A pituitary tumour is a growth in the pea-sized gland at the base of the brain that controls most of the body's hormones. Nearly all are benign adenomas, now also termed pituitary neuroendocrine tumours. They are common: small ones are present in perhaps one in ten people and most never cause trouble.
Problems arise in three ways: the tumour makes too much of a hormone, it presses on the normal gland so that hormone levels fall, or it grows upwards and presses on the optic nerves. Treatment is with tablets for prolactinomas and with surgery through the nose for most others. Care is shared between an endocrinologist and a neurosurgeon.
Symptoms
- Loss of the outer half of the visual field in both eyes, or blurred vision
- Headaches
- Irregular or absent periods, milky nipple discharge, low libido or erectile difficulties (raised prolactin)
- Enlarging hands, feet and jaw, sweating and snoring (acromegaly)
- Weight gain around the trunk, a round red face, purple stretch marks, easy bruising and muscle weakness (Cushing's disease)
- Tiredness, feeling cold, low blood pressure and loss of body hair from underactive pituitary function
- No symptoms, with the tumour discovered on a brain scan done for other reasons
Causes and risk factors
Most pituitary adenomas arise sporadically from a single cell that has acquired a genetic change, and there is no known lifestyle cause. A small proportion occur in inherited conditions, mainly MEN1, familial isolated pituitary adenoma linked to the AIP gene, and Carney complex; these tend to appear at younger ages. Tumours are classified by size, as microadenomas under 1 centimetre or macroadenomas above that, and by the hormone they produce, if any. Pituitary carcinoma, defined by spread elsewhere, is extremely rare.
How it is diagnosed
- Hormone blood tests: Prolactin, IGF-1, cortisol with ACTH, thyroid hormones, sex hormones and sodium. Dynamic tests, such as a dexamethasone suppression test or a glucose tolerance test with growth hormone, confirm excess.
- Pituitary MRI with contrast: A dedicated scan with thin slices shows the tumour, its size and its relation to the optic chiasm and cavernous sinuses.
- Formal visual field testing: Detects and documents pressure on the optic nerves, and is repeated after treatment.
- Inferior petrosal sinus sampling: A specialised catheter test used when Cushing's disease is suspected but the MRI shows no clear tumour.
Treatment options
- Observation: Small non-functioning tumours that do not affect vision or hormones are monitored with MRI and blood tests.
- Dopamine agonist tablets: Cabergoline shrinks most prolactinomas and normalises prolactin, so surgery is rarely needed for this type.
- Endoscopic transsphenoidal surgery: Removal through the nostrils and sphenoid sinus without external cuts. The first choice for acromegaly, Cushing's disease, and non-functioning macroadenomas pressing on the optic nerves.
- Medical therapy for hormone excess: Somatostatin analogues or pegvisomant for acromegaly, and cortisol-lowering drugs for Cushing's, when surgery does not achieve remission.
- Radiotherapy or radiosurgery: For residual or recurring tumour. It acts slowly over years and commonly leads to underactive pituitary function later.
- Hormone replacement: Hydrocortisone, levothyroxine, sex hormones, growth hormone or desmopressin as needed, often lifelong.
When it is urgent
A sudden severe headache with vomiting, double vision, drooping eyelid, loss of vision or collapse may be pituitary apoplexy, which is bleeding into the tumour and requires emergency hospital care and steroids. People with known cortisol deficiency who develop vomiting, severe illness or injury need an emergency hydrocortisone injection and hospital assessment. Go to the nearest hospital; do not travel.
Travelling to Türkiye for treatment
Pituitary surgery gives better results in the hands of surgeons who do it frequently, so seeking an experienced team is reasonable. Hormone tests, MRI and visual fields can be completed in a few days, and endoscopic surgery typically requires about 10 to 14 days, including a sodium check roughly a week after the operation and clearance to fly. Dose titration of cabergoline, hormone replacement and yearly MRI surveillance need an endocrinologist near your home, so make sure one is involved before you travel.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
Frequently Asked Questions
Is a pituitary tumour a brain cancer?
No. It is almost always benign and does not spread. It matters because of its hormonal effects and its position near the optic nerves.
Will I need surgery for a prolactinoma?
Usually not. Cabergoline controls the large majority, including big tumours. Surgery is for those who cannot tolerate or do not respond to the tablets.
Can the tumour come back after surgery?
Yes, in a minority, sometimes many years later. That is why follow-up MRI and hormone tests continue long term.
Will I need hormone tablets for life?
Some people do, if the normal gland was damaged by the tumour, surgery or radiotherapy. Others recover normal function. Testing about 6 weeks after surgery clarifies this.