The pituitary gland, located about three to four inches behind the nose, produces a number of different hormones important to the body's function.
Occasionally, the cells that produce the hormones can grow without control and form a tumor.
Pituitary gland tumors are generally benign, but if they are not treated, they can create multiple problems in the body and lead to diseases such as Cushing's disease, acromegaly, gigantism or prolactinoma.
Cushing's disease is the result of a tumor that is stimulating the production of cortisol, the stress hormone.
Symptoms of Cushing's include:
- Weight gain
- Rounded face appearance
- Development of a hump behind the back
- Purple stretch marks
- Bruising easily
- Muscle weakness
- Visual problems
Acromegaly and gigantism
An overproduction of growth hormone can cause a number of problems. If the tumor is in patients younger than 18, it can lead to gigantism. If the patient is over 18, it leads to acromegaly.
Acromegaly symptoms include:
- Vision problems
- Increased body hair
- Hard and thickened nails
- Change in glove size
- Change in shoe size
- Facial feature coarsening
- Swollen eyelids
- Back and joint pain
Gigantism symptoms include:
- Sudden increase in growth
- Enlarging of the head
- Exaggerated growth of the hands
- Exaggerated growth of the feet
- Coarsening of facial features
- Excessive sweating
Tumors that produce the hormone prolactin (the hormone that stimulates breast gland growth and milk production) can present with:
Changes in menstruation or fertility during reproductive years
- Menstrual cycle changes that include infrequent periods, no periods, or irregular cycles.
Galactorrhea, or milk production
Decreased estrogen leading to vaginal dryness
- Shrinking of testicles, which can lead to decreased libido, erectile dysfunction, or infertility
Men can also develop milk production from the breasts
Headache and visual loss can occur with any pituitary tumor
The latest approach to treating pituitary tumors is the endoscopic approach. Large incisions on the nose are no longer necessary.
Instead, we use a 4mm endoscope and pass it through the nose to open the sphenoid sinus (the sinus next to the pituitary gland). A computer is used to track the location of the endoscope.
Once the endoscope is in place, instruments are passed through the nostrils and the tumor is removed. This surgery takes about one to two hours.
Advantages of endoscopic approach
Some benefits of this minimally invasive, endoscopic approach may include:
Elimination of cosmetic problems caused by the tumor
No incisions on the nose or under the lip
Minimal postoperative pain or discomfort
- No need for placement of the head holder pins in the head
Shorter procedure duration
No need for a large retractor placed in the nose
Reduced likelihood of nose scarring
- No intraoperative radiation
- The ability to place an angled endoscope within the tumor cavity and to see areas behind ledges not always possible with the traditional approaches with a microscope
The endoscopic skull base surgeon works with the neurosurgeons at the UC Irvine Medical Center in the removal of pituitary tumors using the endoscopic approach. The minimally invasive approach and resection is done with the two surgeons working side by side.
This approach has become the best one in the treatment of these skull base disorders. The team involves a head and neck skull base surgeon (neurotologist or anterior skull base surgeon) and a skull base neurosurgeon. The combination of the two specialties allows for the best care for the patients.
The Skull Base Surgery Team at UC Irvine discusses the plan of treatment for the patients and plans for the best option for each particular patient. The team also reviews imaging studies for patients from outside of Southern California before their visit and accommodates these patients to give them the best possible and most efficient care.
To learn more, call 714-456-7017 or make an appointment online ›