The pituitary, a small, pea-sized organ located at the base of the brain, behind the eyes, is a "master gland" of the body. It produces many hormones that control other endocrine glands and certain functions of the body. Given all that it controls, it's no wonder that pituitary disorders are often complex, and that successful diagnosis and treatment of such disorders can be a challenge.
The Stony Brook Pituitary Care Center provides easy access to personalized, coordinated expert care for a wide range of pituitary-related disorders including tumors of the pituitary. The latter, though usually benign (noncancerous), can cause vision problems and hormonal imbalance.
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| Igor Kravets, MD | Raphael Davis, MD |
Under the direction of Igor Kravets, MD, an endocrinologist, and Raphael Davis, MD, a neurosurgeon, our team includes specialists from endocrinology, neurosurgery, otolaryngology (ENT), radiation oncology, neuropathology, neuroradiology, neuro-ophthalmology and patient education and support. It's the only center in Suffolk County to offer a multidisciplinary team of experts for pituitary care. Having all of the coordinated expert pituitary care you need in one location close to home can make the course of your treatment easier.
To make an appointment with one of our Pituitary Care Center specialists, call (631) 444-0580.
The many disorders that the Center diagnoses and treats include:
- Adenomas — noncancerous (benign) tumors that develop in the pituitary gland.
- Craniopharyngiomas — noncancerous tumors that develop in a part of the brain called Rathke’s pouch, which is at the base of the brain above the pituitary gland. These tumors usually consist of a mix of calcium deposits and pockets of fluid called cysts.
- Rathke’s cleft cysts — these are not tumors, but rather noncancerous, closed pockets of fluid that develop at the base of the brain and grow as fluid collects inside, pushing on surrounding structures.
- Acromegaly — a condition caused by a pituitary tumor’s excessive production of growth hormone that results in excessive growth of the hands, feet, forehead and jaw and leads to many complications, such as diabetes, high blood pressure and sleep apnea.
- Cushing’s disease — a condition caused by a pituitary tumor’s excessive production of adrenocorticotropic hormone (ACTH) which, in turn, triggers excessive production of cortisol , a stress hormone made by adrenal glands. Cushing’s disease manifests as weight gain, easy bruising, round and reddish face, a fat pad on the back of the neck, high blood pressure and wide, pink stretch marks on the abdomen
- Hyperprolactinemia — a condition caused by high levels of prolactin in blood. Prolactin is a pituitary hormone regulating breast milk production in pregnant and nursing women. Men’s pituitaries also secrete prolactin; however, the role of this hormone in men is unclear. Causes of high prolactin levels include an excessive production of the hormone by a pituitary tumor, compression of the pituitary stalk by a large pituitary tumor and other conditions. In men, high prolactin levels can lead to erectile disorder. In women, this condition may cause irregular or absent periods as well as secretion of breast milk despite not giving recent birth.
What you should know about pituitary tumors:
A pituitary tumor is an abnormal growth of cells in the pituitary gland. Most pituitary tumors are benign (non-cancerous). However, because of the location of the pituitary gland at the base of the skull, pituitary tumors can cause problems if they grow large enough to press against surrounding structures. One such structure is an intersection of the optic nerves called the optic chiasm. Pressure against the optic chiasm can cause visual problems. Also, a pituitary tumor can cause illness by disrupting the normal balance of hormones in the body.
No one knows for sure what causes pituitary tumors. About one to five percent of pituitary tumors occur within families. Most pituitary tumors are not inherited, however there are certain rare, inherited conditions, such as multiple endocrine neoplasia Type 1 (MEN1), that carry a higher risk of pituitary tumors.
Symptoms
Symptoms caused by pituitary tumors vary depending on their type and size. Not all pituitary tumors cause symptoms. Many pituitary tumors are not diagnosed until symptoms appear; some pituitary tumors are found incidentally on brain imaging obtained for an unrelated reason.
Certain symptoms of pituitary tumors may develop when these tumors grow so large that they exert pressure on surrounding structures. Such symptoms include:
- Changes in vision (particularly loss of peripheral vision)
- Headache
Other symptoms of pituitary tumors are related to either deficiency or excessive production of certain hormones. Common symptoms caused by such hormonal disturbances include:
- Irregular or absent menstrual cycles
- Erectile dysfunction and loss of sex drive
- Weight changes
- Production of breast milk by a woman who has not given birth
- Accelerated or stunted growth in a child or teenager
- Growth of the hands, feet, forehead and jaw in adults
- Development of a round face, a hump between the shoulders or both
Diagnosis
To diagnose a pituitary tumor, a Stony Brook endocrinologist will ask you about the symptoms you are experiencing, and about your personal and family health history. They will perform a physical exam and order tests of your blood and urine. A magnetic resonance imaging (MRI) scan or computerized tomography scan (CT or CAT scan) may also be ordered to obtain detailed images of the brain and the pituitary gland. In rare instances, a biopsy (surgical procedure to remove a small sample of the tumor for examination under a microscope) is required.
Treatment
Patients diagnosed with a pituitary tumor that requires surgery can rest assured that the experts at the Stony Brook Pituitary Care Center are skilled in the latest minimally invasive surgery techniques using natural pathways through the nose to achieve excellent results. Treatments may include surgery, radiation therapy or medication. Transsphenoidal surgery is surgery performed through the nose and (sphenoid) sinus to remove a pituitary tumor. It can be performed with an endoscope, microscope or both and is a team effort between neurosurgeons and ear, nose and throat (ENT) surgeons. Radiation therapy uses high energy x-rays to kill the tumor cells and is recommended if surgery is not an option, if the pituitary tumor cannot be removed entirely during surgery, or if the tumor causes symptoms not relieved by medicine.
To make an appointment with one of our Pituitary Care Center endocrinologists, call (631) 444-0580. To make an appointment with one of our Pituitary Care Center neurosurgeons, call (631) 444-1213.