Pituitary Tumors

Most pituitary tumors are benign (non-cancerous) growths. They can affect health by producing too much of a hormone, reducing normal hormone production, or pressing on the optic nerves and nearby structures. A pituitary tumor does not automatically mean that surgery is needed. The right plan depends on the tumor type and size, hormone results, vision, symptoms, and your individual goals.

Dr. Jerold Justo’s work in pituitary care spans both tertiary multidisciplinary care and regional access. He was part of the core group that developed The Medical City’s dedicated multidisciplinary Pituitary Clinic in Manila and helped pioneer endoscopic pituitary surgery in Aklan through Panay Health Care—bringing minimally invasive pituitary care closer to patients in the province.

Institutional features

These institutional articles describe the multidisciplinary Pituitary Clinic in Manila and the development of endoscopic pituitary surgery in Aklan.

What symptoms can a pituitary tumor cause?

Symptoms vary depending on whether the tumor changes hormone levels or presses on nearby structures. Possible symptoms include:

• Persistent or worsening headaches

• Blurred vision, double vision, or loss of side (peripheral) vision

• Irregular or absent menstrual periods, unexpected breast milk production, infertility, low libido, or erectile dysfunction

• Enlargement of the hands or feet, changes in facial features, excessive sweating, or joint pain

• Unexplained weight gain, easy bruising, muscle weakness, high blood pressure, or changes in blood sugar

• Fatigue, weakness, dizziness, or other symptoms of low pituitary hormone levels

Some pituitary tumors cause few or no symptoms and are found incidentally on a scan performed for another reason.

When should you seek urgent care?

A sudden severe headache with vision changes may signal pituitary apoplexy, a medical emergency.

Seek urgent assessment rather than waiting for a routine clinic appointment.

Go to the nearest emergency department for a sudden severe headache, new or rapidly worsening loss of vision, double vision, repeated vomiting, fainting, marked drowsiness, or confusion. Rarely, these symptoms can signal bleeding into a pituitary tumor (pituitary apoplexy) or an acute hormone problem. This website is not an emergency service.

How is a pituitary tumor evaluated?

Evaluation is tailored to the individual and may include:

• A detailed history and neurological examination

• A dedicated pituitary MRI, with review of any previous CT or MRI scans

• Blood tests to check pituitary and target-gland hormones

• Formal visual-field testing when the tumor is close to the optic nerves

• Additional assessments based on the suspected tumor type and your general health

Because symptoms can overlap with many other conditions, the scan, hormone results, vision findings, and clinical history should be interpreted together.

Does every pituitary tumor require treatment?

No. Some small, nonfunctioning tumors can be monitored with repeat imaging, hormone tests, and eye examinations. Treatment may be recommended when a tumor affects vision, produces excess hormones, reduces normal pituitary function, grows over time, or causes other significant symptoms.

What treatments may be considered?

The treatment plan may include one or more of the following:

• Observation with scheduled follow-up

• Medication—particularly for many prolactin-producing tumors—or hormone replacement when needed

• Surgery to remove or reduce the tumor

• Stereotactic radiosurgery or other radiation treatment for selected residual, recurrent, or surgically unsuitable tumors

The best option depends on the exact diagnosis. A prolactinoma, for example, is often treated first with medication rather than surgery.

Endoscopic endonasal pituitary surgery

When surgery is appropriate, many pituitary tumors can be approached through the nostrils using an endoscope. This endoscopic endonasal or transsphenoidal approach avoids a scalp incision and provides a direct route to the pituitary region. The aims may include relieving pressure on the optic nerves, controlling hormone overproduction, obtaining a diagnosis, and preserving normal pituitary function whenever possible.

Not every tumor is suitable for the same approach, and a larger operation is occasionally necessary. The expected benefits, alternatives, extent of resection, and risks—including bleeding, infection, cerebrospinal fluid leak, hormone changes, and injury to nearby nerves or blood vessels—should be discussed for each individual case.

Why multidisciplinary care matters

Pituitary tumors sit at the intersection of the brain, vision, and hormone systems. Care may therefore involve a neurosurgeon, endocrinologist, ophthalmologist, ear–nose–throat surgeon, neuroradiologist, and radiation oncologist. Coordinated review helps match the treatment to the tumor while protecting vision and long-term hormone health.

Preparing for a consultation

Please bring your MRI or CT images—not only the written report—together with hormone laboratory results, visual-field or eye-test results, medication list, previous operative or pathology reports, and a timeline of your symptoms. If possible, note changes in vision, menstrual cycle, sexual function, weight, thirst or urination, hand or shoe size, and the appearance of the face or skin.

A consultation provides individualized assessment and does not guarantee that surgery will be recommended. Treatment decisions are made after reviewing the complete clinical information.