What I Treat
Pituitary Surgery
Surgery for the master gland
The pituitary gland is small enough to sit on a fingertip, yet it directs much of the body's hormonal balance, growth, metabolism, reproduction, and the stress response among them. A tumour here can present to an endocrinologist, an ophthalmologist, a fertility clinic, or a neurosurgeon, depending on which system it disturbs first, which is why pituitary care is never a solo effort.
The gland
The master gland
What is the pituitary?
A pea-sized gland that sits behind the bridge of the nose, just below the brain. Despite its small size, it is one of the most important glands in the body — it regulates growth, metabolism, reproduction, and the stress response through the hormones it releases into the bloodstream.
Types of tumours
Almost always benign adenomas. Two broad categories: functioning tumours, which produce excess hormones and cause systemic illness; and non-functioning tumours, which do not secrete active hormones but press on surrounding structures as they grow. Both require specialist assessment.
Clinical picture
Symptoms
Functioning tumours
- Unexplained weight changes
- Irregular periods or fertility problems
- High blood pressure
- Enlarged jaw, hands, and feet (acromegaly)
- Mood disturbance and fatigue
Non-functioning tumours
- Vision problems, particularly loss of peripheral vision
- Headaches
- Fatigue and low energy
- Loss of libido
- Nausea or vomiting (if large)
Work-up
How it is diagnosed
Blood tests
Comprehensive hormone profile checks for excess or deficiency of pituitary hormones. This includes prolactin, growth hormone, IGF-1, cortisol, ACTH, TSH, and gonadotrophins.
MRI scan
Dedicated pituitary-protocol MRI with thin slices through the sella turcica. This shows the size of the tumour, its relationship to the optic chiasm above, and any cavernous sinus involvement.
Visual field test
Performed by an ophthalmologist to map any loss of peripheral vision caused by the tumour pressing upward on the optic chiasm. This test is essential for surgical decision-making.
Together, these three investigations — blood tests, MRI, and visual field testing — tell us whether the tumour needs treatment and what kind. They also establish a baseline against which all future progress is measured.
The approach
Transsphenoidal surgery
The standard approach to the pituitary is through the nose, using an endoscope — a thin camera with a light source. The surgeon passes instruments alongside the endoscope through the natural nasal airway, opens the sphenoid sinus at the back of the nose, and reaches the pituitary fossa without any external incision.
This leaves no external scar. Recovery is shorter than with open cranial approaches, and the view provided by the endoscope is often superior to that of the microscope for midline skull base lesions.
Outcomes
What to expect
- 1Hospital stay: 2 to 4 days — shorter than with open cranial surgery
- 2Return to desk-based work: 2 to 3 weeks — physical jobs may require longer
- 3Long-term hormone monitoring — some patients require hormone replacement after surgery, and this is managed by the endocrinology team
- 4Repeat MRI scans as routine follow-up — usually at 3 months, then annually, to detect any regrowth early
Medical disclaimer: The information on this page is for general educational purposes only. It is not a substitute for individual medical advice, diagnosis, or treatment. Always consult your own doctor or specialist with any questions you may have regarding a medical condition.
Explore More