Pituitary Tumors and Surgery

What is the pituitary gland?

The pituitary gland is a pea-sized hormonal gland located in the base of the skull and behind the eyes. It is connected to the brain by a stalk.  It is called the master gland of the body because of the ability to control various other systems.

The pituitary gland controls a number of different hormones (chemicals) affecting different body systems. These include: cortisol (a steroid hormone, which is responsible for a wide range of body functions); thyroid hormone (which controls your metabolic rate); sex hormones (for reproduction); prolactin (for breast milk production in women); growth hormone (for growth during childhood and adolescence) and anti-diuretic hormone (for water balance).

What are pituitary tumors?

Pituitary tumors, also known as ‘adenomas’, are benign (non-cancerous) growths of the pituitary gland. These tumors can be functional or non-functional.

Functional tumors secrete hormones in excess. The commonest is a prolactin-producing tumor (also called ‘prolactinoma’) which manifests as abnormal milk discharge from the breasts and stoppage of normal menstrual cycles.  Tumors which produce excess steroid hormones (Cushing’s disease’) lead to hypertension, psychological disturbances, and typical features- obesity, moon's face, tumors producing excess growth hormones (‘acromegaly’) lead to gigantism with swelling of hands and feet, nose.

Non-functional pituitary tumors tend to grow large and compress on the optic nerves, thus affecting the eyesight. It can also cause damage to the surrounding normal pituitary tissue and result in the deficiency of some or all of the hormones produced by the pituitary gland.

What does pituitary surgery involve?

Surgery is the primary treatment of pituitary tumors. Most operations on the pituitary gland are carried out through the nose using a microscope or an endoscope. This gives the surgeons easy access to the gland with minimal injury to the patient. It is called ‘trans-nasal, trans - sphenoidal surgery’. Occasionally, the surgeon may need to reach the tumour by exposing the brain through the skull. This is called ‘trans-cranial surgery’.

What are the benefits of a ‘trans-nasal surgery’?–

  • Lesser pain and discomfort
  • Minimal blood loss
  • No scar
  • Shortest and safe approach
  • Lesser hospital stay

Why is a pituitary surgery needed?

Surgery is the best possible treatment for pituitary tumors with success rates of more than 90%. However, surgery is not indicated for prolactinomas as these tumors melt with medical treatment with drugs.

In the case of residual tumors or tumors located in critical areas, radiosurgery is considered as a safe and effective treatment. 

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