Pituitary Adenoma

Pituitary Adenoma Treatments in Orange County

Pituitary Adenoma Treatments in Orange County by Dr. LouisPituitary adenoma is uncommon, and non-cancerous. It is a benign tumor that develops on the pituitary gland, found inside the skull just above the nasal passages. Pituitary cancers are called pituitary carcinomas, and are extremely rare. Pituitary adenomas are classified according to size:

Microadenomas- are tumors that are smaller than one centimeter across. They rarely press on other tissue, but they can cause symptoms if they release too much of a certain hormone into the bloodstream.

Macroadenomas- are larger than one centimeter across. Macroadenomas can also affect hormone production and they are large enough to press on nearby tissue or nerves, causing damage.

Most pituitary adenomas are not inherited and develop spontaneously. The pituitary gland is composed of different types of hormone producing pituitary cells that gets released into the bloodstream, affecting other organs in the body. Pituitary adenomas arise from one of these specialized cells. Tumor cells that cause overproduction of hormones is called functional adenoma. Functional adenomas include:

Prolactinoma- a tumor that overproduces prolactin
Acromegaly- caused by an excess growth hormone
Cushing’s disease- caused by a pituitary tumor stimulating an overproduction of cortisol

Symptoms of pituitary adenoma depends upon several factors, including whether the tumors are hormone-producing or clinically nonfunctioning. Not all adenomas exhibit symptoms, therefore it can be difficult to diagnose early. Non-functional or functioning pituitary adenomas often grow until they become macroadenomas, which can press on surrounding tissues and nerves, and affect hormone function. The following symptoms may be experienced by patients with pituitary adenomas:

Symptoms of overproduction of hormones:

  • Prolactinoma
  • Acromegaly
  • Hyperthyroidism

 

Symptoms related to macroadenoma

  • Vision loss
  • Loss of the outer peripheral vision
  • Loss of visual acuity (blurry vision)
  • Colors not perceived as bright as usual
  • Loss of pituitary function

 

Symptoms for pituitary insufficiency

  • Hypopituitarism
  • Reduction of sex hormones
  • Low testosterone level for men
  • Decreased sexual drive and impotence
  • Loss of body and facial hair
  • Infertility for women
  • Loss of menstrual periods
  • Hypothyroidism
  • Death can occur in severe case
  • Stunted growth and delayed puberty for children
  • Tiredness, loss of muscle mass and tone
  • Headache

Pituitary adenoma may be suspected based on symptoms. Robert Louis, MD will conduct thorough medical history, and physical findings. Explaining your symptoms is a crucial part of diagnosing pituitary adenoma, as your information is used to determine whether a pituitary tumor is secreting excess hormones and if there is evidence of pituitary insufficiency. Standard diagnostic tests for pituitary adenoma include:

To diagnose pituitary adenoma, Robert Louis, MD, who has the experience and training in diagnosing acromegaly, will conduct thorough medical history, and physical test for existence of acromegaly in patients. Standard diagnostic tests include:

  • Hormone testing
  • Oral glucose tolerance test
  • Magnetic resonance imaging

 

Hormone testing: Dr. Louis will order blood tests to specifically look for an elevated level of IGF-1. In premenopausal women, the GH levels can be high even though the IGF-1 levels are normal,an estrogen-resistant phenomenon.

Magnetic resonance imaging (MRI): This is the preferred way to detect acromegaly, using special MRI pituitary protocol to properly visualize the piuitary tumor.

Pituitary adenoma treatment will depend on multiple factors, including size and location of the tumor, age and overall health condition of the patient. Surgical removal of pituitary adenoma is the best chance for a cure. If the tumor invaded surrounding tissues, however, there is a lower chance of a surgical cure. In that case, you may be recommended to undergo other treatment options, such as medication or radiation therapy. Treatment options for pituitary adenoma include:

Minimally Invasive Endoscopic Transsphenoidal Surgery
Orange County neurosurgeon Robert Louis, MD, specializes in minimally invasive endoscopic transsphenoidal surgery for removal of pituitary adenoma. This sophisticated procedure removes the tumor while minimizing complications, hospital time, trauma and discomfort. Dr, Louis has the specialized skills and training with this advanced technique. Read more about Endoscopic Transsphenoidal Surgery.

Medication-
Sometimes use of medication, and not surgery, may be the best initial course of treatment. However, in most cases, patients require a combination of medical and surgical treatment remove pituitary adenoma. Medications are prescribed to help normalize or suppress growth hormone production and address symptoms of soft tissue swelling, headache and other symptoms.

Radiation therapy-
Radiation therapy for pituitary adenoma is recommended for some patients when surgery and medication are not sufficient to control the tumor. Radiation therapy involves highly focused dose of radiation to the tumor. It takes an average of 18 months to lower the GH and IGF-1 levels. Continued long-term follow-up with an endocrinologist is recommended after radio therapy for pituitary adenoma.

Robert Louis, MD, a fellowship-trained Orange County Neurosurgeon, is the Director of the Skull Base and Pituitary Tumor Program at Hoag Memorial Hospital in Orange County, California. Dr. Louis has particular expertise in endoscopic and minimally invasive treatment of benign and malignant brain tumors, sellar and parasellar tumors and skull base tumors.

Dr. Robert Louis specializes in minimally invasive endoscopic transsphenoidal surgery for the removal of pituitary tumors. For appointments, please call (949) 274-7336 or Contact Us.