Accurately diagnosing a pituitary disorder or tumor requires advanced imaging and diagnostic techniques, many of which may not be available at local hospitals. In addition to the standard MRI, Penn Pituitary Center offers a unique and specialized scan called the micro adenoma sequence MRI scan that is able to find tumors that are 2 mm in size or smaller. Because of their size, these tumors are often missed by standard imaging. At Penn, the micro adenoma sequence MRI scan allows surgeons to completely remove malignant cells leading to a much improved quality of life.
If pituitary tumors are small and do not cause any problems, they can be monitored overtime. However, if they grow, problems may arise so clinical supervision is necessary upon discovery of these tumors. In many cases, these small pituitary tumors do not produce any symptoms and are often diagnosed as the result of investigating a hormonal imbalance.
With larger non-functional pituitary tumors, patients often experience headaches, vision problems, and symptoms of pituitary insufficiency. Vision problems are a serious complication of pituitary tumors and usually begin with loss of peripheral vision. If untreated, vision problems typically progress to blindness. However, if pituitary tumors are caught early enough and treated surgically, vision usually improves.
The Penn Pituitary Center offers the following latest diagnostic technologies available today, including:
- Provocative Endocrine Testing: Hormone testing is important in diagnosing pituitary tumors. It can help rule out other conditions, identify hormones that may need to be replaced, and determine how the pituitary gland is being affected by the tumor. At Penn, we use provocative endocrine testing including stimulation and suppression of growth hormone, corticotropin-releasing hormone (CRH) testing, nuclear medicine studies, metyrapone testing and water-deprivation testing. These tests allow us to introduce provocative agents or situations and monitor the hormonal response.
- Inferior Petrosal Sinus Sampling (IPSS): This test is given to diagnose Cushing's Disease. Performed in Interventional Radiology, IPSS confirms whether or not excess hormone, such as ACTH (adrenocorticotropic hormone), is being produced by the pituitary gland. It helps to distinguish Cushing's Disease from ectopic ACTH syndrome.
- High-Resolution MRI (3T): Penn offers advanced imaging such as the 3T MRI which provides high resolution and produces extremely clear images of the pituitary and surrounding structures. The 3T MRI is considered powerful and allows surgeons to see minute details that are important for diagnosing. This technology is faster and decreases overall scan time. For small tumors less than 10 mm in size, the micro adenoma sequence MRI scan produces thin slices and enables Penn surgeons to significantly improve diagnostic accuracy.
Second Opinion for Pituitary Tumor
There are many decisions to make and many feelings to process when you've been diagnosed with a pituitary tumor. Many individuals seek a second opinion from Penn's neurosurgeons to help decide what the best treatment might be. During a second opinion, a Penn neurosurgeon will review your medical history, current diagnosis and any images that have been taken. It is very important to bring all images of your brain and pituitary tumor, regardless of how long ago they were taken. This will help us determine the tumor's location and growth over time.