The most common problem with the pituitary gland occurs when a benign tumour (used to describe a ‘growth’) also called an adenoma, develops. Pituitary tumours are not ‘brain tumours’. The term benign is used by doctors to describe a swelling which is not cancerous.
Pituitary tumour vs brain tumour
We support the position that pituitary tumours are not brain tumours. There is a great deal of debate on this subject. We recognise that some sources, including the NHS, do class these as brain tumours. However, our Medical Committee agree that while the pituitary is located within the brain, it is not part of the brain. A pituitary tumour, or adenoma is not a brain tumour, though may sometimes be referred to that inaccurately, and will be, in most instances, benign (non-cancerous).
Other causes of pituitary disorders
Pituitary dysfunction in traumatic brain injury
Head injuries vary in severity and can have a number of consequences beyond the initial accident. These can include neuroendocrine dysfunction. ‘Neuroendocrine’ means problems with the endocrine (or hormone) system that originate from the brain possibly the pituitary gland or hypothalamus.
Neuroendocrine problems are mainly due to pituitary dysfunction. These can be due to alteration in the acute phase (first few hours and days), with temporary changes in blood hormone levels. These early changes usually correct with time and post injury medical management.
There is also evidence that long-term neuroendocrine dysfunction resulting from permanent damage at pituitary or hypothalamic level can occur during a traumatic brain injury.
Traumatic brain injury is common. Pituitary dysfunction following this may occur and is a serious consequence. We would therefore advise that you contact your GP if you have any concerns and experience some of the following symptoms:
- mild headaches,
- feeling sick,
- problems concentrating,
- poor memory,
- problems sleeping,
- lack of appetite,
- sexual and fertility difficulties,
- an increased thirst and excessive urinating.
Your GP may consider referral to an Endocrinologist if appropriate. Headway can offer support and information for those with traumatic brain injury.
If the blood supply to the pituitary is restricted, the gland tissue can die resulting in hypopituitarism. Infarctions can occur as a result of impaired blood flow to the pituitary gland or head trauma.
Sheehan’s Syndrome (also known as postpartum hypopituitarism, or postpartum pituitary insufficiency) may occur in a woman who has severe uterine haemorrhage during childbirth.
This type of tumour or cystic mass is quite rare and congenital (from birth). It exerts pressure on the hypothalamus which lies just above the pituitary gland and is responsible for releasing hormones that start and stop the release of pituitary hormones.
The Rathkes pouch eventually forms the pituitary gland and normally closes early in foetal development. A remnant may persist as a cleft that lies within the pituitary gland and occasionally this remnant gives rise to a fluid-filled large cyst called Rathkes Cleft Cyst (RCC).
Empty Sella Syndrome (ESS) is a disorder that involves the ‘sellaturcica’ a bony structure at the base of the brain that surrounds and protects the pituitary gland. ESS would show up on an MRI scan revealing a sella turcica that appears to be empty.
Multiple Endocrine Neoplasia (MEN)
MEN syndromes are inherited disorders (passed down in families). The disorder causes more than one gland in the body’s Endocrine system to develop growths. There is a patient group dedicated to providing support to those affected by MEN, for further information please see the AMEND website.
Another cause of hypopituitarism that may be associated with pregnancy is Lymphocytic Hypophysitis. This is due to inflammation in the pituitary caused by immune cells. The reasons why this occurs is not understood. With modern obstetric practice the occurrence of hypopituitarism after childbirth, though uncommon, is more frequently due to this condition than Sheehan’s Syndrome.