Diagnosis
If a person has any symptoms of a pituitary tumor, a doctor should conduct a physical examination and take their full medical history. The doctor may also ask about the patient's family history and any known inherited genetic diseases that may increase the risk of developing a pituitary tumor. If the doctor suspects a pituitary tumor, he or she may recommend any of the following diagnostic procedures:
Blood tests
The doctor may recommend blood tests to measure the levels of different hormones that may be affected by a pituitary tumor. The doctor will take a blood sample and send it to the laboratory for further testing.
24-hour urine test
With this test, the doctor collects all of the urine for a 24-hour period. By collecting all urine for 24 hours, the doctor can measure the average levels of a substance in the urine over the entire day and get a better understanding of what is going on in the body. The doctor may recommend a 24-hour urine test to measure the levels of cortisol if there is a concern for Cushing disease.
Neurological exam
The doctor may recommend a neurological exam to check brain, spinal cord and nerve function, which may be affected by a pituitary tumor. The doctor will make sure your mental functions, coordination, muscles and reflexes are all working properly.
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Eye exam/Visual field exam
The doctor may refer the patient to an eye doctor, since large pituitary tumors can press on the optic nerve. The eye doctor will test overall eye health as well as central and peripheral vision to detect any vision abnormalities.
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Venous sampling
The doctor will take samples of blood from the veins coming from the pituitary gland and determine the levels of various hormones in the sample. The doctor may perform this procedure if blood and urine tests indicate an ACTH-producing tumor (Cushing disease), but the gland looks normal or indeterminate on imaging tests.
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Magnetic resonance imaging (MRI) scan
Magnetic resonance imaging (MRI) uses a powerful magnet to produce detailed images of body parts. Magnetic waves are absorbed by the body and then released in a certain pattern, which is translated by a computer in order to show "slices" of the body. They are very useful in examining the soft tissues of the body and other internal organs and structures, such as the bones, brain and spinal cord. MRI scans before and after intravenous contrast are the best ways to detect pituitary tumors. MRI does not carry the risk of radiation exposure.
Biopsy
Biopsies are not usually performed on pituitary tumors. Tests that measure hormone levels are usually very accurate by themselves in determining whether you have a pituitary tumor, and if so, what type.
