Pituitary Disorders Program
The pituitary gland is a pea-sized organ located in the base of the brain. While small, it plays a large role in regulating key body functions, including:
- Growth and development
- Sexuality and reproductive function
- Stress response
- Overall quality of life
In fact, the pituitary gland is sometimes referred to as the master gland, since the hormones it produces control other glands in the body’s endocrine system. The pituitary gland also sits near important intracranial nerves and blood vessels. As a result, when the pituitary gland isn’t functioning properly, it can cause a wide range of hormonal and neurological symptoms. Pituitary tumors are the most common cause of pituitary disorders.
Pituitary tumors, also known as adenomas, are typically slow growing and typically benign (non-cancerous). There are two types:
- Secretory adenomas: These produce too much of a pituitary hormone. The specific treatment will depend on the pituitary condition that is caused by the tumor.
- Non-secretory adenomas: These do not produce hormones but may affect the function of the pituitary gland and may cause loss of vision as they enlarge. Treatment may include observation when the tumor is small. However, when the tumor becomes larger, surgery may be recommended, followed by radiation therapy in some cases.
Pituitary disorder diagnosis
To diagnose a pituitary condition, your endocrinologist first reviews your medical history and performs a physical examination. After that, your physician may order additional tests, including:
- Blood tests to measure hormone concentrations
- CT or MRI to image your pituitary gland
- An eye examination
Expert, multidisciplinary treatment
The Henry Ford Pituitary Disorders Program is led by the Division of Endocrinology. Our endocrinologists are experienced in the diagnosis and management of all pituitary conditions.
For pituitary disorders not caused by a tumor: Treatment typically consists of medication.
When the diagnosis is a tumor: Treatment may include medication. But when the tumor is large or it is a secretory adenoma, multidisciplinary treatment – including radiation therapy or surgery – may be recommended. In these cases, our endocrinologists collaborate with the Henry Ford Skull Base, Pituitary and Endoscopy Center [Link: https://www.henryford.com/services/nasal-skull-base-pituitary-tumors/treatments] to provide coordinated care, as necessary. This team features specialists from Endocrinology and other Henry Ford Medical Group experts, including:
- Radiation therapists
Treatment for specific pituitary disorders
- Cushing’s disease is a pituitary condition produced by a tumor that secretes excessive amounts of adrenocorticotropic hormone.
- This hormone stimulates the adrenal gland, producing excessive amounts of cortisol.
- Surgery to remove the tumor is generally recommended. Medications and radiation therapy are alternative treatments.
- Other tumors or conditions also may lead to excess secretion of cortisol, such as tumors of the adrenal gland and lung, but in these cases the condition is called Cushing’s syndrome.
- If left untreated, both Cushing’s disease and Cushing’s syndrome can seriously affect quality and length of life.
- Acromegaly is a pituitary disorder caused by excessive secretion of growth hormone from a pituitary adenoma during childhood, resulting in a very tall person (i.e., a giant).
- If left untreated, acromegaly will negatively affect quality and length of life.
- Two medications (Parlodel and Octreotide) may be effective.
- Surgery, medications before and/or after surgical treatment, and/or radiation therapy may be recommended.
- This pituitary condition can affect both women and men.
- In women, excessive amounts of prolactin may disturb the regularity of the menstrual cycle and sometimes produce milk from the breast.
- In men, most symptoms result from tumor growth, which can affect vision. Excessive prolactin secretion may also cause disturbed sexual function.
- Over-secretion of prolactin does not carry the significant medical risks seen with other pituitary disorders such as Cushing’s disease and acromegaly.
- In young women who wish to become pregnant, treatment may be required to restore the menstrual cycle.
- The drug Parlodel can be very effective in reversing the symptoms of over-secretion of prolactin and in shrinking the tumor.
- A newer drug (Dostinex) seems to have low incidence of side effects.
- Because drug therapy is now the treatment of choice for prolactin-secreting adenomas, surgery typically is not recommended.
- These are benign and only require treatment if they become larger and pose a risk of visual loss.
- Typically, a minimally invasive procedure known as transsphenoidal microsurgery is recommended for this pituitary condition.
- Transsphenoidal means “through the sphenoid sinus.” This procedure uses the natural openings of the nose and the sphenoid sinus (located behind the eyes) to access and remove the cyst.
Empty sella syndrome
- This is not a disease but rather an anatomical description of the pocket (the sella) in which the pituitary gland lies.
- In empty sella, the pituitary gland has shrunk or become flattened in the sella.
- MRI and CT scans can detect this.
- There may be several causes for the empty sella, and in rare instances it may be associated with cerebrospinal fluid (CSF) leakage.
- If CSF leakage is present, treatment with transsphenoidal surgery may be necessary to seal the leak.
Infections and inflammatory conditions
- In rare instances, infections or inflammatory pituitary conditions may occur.
- Treatment depends on the specific case.
Non-pituitary tumors in the sella
- Most pituitary gland tumors will be adenomas, but in rare cases other tumors may be found in or involving the gland.
- MRI greatly assists in distinguishing these lesions from the common pituitary tumor.