism, the stress response, and functions of the sex organs via the thyroid gland, adrenal gland, ovaries, and testes. A pituitary tumor is an abnormal growth of cells within the pituitary gland.

Most pituitary tumors are benign, which means they are non-cancerous, grow slowly and do not spread to other parts of the body; however they can make the pituitary gland produce either too many or too few hormones, which can cause problems in the body. Tumors that make hormones are called functioning tumors, and they can cause a wide array of symptoms depending upon the hormone affected.

Tumors that don’t make hormones are called non-functioning tumors. Their symptoms are directly related to their growth in size may include headaches, vision problems, nausea, and vomiting. Diseases related to hormone abnormalities include Cushing’s disease, in which fat builds up in the face, back and chest, and the arms and legs become very thin; and acromegaly, a condition in which the hands, feet, and face are larger than normal.

Pituitary hormones that impact the sex hormones, such as estrogen and testosterone, can make a woman produce breast milk even though she is not pregnant or nursing, or cause a man to lose his sex drive or lower his sperm count. Pituitary tumors often go undiagnosed because their symptoms resemble those of so many other more common diseases.

Is there any treatment?
Generally, treatment depends on the type of tumor, the size of the tumor, whether the tumor has invaded or pressed on surrounding structures, such as the brain and visual pathways, and the individual’s age and overall health. Three types of treatment are used: surgical removal of the tumor; radiation therapy, in which high-dose x-rays are used to kill the tumor cells; and drug therapy to shrink or destroy the tumor.

Medications are also sometimes used to block the tumor from overproducing hormones. For some people, removing the tumor will also stop the pituitary’s ability to produce a specific hormone. These individuals will have to take synthetic hormones to replace the ones their pituitary gland no longer produces.

What is the prognosis?
If diagnosed early enough, the prognosis is usually excellent. If diagnosis is delayed, even a non-functioning tumor can cause problems if it grows large enough to press on the optic nerves or the brain. Early diagnosis and treatment is the key to a good prognosis.

Why UAB?
The UAB Pituitary Disorders Clinic provides comprehensive evaluation and treatment for patients with pituitary tumors, pituitary hormone abnormalities, growth and development problems, and related disorders. The UAB Pituitary Disorders Clinic is the only multidisciplinary clinic in the state, combining experts in the fields of neurosurgery, endocrinology, ear, nose, and throat surgery, radiation oncology, neuro-ophthalmology, neuropathology, diagnostic and interventional neuroradiology, and more. Our specialists work together to create treatment plans specific to each of our patients’ unique needs utilizing the most novel and effective treatments available.

UAB ranks in the top 20 in the country for the number of surgical cases we treat, which means that our team’s experience is extensive. For more than seven years, UAB has offered minimally invasive endoscopic approaches for pituitary tumors, allowing our patients to avoid more intrusive surgeries.
UAB is committed to improving the field of pituitary tumor care by conducting research in pituitary disorders and providing residency and continuing education for up-and-coming pituitary and neuroendocrine specialists.

The Pituitary Disorders Clinic is under the umbrella of UAB Neurosciences, a combination of the Division of Neurosurgery and the Department of Neurology. We offer 14 distinct services with specialized evaluations and treatments for conditions including stroke, epilepsy, movement and spinal disorders, and more. Our treatments include computer-assisted neurosurgery, vascular neurosurgery, neuroimmunology and nuclear imaging, among others. UAB Hospital houses a state-of-the-art 60-bed neurology/neurosurgery nursing unit, a 21-bed neuro-intensive care unit, a neuroimaging unit, and a seven-bed seizure monitoring unit.