The pituitary is a pea-sized gland at the base of the brain that controls the body's hormone systems. Pituitary tumours (adenomas) are almost always benign, but they can disturb hormones or press on the optic nerves and affect vision. Many are managed with medication alone; others need surgery through the nose — with no visible scar.
How pituitary tumours present
Presentations include vision problems (classically loss of the outer visual fields), headaches, and hormonal effects — irregular periods or milk secretion (prolactinomas), changes in facial features and hand size (acromegaly), weight gain with easy bruising (Cushing's disease), or general hormone deficiency causing fatigue. Some are found incidentally on scans done for other reasons.
Evaluation comes first
Every pituitary tumour needs a dedicated MRI of the pituitary, a full hormonal blood panel and, when the tumour is near the optic nerves, formal visual field testing. This work-up decides the treatment — importantly, prolactinomas (a common type) are usually treated with tablets, not surgery.
Endoscopic trans-nasal surgery
When surgery is indicated, most pituitary tumours are removed through the nostril using an endoscope — the trans-nasal, trans-sphenoidal approach. There is no external cut and no visible scar. The endoscope gives a magnified, panoramic view of the tumour, helping preserve the normal gland while removing the adenoma.
Recovery and follow-up
Hospital stay is typically short. After surgery, hormone levels are monitored and some patients temporarily need hormone support. Long-term follow-up with periodic MRI and endocrine review is essential, and care is coordinated with an endocrinologist where needed.