Pituitary Tumor

The pituitary gland sits at the base of the skull and regulates much of the body's endocrine system. Tumors of the pituitary are typically benign adenomas, classified by what they make: prolactin-secreting, growth-hormone-secreting (causing acromegaly), ACTH-secreting (causing Cushing's), or "non-functioning" tumors that do not produce excess hormone.

Non-functioning tumors typically come to attention because they press on something — most often the optic nerves directly above the gland — causing visual changes. Hormone-secreting tumors come to attention because of the specific endocrine syndrome they create.

Care is multidisciplinary from the start. I work closely with endocrinology and, when vision is affected, with neuro-ophthalmology. The right plan starts with a clear understanding of what the tumor is doing — hormonally and structurally.

For prolactin-secreting tumors, medical therapy with dopamine agonists is often the first line and frequently the only treatment needed. For other secreting tumors and for non-functioning tumors causing mass effect, surgery is typically the answer.

The standard surgical approach is endonasal transsphenoidal — through the nose, no incision visible externally. Modern endoscopic technique allows excellent visualization, minimizes disruption to surrounding structures, and supports a relatively quick recovery for most patients.

Surgery is considered for symptomatic non-functioning tumors (especially with visual involvement), for hormone-secreting tumors not controlled medically (or where medical therapy is not appropriate), and for tumors causing pituitary apoplexy — a sudden bleed within the tumor, which is an emergency.

The goals are restoring vision, normalizing hormones, and preserving as much of the normal pituitary function as possible. Recovery from endonasal surgery is typically two to three nights in the hospital and a few weeks of activity restriction.