At a glance
What it is
Pituitary tumours are abnormal growths originating from the anterior or posterior pituitary gland. Over 90% are benign adenomas. Microadenomas are < 1 cm; macroadenomas are ≥ 1 cm and may compress adjacent structures. Functioning tumours secrete hormones in excess — the type of hormone determines the clinical syndrome. Non-functioning tumours present through mass effect on the optic chiasm, normal pituitary tissue, and cavernous sinuses. Most are sporadic; some occur in the context of MEN1 syndrome.
Symptoms
Mass effect (macroadenomas): headache; bitemporal hemianopia or visual field defects from optic chiasm compression; hypopituitarism from compression of normal pituitary tissue (fatigue, weight changes, amenorrhoea, sexual dysfunction). Hormone excess: ACTH tumour — Cushing syndrome (central obesity, hypertension, striae, diabetes, osteoporosis); GH tumour — acromegaly (enlarged hands/feet, coarsened facial features, sleep apnoea, diabetes); prolactinoma — galactorrhoea, amenorrhoea, infertility, erectile dysfunction; TSH tumour — hyperthyroidism.
Approach
Multidisciplinary team (neurosurgeon, endocrinologist, radiation oncologist, ophthalmologist). Incidental microadenomas without symptoms or hormone excess: watchful waiting. Functioning tumours: medical therapy first for prolactinomas (cabergoline/bromocriptine highly effective); surgery first for most other functioning types. Macroadenomas with visual compromise: urgent surgery. Endoscopic transsphenoidal resection is the standard surgical approach. Radiation (stereotactic radiosurgery or IMRT) for residual or recurrent tumours. Hormone replacement for hypopituitarism.
What pituitary tumours are
The pituitary gland — a pea-sized structure at the base of the skull in the sella turcica — regulates most of the body's endocrine system by secreting tropic hormones that govern the thyroid, adrenal glands, gonads, and growth. Pituitary tumours disrupt this regulation either by oversecreting a specific hormone (functioning tumours) or by compressing and destroying normal pituitary tissue (non-functioning or large tumours causing hypopituitarism).
**Classification**
*Microadenomas (< 1 cm):* confined to the sella; rarely cause mass effect. Most present because of hormone overproduction.
*Macroadenomas (≥ 1 cm):* may extend suprasellarly, compress the optic chiasm (causing visual field defects), invade the cavernous sinuses (cranial nerve palsies), or compress the hypothalamus. Also compress normal pituitary tissue, causing hypopituitarism.
**Hormone-secreting tumour syndromes**
*Prolactinoma (most common):* excess prolactin causes galactorrhoea and amenorrhoea in women; hypogonadism, erectile dysfunction, and gynaecomastia in men. Medical treatment with dopamine agonists (cabergoline, bromocriptine) is highly effective and often curative — surgery reserved for drug-resistant or intolerant cases.
*ACTH-secreting tumour (Cushing's disease):* excess ACTH stimulates cortisol overproduction. Cushing syndrome features: central obesity with moon face and buffalo hump, purple striae, muscle weakness, hypertension, diabetes, osteoporosis, and psychiatric disturbance. Treated surgically; pasireotide, ketoconazole, or mifepristone used as adjuncts.
*GH-secreting tumour (acromegaly):* excess GH causes progressive enlargement of hands, feet, and facial features; jaw protrusion; increased ring and shoe size. Complications include sleep apnoea, cardiomyopathy, diabetes, and colon polyps. Treated surgically; somatostatin analogues (octreotide, lanreotide) used if surgery fails to normalise GH.
*TSH-secreting tumour:* the rarest functioning type; causes hyperthyroidism with normal or elevated TSH (tricky diagnosis). Treated surgically.
**Non-functioning tumours**
Present with mass effect symptoms — headache and visual field defects. Hypopituitarism from compression of normal pituitary causes fatigue, cold intolerance, amenorrhoea, sexual dysfunction, and diabetes insipidus. Treatment is surgical decompression.
**Surgical approaches**
*Endoscopic transsphenoidal resection* (standard approach): the tumour is removed via the nose and sphenoid sinus without external incision; no brain retraction required. Excellent visualisation; appropriate for most tumours.
*Transcranial (craniotomy):* reserved for very large or invasive tumours with significant suprasellar or lateral extension not accessible transsphenoidally.
**Radiation therapy**
Used for residual or recurrent tumours not controlled by surgery or medication: - *Stereotactic radiosurgery (Gamma Knife, CyberKnife):* single high-dose, focused; best for small, well-defined residual tumour ≥ 3mm from optic chiasm - *Fractionated stereotactic radiotherapy (FSRT) / IMRT:* for larger tumours or those close to the optic apparatus; delivered over 4–6 weeks - Benefits may take months to years; risk of hypopituitarism increases with time after radiation
Treatment options at Alimran Medical Center
Neurosurgery
- Endoscopic transsphenoidal pituitary surgery
- Transcranial (craniotomy) resection
Neuromodulation
Injection & advanced therapies
- Botox® injections
- Ozone injection
- Trigger point injections
- Pulsed radiofrequency
- Acupuncture
Physiotherapy
- Electrical stimulation
- Short and long wave therapy
- Laser therapy
- Ultrasound therapy
- Post-operative rehabilitation
Book a consultation
The secretary schedules first appointments during clinic hours; please have prior imaging, operative notes and a current medication list available at the time of the call.
This page provides general information about pituitary tumours and is not a substitute for individual medical assessment. If your symptoms are severe or worsening, contact a clinician promptly.