Sustainable, effective care for endocrine conditions
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Macquarie is a pituitary centre of excellence
The Pituitary Neuroendocrine Tumour Clinic is a multidisciplinary clinic treating patients affected by tumours in and around the pituitary gland, as well as other neuroendocrine tumours.
Pituitary and sellar tumours are common and have an estimated prevalence of around 20% with clinically relevant pituitary adenomas occurring in one in 1000 people. However, misdiagnosis is a common problem and some reports suggest that many more people could have undiagnosed pituitary issues.
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.
Some pituitary tumours can exist for years without causing symptoms and some will never produce symptoms. Most pituitary tumours occur in people with no family history of pituitary problems and the condition is not usually passed on from generation to generation. Occasionally tumours are inherited.
By far the most common type of tumour (about half of all cases) is the ‘non-functioning’ tumour. This is a tumour which doesn’t produce any hormones itself. It can cause headaches and visual problems or it can press on the pituitary gland, causing it to stop producing the required amount of one or more of the pituitary hormones. This effect can also happen by the treatment you are given for a tumour, such as surgery or radiotherapy. Alternatively, your pituitary tumour may begin to generate too much of one or more hormones.
The following list shows many of the symptoms associated with pituitary conditions. It covers different pituitary conditions and patients will not display all of these symptoms, only the ones relevant to their particular condition.
- vision problems
- unexplained weight gain
- loss of libido
- feeling dizzy and nauseous
- pale complexion.
- muscle wasting
- coarsening of facial features
- enlarged hands and feet
- excessive sweating and oily skin
- moon face (with reddened skin on face)
- carpal tunnel syndrome.
Having some of these symptoms does not necessarily mean you have a pituitary condition. Once you are diagnosed, it may help you to know about other symptoms which you might experience that are associated with your condition. Please make sure you tell your doctors about all symptoms that you experience, this will help them to treat you.
When to see your doctor
Their clinical manifestations are broad, particularly apparent when they impact hormone or visual function.
Typical appointments are on a Thursday morning every fortnight, in the combined Pituitary Clinic. Urgent consultations can be arranged separately with Professor Antonio Di Ieva and/or Associate Professor Veronica Preda.
Some of the pituitary conditions are:
- pituitary adenoma
- adult growth hormone deficiency
- Cushing's Disease
- diabetes insipidus
Rarer conditions include the following:
- Empty Sella Syndrome
- Kallmann's Syndrome
- Rathke's Cleft Cysts
- Familial Multiple Endocrine Neoplasia Type 1
- Wolfram Syndrome
- Septo-Optic Dysplasia
- Sheehan's Syndrome
- Lymphocytic Hypophysitis
- Nelson's Syndrome.
There are some types of tumours that have been found due to specific genetic causes, which help target how we manage them.
The team at MQ, led by internationally trained Professor Antonio Di Ieva (Neurosurgeon) and Associate Professor Veronica Preda (Endocrinologist) have been involved in the treatment and discovery of the genetic causes during their work overseas.
Once you have had your blood test results, and your scan and returned to see the multidisciplinary team, your management will be determined. This may include any of the following:
- Hormone therapy – sometimes medication and/or replacement hormones are given, and your Endocrinologist will monitor your levels with regular blood tests.
- Surgery – the Endocrinologist works in conjunction with a Neurosurgeon. The neurosurgeon will see you to discuss the type of surgery he will perform, how long he expects you to be in hospital and recuperation period afterwards. You will be able to discuss any problems or fears you have at this time.
- Radiotherapy – this may be given instead of, or following surgery, or later if it is necessary. We collaborate with the team at MQ.
There are rare familial conditions that may be the cause of tumours near or of the pituitary. There are no other known risk factors.
The doctors of the Pituitary Neuroendocrine Tumour Clinic are actively involved in research and academic activity.
- The Handbook of Skull Base Surgery (Thieme, New York, 2015), edited by Professor Di Ieva, is the only handbook on the surgical and medical treatment of pathologies of the skull base (including the pituitary gland).
- Our doctors are involved in the Computational NeuroSurgery (CNS) Lab — the only of its kind in the world — where diseases of neurosurgical interest, including pituitary tumours, are analysed by means of Artificial Intelligence.