Persistent Headache May Be a Sign of Tumor

The most important organ that provides the entire hormonal balance of our body is the pituitary gland. The most important disease originating from the pituitary gland is pituitary tumors.

In a significant part of pituitary diseases, the symptoms can be very mild, so there is often a waste of time in the diagnosis of the disease. Endocrinology Specialist Prof. Dr. Fahrettin Keleştemur, who drew attention to the persistent headaches, said, "If the cause of the headache cannot be found despite detailed investigation, a pituitary tumor should also be taken into consideration."

Tumors that arise in the pituitary gland, which is defined as the conductor of all the hormones in our body, can lead to excessive secretion of hormones depending on the type of tumor and, accordingly, to the emergence of different diseases pictures. Also, pituitary hormones may be secreted insufficiently due to the compression of the tumor mass, which is not uncommon. Pituitary diseases may present with a wide variety of symptoms such as headache, menstrual irregularity, weight gain, increased hair growth in women, and milk coming from the nipples despite the absence of breastfeeding, rarely milk coming from the nipples in men, hair loss, weakness, fatigue, loss of strength, and sexual insufficiency. The vast majority of pituitary tumors are benign and have a very small chance of becoming cancerous. Yeditepe University Hospitals Medical Coordinator and Endocrinology Specialist Prof. Dr. Fahrettin Keleştemur said that since a significant part of the complaints related to pituitary diseases can be seen in many non-pituitary diseases, patients may lose time until the diagnosis is made.

Pituitary Gland Is the Most Important Organ for the Development of the Body

Comparing the pituitary gland to a conductor, Prof. Dr. Fahrettin Keleştemur said, “This important pea-sized organ is located at the base of the skull, just behind the root of the nose. In women, it may get a little larger during pregnancy. The pituitary gland secretes hormones that the body needs in line with the stimuli it receives. It also takes into account the level of hormones in the bloodstream and decides which hormone to secrete, when, and how much. The pituitary gland is the most important organ in the organism in terms of the development of our body, the functioning of the organs, and the provision of energy balance with these hormones it secretes.”

Narrowing in Vision is an Important Sign

Prof. Dr. Fahrettin Keleştemur reminded that different disease pictures may occur as a result of excessive secretion of hormones, and added that problems can be seen depending on the size of the tumor. Stating that pituitary gland tumors should be considered in chronic headaches that do not go away despite treatment, Prof. Dr. Fahrettin Keleştemur continued his words as follows:

“As the pituitary tumor grows upwards, it may compress the optic nerve, causing narrowing of the visual field and eventually loss of vision, and findings such as double vision or drooping eyelids may occur due to lateral growth. Therefore, some patients may first apply to an ophthalmologist. Pituitary tumors should definitely be considered when such visual disturbances occur.”

The Most Important Cause of Short Stature

Reminding that the growth hormone responsible for height growth is secreted from the pituitary gland, Prof. Dr. Fahrettin Keleştemur continued his words as follows:

“The most important cause of short stature is growth hormone deficiency. On the other hand, excessive growth hormone secretion during childhood, when the growth plates are not closed yet, results in excessive height growth or gigantism. In case of excessive secretion of growth hormone in adulthood, a disease called acromegaly occurs. Enlargement occurs on the internal organs, face, hands, or feet. These people state that they cannot fit into their shoes due to the growth of their feet and that they cannot wear their rings as a result of the thickening of their fingers. In addition, the tip of the nose grows, the forehead comes forward, the chin and tongue grow, and the face becomes coarse. In addition to physical problems, patients often experience metabolic and psychological disorders.”

Be Careful If You Have Hair Loss

Noting that the thyroid gland provides the energy balance of the body, Prof. Dr. Fahrettin Keleştemur said, “The functioning of the thyroid gland is also under the control of a hormone called TSH secreted from the pituitary gland. If TSH deficiency occurs, thyroid gland failure (secondary hypothyroidism) occurs. In these patients, symptoms such as chills, fatigue, getting tired quickly, weight gain despite the decrease in appetite, and a tendency to sleep are observed. In excess of TSH (secondary hyperthyroidism), an excessive amount of thyroid hormone is secreted from the thyroid gland and symptoms such as weight loss, tremors in the hands, palpitations, hair loss, and insomnia occur.”

The Cortisol Balance of Those Who Cannot Lose Weight Despite Everything Should Be Checked

In some pituitary gland tumors, more than normal ACTH hormone is secreted and increased ACTH causes excessive secretion of cortisol hormone from the adrenal gland, which is called Cushing's disease. Underlining that cortisol excess should be investigated in patients who cannot lose weight and whose blood sugar cannot be controlled despite treatment and lifestyle changes, Prof. Dr. Fahrettin Keleştemur continued his words as follows: “In Cushing's disease, fat deposition and weight gain occur in the abdominal region, while thinning occurs in the arms and legs. The skin becomes thinner and, as a result, bruising is seen even with simple bumps. Other symptoms include excessive hair growth or hair loss in women, violet-colored stretch marks on the abdomen or upper arm area, and menstrual irregularity in women. These patients should be followed up for life.

“As a result of insufficient secretion of ACTH hormone, the adrenal gland cannot make enough cortisol. The body remains vulnerable to stress, especially infectious diseases. Symptoms such as weakness, fatigue, feeling unwell, low blood pressure, low blood sugar, and weakness occur. Some patients are brought to the hospital in a coma.

The most common pituitary tumors are prolactin-secreting tumors. It is more common in women. Prolactin is the hormone responsible for milk production in the postpartum period. A prolactin-secreting pituitary tumor should be considered in case of milk coming out of the nipples spontaneously or by squeezing outside the lactation period. Rarely, this finding can also be seen in men. In some pituitary tumors, there may be no hormonal disorder.”

“Treatment is Determined by the Underlying Cause”

Yeditepe University Hospitals Endocrinology Specialist Prof. Dr. Fahrettin Keleştemur, who stated that both pituitary tumors and other pituitary diseases usually progress slowly and insidiously, therefore the diagnosis is delayed, gave the following information about the treatment approach:

“The definitive diagnosis of the disease is made by a careful examination of the patient, laboratory tests, and imaging methods. Depending on the type of disease, drug therapy, surgical treatment, and radiation therapy are applied. If hormone excess and tumor growth cannot be stopped by medical or surgical treatment, radiation therapy can be applied. Surgical treatment is at the forefront in the majority of pituitary tumors. It may be possible to completely get rid of the pituitary tumor with an endocrinologist experienced in pituitary diseases, a neurosurgeon, and sufficient technological infrastructure. However, nowadays, drug therapy is becoming more and more widespread in parallel with the successful results obtained. In most pituitary tumors that secrete prolactin hormone, the first treatment is drug therapy. Today, we use radiation therapy less frequently than in the past.”