Types of Pituitary Tumors

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Houston Methodist’s team of pituitary tumor specialists provide precise diagnostics, state-of-the-art treatment options and empathetic care for all types of pituitary gland tumors.

Physicians at the Kenneth R. Peak Center for Brain and Pituitary Tumor Treatment and Research provide comprehensive neurosurgical and oncological treatment plans. While pituitary tumors are rarely malignant, they can cause blindness or other life-threatening disorders if untreated.


Our neurosurgeons work across disciplines, seamlessly and collaboratively, so that every patient benefits from the full breadth of our expertise.

Types of Pituitary Tumors


Pituitary adenomas are benign (noncancerous) growths found in about 1% of the population. There are two general types of adenomas:


  • Endocrine-active tumors, which secrete hormones and account for approximately half of all pituitary adenomas. Left untreated, endocrine-active tumors can lead to hormone-related conditions such as Cushing’s disease or gigantism.
  • Endocrine-inactive tumors, which do not secrete hormones but may apply pressure to the brain and its surrounding structures.


Pituitary adenomas are classified based on their size and hormone production. Microadenomas are smaller than 1 cm (less than half an inch) in diameter, while macroadenomas are larger than 1 cm in diameter.


Pituitary adenomas can become cancerous, particularly if they are fast-growing. Pituitary carcinomas are extremely rare malignant pituitary adenomas. Pituitary carcinomas look like pituitary adenomas under a microscope. The only way to distinguish them is by monitoring when the tumor spreads to another part of the body.

Endocrine-active Pituitary Adenomas (Non-Cancerous Tumors)

Growth hormone-secreting tumors

Growth hormone (GH) is necessary for normal child development and helps adults maintain healthy bone and muscle tissue. Overproduction of GH can lead to acromegaly, or enlarged bones in the hands, feet and face.


Additional symptoms include:


  • Arthritis
  • Carpal tunnel syndrome (due to enlarged wrist tissue)
  • Enlarged forehead, jaw, nose, lips and/or tongue
  • Fingers and/or toes becoming wider
  • Hands feeling soft, like bread dough
  • Headaches
  • Shoes and rings no longer fit
  • Skin changes, including skin tags, oily skin and excessive sweating 
  • Sleep apnea
  • Spaces between teeth becoming wider
  • Voice deepening in males


Diagnosis can take years because the physical changes take place slowly. Long-term or untreated acromegaly is a life-threatening disorder. Although rare in children, GH-secreting tumors can lead to gigantism if a child has not reached puberty.


People aged 45 and older are at double the risk of fatal stroke or heart attack compared with peers. If left untreated, GH-secreting tumors can cause high blood pressure, heart disease, type 2 diabetes, thyroid cancer and colon polyps.

Adrenocorticotropic hormone (ACTH) tumors

The pituitary gland produces ACTH, which triggers the adrenal glands to produce the steroid cortisol. Cortisol helps regulate blood pressure, cardiovascular function and the metabolism of proteins, carbohydrates and fats. It also reduces the body’s inflammatory response, helps insulin break down sugar for energy and helps the body respond to stress.


Pituitary tumors in cells that make ACTH cause excessive cortisol production, which creates a collection of symptoms known as Cushing’s disease.


Although rare, Cushing’s disease affects women five times more than men. It is most common among adults 20 to 50 years old and is associated with high blood pressure that is hard to control, diabetes, irritability, anxiety and depression. Cushing’s disease is fatal if left untreated.


Symptoms include:


  • Bone pain
  • Collection of fat between the shoulders (buffalo hump)
  • Increased hair growth on the face, neck, chest, abdomen and thighs (in women)
  • Increased fat around the neck
  • Irregular menstrual cycle or no periods at all
  • Lower sex drive and fertility in men
  • Mental changes
  • Obesity and slow growth in children
  • Purple marks on the abdomen, thighs, buttocks, arms and breasts
  • Rounded face (sometimes called moon face)
  • Severe fatigue
  • Thin and fragile skin that bruises easily
  • Thin, weakened bones resulting in rib and spine fractures from everyday activities
  • Upper-body obesity with thin arms and legs
  • Weak muscles 

Prolactinomas (prolactin-secreting adenomas)

Tumors that arise in cells that produce the hormone prolactin are called prolactinomas. These tumors cause an overproduction of prolactin (hyperprolactinemia), which decreases estrogen levels in women and testosterone levels in men, leading to infertility.


Men and women may have different symptoms. Men’s symptoms include enlarged breasts and erectile dysfunction. Women’s symptoms include:


  • Acne
  • Excessive face and body hair
  • Irregular menstrual cycle or no periods at all
  • Milky discharge from breasts when not pregnant or breastfeeding
  • Vaginal dryness, leading to painful sex


General symptoms include:


  • Headaches
  • Infertility
  • Low bone density
  • Low levels of other hormones (hypopituitarism) due to pressure from the tumor
  • Low sex drive
  • Vision problems

Thyroid-stimulating hormone (TSH) tumors

Thyroid-stimulating hormone secreting tumors are rare, but people who have them develop symptoms characteristic of an overactive thyroid (hyperthyroidism).


Symptoms of these tumors can include:


  • Anxiety
  • Enlarged thyroid (lump in the front of the neck)
  • Frequent bowel movements
  • Increased appetite
  • Rapid or irregular heartbeat
  • Shaking or tremors
  • Sweating or feeling hot
  • Unexplained weight loss

Endocrine-inactive (Nonfunctional) Tumors

These pituitary adenomas do not produce hormones, though some secrete a defective hormone that has no endocrine effects. Because they do not alter hormone levels, they are often found during a brain scan for some other reason, or after they have grown large enough to exert pressure on surrounding tissues or structures, producing symptoms.


Symptoms of nonfunctional pituitary tumors include:

  • Headaches that get progressively worse
  • Increased pressure in the brain
  • Loss in peripheral vision (the extreme left or right sides of what you see) or double vision
  • Problems with memory, weakness or numbness if the tumors are very large and press on other areas of the brain
  • Severe vision loss, including blindness

Other Types of Pituitary Tumors


These tumors occur near the pituitary stalk (which connects the pituitary gland to the brain) and form as result of deficiencies in normal endocrine development. They are usually benign (noncancerous) and are typically diagnosed when they grow large enough to exert pressure on the brain, optic nerve or pituitary gland.


Symptoms include:

  • Delayed growth in children
  • Excessive thirst and urination
  • Obesity
  • Vision problem or swollen optic nerve


Adamantinomatous (ordinary) craniopharyngiomas are less solid (with cysts) tumors that tend to affect children younger than 14 years of age. These tumors account for 5 to 10% of all childhood brain tumors.


Papillary craniopharyngiomas are more solid tumors and typically found in adults over age 45.

Craniopharyngiomas are more common in African Americans.

Surgery is usually the first line of treatment, followed by radiation (in adults and children 3 years and older).

Pituitary carcinomas

These are very rare, cancerous tumors that make up just 0.2% of all pituitary adenomas. They are equally common in women and men, most often occurring in middle age.


Symptoms often mimic those of pituitary adenomas, as most pituitary carcinomas also secrete hormones. Because of this, pituitary carcinomas are sometimes discovered after they have spread to other parts of the body. These tumors often require aggressive treatment, which may include surgery, radiation and chemotherapy.

Rathke's cleft cysts

Cysts occur during fetal development when the pituitary gland does not properly form. During normal development, the pituitary gland forms because of downward growth of the brain into the posterior lobe, and the upward growth of cells that become the secreting part of the gland, called the anterior lobe. There is a little pouch or cavity between the two lobes that seals by birth, and the two parts of the gland become one.


When the pouch does not seal, the cells secrete a mucinous substance that causes progressive enlargement (Rathke’s cleft cysts). Your doctor will monitor these cysts carefully with frequent MRI brain scans to make sure they do not get larger.

Treatment Options for Pituitary Adenomas

Most pituitary tumors can be successfully treated. Virtually all tumors can be removed surgically or reduced in size with other means, and prognosis for patients is excellent. Our specialists at Houston Methodist offer many treatment options to remove or shrink pituitary tumors, making it possible to devise the best options to treat your pituitary adenoma:


  • Minimally invasive surgery
  • Standard surgical removal of the pituitary tumor
  • Precisely focused image-guided minimally invasive radiation therapy
  • Hormone therapy

Learn More About Pituitary Tumors

Belinda Amboree’s vision was deteriorating until she underwent endoscopic surgery to remove the pituitary tumor pressing on her optic nerve.
Learn More about Belinda's journey >

Patient Success

Jeff Duplantes thought he had a sinus infection. He underwent endoscopic surgery after imaging revealed a large pituitary tumor.
Learn More about Jeff's journey >

Removing Tumors Previously Out of Reach

We designed neurosurgical endoscopes 1/10 of an inch in diameter. Instead of a large incision, we place these endoscopes through tiny natural pathways to navigate through the nostrils and sinuses to the base of the brain. This allows us to remove tumors in areas that were previously inaccessible.

Our physicians at Houston Methodist specialize in treating pituitary tumors at the following convenient locations.

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