Endocrine tumors

Where they can appear

The thyroid (thyroid nodules), parathyroids, pituitary (adenomas, for example prolactinoma), adrenal glands and the endocrine part of the pancreas can be affected. Neuroendocrine tumors are a separate group and can also develop in other organs, such as the bowel and lungs. Diagnosis and treatment vary with the origin and features of the mass.

Does every tumor produce hormones

No. Functioning tumors produce excess hormone and cause specific symptoms (for example milk discharge and cycle disturbance from prolactinoma, Cushing’s syndrome from a tumor producing ACTH or cortisol, hypoglycemia from insulinoma). Non-functioning tumors may be discovered incidentally or cause problems because of size and location, for example headache and narrowing of the visual field from large pituitary adenomas. A normal hormone test does not exclude every mass. On the other hand, a raised hormone does not automatically prove a tumor is present.

Which signs call for a check

Depending on the gland, there may be disturbances of the cycle, milk discharge from the breast outside breastfeeding, changes in vision, episodes of hypoglycemia or disorders of blood pressure. A thyroid nodule, especially with growth, voice change or difficulty swallowing, needs assessment. Most thyroid nodules are not cancer. The symptoms mentioned also have other, more common causes.

How they are investigated

Assessment includes clinical history, examination and selected hormone tests. Ultrasound is used for the thyroid; for other glands, magnetic resonance imaging, CT or other imaging may be recommended at the relevant center. Taking a tissue sample (biopsy) is not the first step for every endocrine mass; for a thyroid nodule, fine-needle aspiration is used according to the ultrasound features. The need for biopsy, surgery or genetic testing is decided by the specialist.

How they are treated and followed

Periodic checks, drugs that control hormone production, surgery or oncology treatment (see oncology) may be needed. For some pituitary tumors, for example prolactinomas, drug treatment may be the first choice. In selected hereditary conditions, such as multiple endocrine neoplasia type 1, assessment of family members may be recommended. There is no single treatment or set of tests that applies to all endocrine tumors. Checks take place every 6 months to a year, or sooner when the doctor considers it reasonable.

Care at Tirana Polyclinic: we offer endocrinology consultation, thyroid ultrasound as indicated and interpretation of tests and external imaging. When needed, care at a specialized center is recommended.