A pituitary adenoma is a benign (non-cancerous) tumor that develops in the pituitary gland, a small structure located at the base of the brain responsible for controlling many of the body’s hormones.
Although most pituitary adenomas grow slowly, they can affect hormone balance, vision, and overall wellbeing. Early diagnosis and modern minimally invasive techniques allow highly effective and safe treatment.
Symptoms
Symptoms depend on whether the tumor produces excess hormones (functioning adenoma) or simply causes pressure on nearby structures (non-functioning adenoma). Hormonal symptoms may include:
- Irregular menstruation or infertility in women
- Galactorrhea (milk discharge unrelated to breastfeeding)
- Decreased libido or impotence in men
- Weight gain, hypertension, and high blood sugar — signs of Cushing’s disease (excess cortisol)
- Enlargement of hands, feet, or facial features (acromegaly)
- Excessive thirst and urination (diabetes insipidus)
- Fatigue, hair loss, or temperature intolerance due to thyroid or adrenal involvement
Pressure-related symptoms may include:
- Gradual loss of peripheral vision (bitemporal hemianopia)
- Persistent headache behind the eyes or forehead
- Sudden, severe headache with vision loss or double vision, which may indicate pituitary apoplexy — bleeding within the tumor that requires urgent medical care.
Diagnosis
Diagnosis typically begins with a brain MRI focusing on the pituitary gland, which identifies the tumor’s size and relation to nearby structures such as the optic chiasm.
Endocrine blood tests measure hormone levels including prolactin, growth hormone, ACTH, cortisol, and TSH to determine if the tumor is functioning.
In some cases, visual field testing is performed to assess any optic nerve compression.
Treatment Options
1. Medical Therapy
Certain adenomas, especially prolactin-secreting tumors (prolactinomas), often respond well to dopamine agonists (cabergoline or bromocriptine), which can shrink the tumor and normalize hormone levels.
2. Endoscopic Endonasal Surgery
For non-responsive or large adenomas, minimally invasive endoscopic surgery through the nasal passages allows precise tumor removal without visible scars. Using high-definition endoscopes, neuronavigation, and intraoperative monitoring, most patients recover quickly and resume normal activities within a few days.
3. Radiosurgery or Radiotherapy
Stereotactic radiosurgery (Gamma Knife, CyberKnife) is an effective option for small residual or recurrent tumors, offering targeted radiation with minimal side effects.
Recovery & Follow-Up
Most patients (without complication) return home within few days after surgery. Hormone levels and vision are reassessed postoperatively.
MRI scans and endocrine follow-up are scheduled regularly to ensure long-term stability.
Some patients may need temporary or lifelong hormone replacement therapy depending on pituitary function.
When to See a Neurosurgeon
If you experience vision problems, unexplained hormonal symptoms, or a newly discovered pituitary lesion on MRI, consultation with a neurosurgeon specialized in endoscopic skull base surgery is recommended. Early evaluation helps preserve both vision and hormonal balance.