Pituitary Tumors

UT Southwestern Medical Center has one of the highest-volume pituitary tumor programs in Texas. Our neurosurgeons evaluate hundreds of patients with pituitary tumors annually, and, with the help of colleagues in the Department of Otolaryngology (Ear, Nose, and Throat Surgery), we surgically remove more than 50 pituitary tumors each year.

Our Neurological Surgery specialists are supported by a large team of physicians and nurses equally experienced in the management of pituitary disorders. 

About Pituitary Tumors

The pituitary gland is a small, rounded structure, normally the size of a kidney bean, located in a depression below the brain, in the center of the skull base. The gland is joined to the brain by a slender stalk, similar in size to that of a cherry connecting it to the branch of a cherry tree. The brain uses this stalk to communicate with the pituitary gland and control many of the body's hormones.   

Pituitary tumors of all sizes can cause problems by interfering with the regulation of hormone production. The two optic nerves join the brain just above the pituitary gland, and, for that reason, vision can also be affected by tumors in this region. Evaluation of a patient with a pituitary tumor is a complex process and usually involves an endocrinologist to evaluate hormone function, an ophthalmologist to evaluate vision, and a neurosurgeon to evaluate the possible benefit of surgery.

Many tumors that involve the pituitary gland are benign, which means they won’t spread to the rest of the body and can often be completely removed by an experienced team of surgeons, leaving the patient cured.

Types of Pituitary Tumors

Types of pituitary tumors include:

• Pituitary adenomas: These benign tumors arise from hormone-producing cells within the pituitary gland. The majority of these tumors do not produce functioning hormones, and, when small, they are usually observed with MRI scans and not treated.

• Craniopharyngiomas: These rare, slow-growing tumors arise from cells around the pituitary stalk and are found in patients of all ages. These tumors can produce problems with vision or hormone function, and, in some cases, they interfere with memory.
  

  Craniopharyngiomas often grow in an invasive manner and can reach a large size before discovery. As a result, a complete surgical removal is often not possible. The goal of decision-making for tumors that cannot be completely removed is to control any remaining tumor with the lowest possible risk.

• Pituitary cysts: Pituitary cysts are a number of benign, fluid-filled cysts that can arise within or next to the pituitary gland. Many of these cysts are discovered by chance on MRI scans taken to evaluate unrelated problems, such as headaches. When the cysts are small, they are monitored but not immediately treated.  

Treating Pituitary Tumors 

The treatment decisions for pituitary tumors depend on the type, size, and individual needs of each patient. 

Medical Treatment

The treatment decisions for pituitary tumors depend on the type, size, and individual needs of each patient. 

Many pituitary tumors do not require surgery. Pituitary tumors that produce a hormone known as prolactin can be treated with medicines that inhibit prolactin secretion and shrink the tumor.

Small pituitary tumors discovered on MRI scans taken to evaluate unrelated problems, such as headaches, are usually monitored but not treated unless they have shown signs of growth or of producing abnormal hormone function. 

Minimally Invasive Surgery

We can remove most pituitary tumors through the nose with minimally invasive techniques, using either a surgical microscope or an endoscope.

All transnasal procedures at UT Southwestern are performed by an experienced team consisting of an ENT (ear, nose, and throat) surgeon and a neurosurgeon, working together.

Radiation Therapy

Patients with pituitary tumors that cannot be completely removed, or that begin to grow back after an apparently complete removal, might benefit from treatment with radiation therapy.

Because the brain structures near the pituitary gland are important for vision and memory, radiation treatments should be focused as tightly as possible within the tumor to minimize the dose of radiation received by these nearby structures.

UT Southwestern offers the most accurate radiation delivery technology available. We have the only Gamma Knife in the Dallas–Ft. Worth Metroplex, and, whenever possible, we use this device to treat recurrent or residual tumors in one day on an outpatient basis.

For tumors that cannot be removed because of their size or proximity to the optic nerves, we use the CyberKnife, a robotic device that maintains accurate radiation delivery for treatments that are delivered in divided doses, over several days or weeks. Our radiation oncologists and neurosurgeons work together to develop a highly individualized treatment plan.