Signs and Symptoms of Pituitary Tumors

Article originally published in the Summer 2019 Connections quarterly newsletter.

Advanced imaging is catching more pituitary tumors than ever before. Often these tumors — once thought to be rare — are found when a patient is being tested for something else. As many as one in four people may have pituitary adenomas without any symptoms. Most of these will be benign but will merit evaluation and monitoring. Other than these incidental findings, pituitary disorders are often challenging to diagnose, as many of the complaints are nonspecific or could arise from multiple pathologies.

Symptoms that raise suspicion of a pituitary tumor

Pituitary tumors and other pituitary disorders can have several signs, but most often fall into these categories:

  • Neurologic symptoms when a pituitary lesion is large (headaches, loss of peripheral vision, double vision)
  • Hormonal deficiencies (fatigue, unintentional weight change, nausea, hair loss, infrequent menstrual periods, excessive thirst and urination)
  • Hormonal overproduction (menstrual irregularities, milky breast discharge, fatigue, weight gain, hirsutism, enlargement of hands and feet, excessive sweating, purple stretch marks and bruising)

Initial pituitary disease diagnostic workup

While a preliminary diagnosis of pituitary disease can be challenging, an initial basic diagnostic workup for pituitary disease is straightforward and can be easily initiated if pituitary disease is suspected. Pituitary magnetic resonance imaging is performed if either a laboratory evaluation indicates the presence of pituitary disease or if a space-occupying lesion is suspected.
Owing to the nuances of pituitary disease, interpretation of a laboratory evaluation can be difficult. The OHSU neuroendocrinology consultation service can provide consultation before and after performing laboratory tests and arrange for more complex dynamic endocrine testing for comprehensive evaluation in specific cases.

Multidisciplinary approach to pituitary diseases

Multidisciplinary management of pituitary tumors in a pituitary center of excellence has been shown to improve both short and long term clinical outcomes.

The OHSU Pituitary Center treats more than 500 patients a year at a multidisciplinary clinic that teams neuroendocrinologists, neurosurgeons, neuro-ophthalmologists and others. We are available for urgent referrals and have several clinical trials underway. Our pituitary care team is committed to providing excellent patient care, contributing to knowledge about pituitary diseases and partnering with community doctors to care for patients.

Dr. Elena Varlamov is a neuroendocrinologist whose research interests include clinical outcomes of pituitary tumors, treatment of acromegaly, Cushing’s disease and growth hormone deficiency.