1. Pituitary tumor
STEPHANIE BRESLIN
Figure 1 JACLYN LAND Figure 2
ASHTI PARAY

2. What is a Pituitary tumor?
 The pituitary gland is a pea sized endocrine
gland located at the base of the brain.
 A pituitary Tumor is caused by an abnormal
growth in the pituitary gland.
 The tumor is benign and most people are
unaware they have it because there are very
little symptoms.
 The hormone releasing cells of the pituitary
gland can be damaged.

3. The symptoms can be:
 Headache
 Lethargy: weariness, lack of energy
 Nasal Drainage
 Nausea and vomiting
 Problems with the sense of smell
 Visual changes such as
-Double vision
-Drooping eyelids
-Visual field loss Figure 3
 These symptoms may occur suddenly and can be very
severe.

4. The symptoms can lead to:
 Hyperthyroidism: a condition in the thyroid gland that
produces to much thyroid hormone.
 Crushing syndrome: When your body is exposed to high
levels of the hormone cortisol.
 Gigantism: abnormal large growth due to excess of the
growth hormone during childhood.
 Nipple discharge: tenderness, skin changes, changes in
shape or discharge from the nipple portion of the breast.
Figure 4 Figure 5

5. Treatments can include:
 Surgery especially if the tumor is pressing on the optic
nerves.
 Can be removed through the nose or sinuses.
 If it doesn’t work through the nose or sinuses it will have to
be removed through the skull.
 Radiation therapy can be used to shrink the tumor.
- It can be used for people who cannot be put through
surgery.
Figure 6 Figure 7

6. Medications:
 These medications can also shrink the tumors:
• Bromocriptine is the first line therapy for tumors
that release prolactin. With this dug it decreases
the prolactin and shrinks the tumor.
• Octreotide is used for tumors that release growth
hormone but only used when surgery cant be
curable.
 Bromocriptine is used to treat symptoms of high levels of a natural
substance called prolactin in the body

7. Medication Images
Figure 8
Figure 9 Figure 10
•Cabergoline •Octreotide

8. Complications:
 If the optic nerve has serious
damage you can go blind.
 The tumor removal may cause
permanent hormone imbalances.
 The affected hormones may need to
be removed.

9. Exams and tests:
Physical Examinations and test will include:
 Cortisol levels
-Dexamethasone Suppression test: measures the response of the
adrenal glands to the ACTH.
-Urine Cortisol: measures the amount of the steroid hormone
cortisol in the urine
 Follicle-stimulating hormone levels: hormones
released by the anterior pituitary gland.
 Insulin growth factor-1 levels
 Luteinizing hormone levels: measures the amount of
luteinizing hormone

10. Exams and tests continued:
 Serum prolactin levels: measures the amount of
prolactin in the blood
 Testosterone/estradiol levels
 Thyroid hormone levels
-Free T4 test: hormone produced by the thyroid
gland. A laboratory test can be done to measure
the amount of T4 in your blood.
-TSH test: measures the amount of thyroid
stimulating hormone in your blood.

11. Random Facts:
 Can occur to people of all ages, most frequent in
children and older adults.
 Most common primary brain tumors consist of;
In ages 15-19, pilocytic astrocytomas followed by
pituitary tumors.
In ages 20-34, pituitary followed by meningioma
tumors.
 Pituitary tumors represent 8.4% of all primany brain
tumors.
 Most pituitary tumors are benign and called
adenomas.

12. Random Facts continued:
 Pituitary adenomas are relatively common, occurring
in 1 out of every 1000 adults.
 Pituitary adenomas have separate names based on
their size.
 A microadenoma is less then 1 centimeter in
diameter
 A macroadenoma is larger then 1 centimeter in size
 Adenomas remain confined to your pituitary gland or
surrounding tissues, and don’t spread to other parts of
your body.

13. QUIZ TIME!
QUIZ TIME
1. Explain what a pituitary tumor is?
2. Name 3 of the symptoms.
3. How can the tumor be removed?
4. If the _____ ______ has serious damage you can go blind.
5. How large is a macroadenoma?
*BONUS* : Pituitary tumors represent __% of all primary brain
tumors

14. Picture Resources:
 FIGURES 1 & 2-
http://www.google.com/imgres?q=pituitary+tumor&hl=en&gbv=2&biw=812&bih=374&tbm=isch&tbni
d=jl6Wh-U2vXNBnM:&imgrefurl=http://www.cedars-sinai.edu/Patients/Programs-and-
Services/Pituitary-Center/Diagnostic-Imaging/Pituitary-
MRIs.aspx&docid=XcMDFKUFo8ZZFM&imgurl=http://www.cedars-sinai.edu/Patients/Programs-and-
Services/Pituitary-Center/Diagnostic-Imaging/Images/coronalPit-MRI_rev_web-ready-
37301.jpg&w=466&h=432&ei=4CJJT_6kK5HDsQLuk_TqCA&zoom=1&iact=hc&vpx=69&vpy=21&dur=15
29&hovh=216&hovw=233&tx=133&ty=233&sig=111409954476902108896&page=3&tbnh=111&tbnw=
95&start=18&ndsp=15&ved=1t:429,r:0,s:18
 FIGURE 3- http://www.eyeptosis.com/
 FIGURE 4- medicinenet.com
 FIGURE 5- - http://www.netterimages.com/image/12845.htm
 FIGURE 6- http://healthlob.com/2011/05/radiation-therapy/
 FIGURE 7- Dizon, M. N. and D. L. Vesely. "Gonadotropin-secreting Pituitary Tumor Associated with
Hypersecretion of Testosterone and Hypogonadism After Hypophysectomy." Endocrinology Practice 3
(May-June 2002): 225–231
 FIGURES 8 & 9-http://www.emedicinehealth.com/drug-cabergoline/article_em.htm
 FIGURE 10- http://acromegaly.wordpress.com/2009/02/07/started-treatment-for-acromegaly/

15. Resources
 1. Melmed S, Kleinberg D. Anterior pituitary. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Williams Textbook of
Endocrinology. 11th ed. Philadelphia, PA: Saunders Elsevier; 2008:chap 8.

 2. 1. Biller BMK, Grossman AB, Stewart PM, et al. Treatment of adrenocorticotropin-dependent Cushing's syndrome: a consensus
statement. J Clin Endocrinol Metab. 2008;93:2454-2462.

 3. National endocrine and metabolic diseases information service. National Institutes of Health. NIH Publication No. 08-3007.
Cushing's Syndrome. http://endocrine.niddk.nih.gov/pubs/cushings/cushings.htm. Published July 2008. Accessed November 10,
2010.

 4. Pituitary tumors information page. National Institute of Neurological Disorders and Stroke.
http://www.ninds.nih.gov/disorders/pituitary_tumors/pituitary_tumors.htm. Accessed April 15, 2010.

 5. Pituitary tumors. American Cancer Society. http://documents.cancer.org/6028.00/6028.00.pdf. Accessed April 15, 2010.

 6. Pituitary tumors. American Brain Tumor Association. http://www.abta.org/Tumor_&_Treatment_Info/Pituitary_Tumors/233.
Accessed April 15, 2010.

 7. Pituitary Tumors Treatment. National Cancer Institute. http://www.cancer.gov/cancerinfo/pdq/treatment/pituitary. Accessed
April 15, 2010
 8. Ari S. Eckman, MD, Division of Endocrinology and Metabolism, Johns Hopkins School of Medicine, Baltimore, MD. Review
provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.