It’s only the size of a pea, but the pituitary gland is so important it’s often called the body’s master gland.
So when it doesn’t work right, big problems literally and figuratively arise.
Jim Pritchard knows if he doesn’t pay attention, his garden will grow out of control. The same could have happened with Pritchard’s health.
“If I had let it go too much longer, it could have pressed on the optic nerve and could have affected my eyesight,” he explains.
Pritchard went in for a routine doctor’s visit, where an enlarged thyroid was detected.
“There are patients that are missed for years and years because they didn’t present with very clear symptoms and nobody thought about the possibility of a pituitary tumor,” explains endocrinologist Maria Fleseriu, MD.
Specialists at Oregon Health and Science University did spot the tumor squeezing Pritchard’s pituitary gland and sent him to surgery.
“That was quite an experience, the operation itself, because they go up through the nose, grab hold of that tumor and collapse it,” Pritchard says.
Pituitary gland tumors are usually benign, but they can cause a host of problems that often show up as blurred or double vision, dizzy spells. They can develop into Cushing’s disease, or in the case of Pritchard, abnormal growth called acromegaly.
“Older data shows that the mortality can be increased up to four times for Cushing’s that’s not treated, and for acromegaly it’s usually doubled,” Fleseriu says.
With medication, Pritchard hasn’t had any significant health issues for the past eight years.
With acromegaly, people often don't notice symptoms until it is brought to their attention by comparing current and old photographs.
Some famous people who had the pituitary disorder include the wrestler Andre the Giant, Lurch from the Addams Family and Herman Munster from the Munsters, two TV comedies from the 1960s.
TOPIC: PITUITARY DISORDERS: ACROMEGALY
REPORT: MB #4261
BACKGROUND: The pituitary gland is a small gland located near the brain. This gland is often referred to as the “master endocrine gland” because it releases hormones that affect many bodily functions. A tumor begins when healthy cells change and grow out of control, and a pituitary gland tumor can be cancerous or benign. Most often, pituitary gland tumors are noncancerous growths, but they can also be dangerous and cause many problems. While some people with a pituitary gland tumor exhibit no symptoms, others will have signs such as headaches, peripheral vision loss, abnormal menstrual cycles in women, lactation without pregnancy, irritability, fatigue, Cushing’s disease (a combination of weight gain, high blood pressure, diabetes, and easy bruising), and Acromegaly (the enlargement of the extremities or limbs and thickening of the skull and jaw caused by too much growth hormone). A pituitary gland tumor is usually identified by its size and can be a microadenoma, meaning it is 10 millimeters or less, or a macroadenoma, which is larger than 10 mm at its widest point.
TREATMENT: While many pituitary gland tumors do not require treatment, others may require a team of medical experts including a neurosurgeon, endocrine system specialist, and a radiation oncologist. Surgical removal of a pituitary tumor usually is necessary if the tumor is pressing on the optic nerves or if the tumor is overproducing certain hormones. The success of surgery depends on the tumor type, its location, its size and whether the tumor has invaded surrounding tissues. There are two surgical techniques to remove the tumor: Endoscopic transnasal transsphenoidal approach, where the tumor is removed through the nose, and transcranial approach (craniotomy), where the tumor is removed through the upper part of the skull via an incision in the scalp. Radiation therapy can be used after surgery if the tumor persists or returns. Medications can sometimes shrink certain types of pituitary gland tumors by blocking excess hormone secretion. If a pituitary tumor or surgery to remove it decreases hormone production, a patient will likely need to take replacement hormones to maintain normal hormone levels. Some people who have radiation treatment also need pituitary hormone replacement.
ACROMEGALY: Acromegaly is a hormonal disorder that develops when the pituitary gland produces too much growth hormone. One of the most common signs is enlarged hands and feet. Acromegaly may also cause a person to experience gradual changes in the shape of the face, such as a protruding lower jaw and brow, an enlarged nose, thickened lips, and wider spacing between the teeth.