Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to an endocrinologist. This is a doctor that focuses on these glands. Tests may include:

• Blood tests-to measure hormone levels, blood sugar levels (prolactin, TSH, growth hormone, corticotrophin or aCTH, beta human gonadotropin, nsulin-like growth factor-1, alpha subunit), and to identify other underlying conditions that may be causing your symptoms
• Urine tests-to measure excretion levels of certain pituitary gland hormones (beta human gonadotropin, cortisol)
• Visual field tests-to check for problems with peripheral vision
• MRI scan -a test that uses strong magnets and radio waves to create pictures of structures inside the brain

Special Tests

• Glucose tolerance test-the standard test for acromegaly
• Dexamethasone suppression test and corticotropin-releasing hormone (CRH) test-best tests to see if excessive secretion of hormones from the adrenal gland is due to a pituitary adenoma

Treatment

Treatment depends on the presence and type of hormones being secreted. It is not uncommon for these treatment options to be used in combination. Talk with your doctor about the best plan for you.

Treatment options include:

Surgery

Surgery is often done to remove the tumor. The pituitary gland may be damaged during surgery. This can be treated with medications. They will replace certain hormones produced by the pituitary.

Medications

Medications can control symptoms and sometimes shrink the tumor. They can block hormone secretion Medications may include:

• Dopamine agnoists 9eg bromocriptine
• Octreotide

Radiation Therapy

Radiation therapy involves the use of radiation to kill tumor cells. The types of radiation therapy used to treat pituitary adenomas include:

• Conventional therapy-radiation is directed at the pituitary from a source outside the body
• Stereotactic radiosurgery-an intense radiation beam is targeted directly at the tumor
• Proton beam radiotherapy-a beam of protons (positively charged particles) is directly focused on the tumor

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