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Non-Secretory Tumors

Three types of non-secretory tumors are non-functioning adenomas, craniopharyingiomas, and Rathke's cleft cysts.

Non-functioning adenoma

While some tumors of the pituitary secrete too many hormones that upset the balance of good health, other pituitary tumors do not secrete hormones. Instead, they cause health problems because of their size and location. A non-functioning adenoma (a type of benign tumor) is one example.

A non-functioning adenoma may cause headaches and vision problems. This type of pituitary tumor also may cause hyposecretion, so the pituitary does not produce enough of the hormones necessary for good health, a condition called hypopituitarism. A non-functioning adenoma often is found when doctors perform an MRI (magnetic resonance imaging) after a head injury or for some other reason. The symptoms of non-functioning adenomas fall into two categories—tumor mass effects and hyposecretion effects.

Tumor mass effects

  • Visual field disturbances, most commonly loss of peripheral vision, at the edges of your vision range
  • Headaches
  • Abnormal control of eye movements

Hyposecretion effects

  • Loss of appetite
  • Weight loss or weight gain
  • Fatigue
  • Irregular or absent menstrual periods
  • Constipation
  • Dry skin
  • Infertility
  • Reduced sex drive
  • Failure to get or maintain an erection
  • Inadequate function of the ovaries or testes
  • Joint pains
  • Dizziness
  • Low blood pressure
  • Low sodium levels in blood

Treatment

The first therapy your doctor probably will recommend is transsphenoidal microsurgery, through the nasal sinuses, especially if your vision is disturbed or the tumor has compressed nerves around your brain, inside of your skull. After surgery, visual problems improve in most people or can go away altogether.

Hormone replacement may be necessary to restore normal hormone levels. In some cases, the pituitary functions normally after successful surgery. If you have a large part of the tumor remaining or the tumor regrows, you may need more surgery and/or radiation therapy.

Craniopharyingiomas and Rathke's cleft cysts

These masses on or near the pituitary gland are non-cancerous growths, but they may be mistaken for a pituitary tumor on an MRI scan. Although they do not arise from the hormone-producing cells of the pituitary gland, they can interfere with normal pituitary function. Craniopharyngiomas are most common during childhood, but can also be found and cause problems in older adults. Rathke’s cleft cysts are often present in adults, but often do not cause symptoms (unless they grow to a large size).

Symptoms of craniopharyngiomas and Rathke's cleft cysts are similar:

  • Growth failure in children
  • Delayed puberty in children
  • Reduced or loss of sex drive
  • Constipation
  • Nausea
  • Frequent urination
  • Excessive thirst
  • Obesity
  • Headaches
  • Menstrual irregularities/loss of menstrual cycle
  • Milk discharge from breasts
  • Problems regulating body temperature
  • Fatigue
  • Increased drowsiness
  • Dry skin
  • Low blood pressure
  • Visual disturbances
  • Confusion

Treatment

The primary treatment is usually surgery. The goal is to completely remove the mass or cyst and preserve normal pituitary, brain, and visual function. If the mass is located in the area of the pituitary, the surgery probably will be through your nasal sinuses (transsphenoidal). If the mass is found above your pituitary, your surgeon may have to go in through the skull. If the mass cannot be completely removed, your doctor may recommend radiation therapy (especially in people with craniopharyngiomas).

Editors:

Anne Klibanski, MD
Massachusetts General Hospital
Harvard Medical School

Nicholas Tritos, MD
Massachusetts General Hospital
Harvard Medical School

Last Review: May 2013