Pituitary tumours: Everything you need to know

Pituitary tumours are a common form of cancer, that need to be diagnosed and treated as soon as possible. In her latest online article, consultant neurosurgeon Miss Eleni Maratos offers her expert insight into the treatment of these tumours.

Where are pituitary tumours located?

A pituitary tumour arises in the pituitary gland, which sits just behind the bridge of the nose, beneath the nerves that return from the eyeballs, mere centimetres behind this area.

What are the symptoms of a pituitary tumour?

A pituitary tumour can impact the body in several ways. As it grows, it exerts pressure on surrounding structures, most notably the nerves returning from the eyeballs. Individuals often complain of tunnel vision, a loss of peripheral vision, blurry vision on the sides, and occasional collisions or oversights, such as not spotting cars or bicycles in their blind spots.

This condition typically affects peripheral vision rather than clarity. Additionally, pituitary tumours can disrupt hormone regulation in the body, leading to conditions such as Cushing's disease or acromegaly. Symptoms of acromegaly include changes in facial features, enlargement of hands and feet, and the need for larger-sized shoes or rings. These tumours are categorised based on whether they primarily cause pressure on the eyes or hormone imbalances, though sometimes both occur.

Another potential complication is pituitary apoplexy, a serious condition resulting from a sudden bleed into the tumour, which can cause rapid-onset visual impairment, double vision, droopy eyelids, and severe headaches. Apart from this acute presentation, most pituitary tumours manifest gradually, with worsening vision or signs of hormone imbalance over time.

Is a pituitary tumour serious? When is treatment required?

Pituitary tumours can indeed be serious, particularly when they affect vision. Pituitary apoplexy, though rare, is a medical emergency requiring prompt intervention. However, even gradual-onset symptoms affecting vision or hormone levels can significantly impact quality of life. While not always immediately life-threatening, they necessitate careful management.

How is this type of surgery performed?

Modern surgical techniques for pituitary tumours often involve endoscopic procedures. Surgeons utilise a tiny camera, known as an endoscope, inserted through one nostril, along with instruments through the other. This approach allows for surgery without facial scarring, as the tumour is accessed through the nasal passage.

Typically performed under general anaesthesia, the procedure involves removing a small section of bone at the back of the nose to access the tumour directly. Despite initial apprehension, patients often wake feeling relatively comfortable following surgery.

What does the recovery period look like after surgery for a pituitary tumour?

Post-surgery, patients may experience grogginess and nasal discomfort, akin to any surgical procedure. Nasal congestion and crusting are common, requiring mouth breathing initially. Hospitalisation typically lasts a few days, during which urine output is closely monitored to assess pituitary function.

Patients are encouraged to take approximately six weeks off work for recovery, although they may engage in light activities at home. Full recovery usually takes around three months.

Can pituitary tumours recur?

There is a possibility of pituitary tumour recurrence despite surgical intervention. Surgeons aim to remove as much of the tumour as safely possible during the initial procedure. However, residual tumour tissue may remain to avoid damaging critical structures. Further treatments, such as additional surgery or radiotherapy, may be necessary if recurrence occurs.

Long-term monitoring and collaborative management with specialists ensure the best possible outcome for patients, potentially involving medication to control tumour growth. Regular scans and ongoing medical supervision are typically advised following initial treatment.

Miss Eleni Maratos is a renowned consultant neurosurgeon based in London. If you would like to book a consultation with Miss Maratos, you can do so today via his Top Doctors profile.