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Pituitary Tumours

The pituitary gland is barely the size of a pea yet it governs growth, metabolism, reproduction, stress response, and fluid balance for the entire body. When a tumour develops within or around this small but mighty gland, the consequences extend far beyond the brain: hormonal imbalance from pituitary tumour can affect every organ system, while the tumour's mass effect on the optic chiasm directly above it can cause progressive vision loss from pituitary tumour before any other symptom appears.

At Shree Hospitals, our dedicated pituitary gland specialists neurosurgeons, endocrinologists, and ophthalmologists work as a unified team to deliver comprehensive Pituitary Tumour treatment in Mumbai, India through endoscopic transsphenoidal pituitary tumour diagnosis and care and long-term hormonal management.

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(24×7 Emergency Care)

1800-268-4000

Our Approach to Managing Pituitary Tumours

Balance the hormones. Preserve the vision. Restore the whole person.

Pituitary tumours are unique in that they are simultaneously a neurosurgical problem (requiring precise resection through the nasal corridor) and an endocrine problem requiring lifelong hormonal expertise. A prolactinoma responds dramatically to dopamine agonist medication and rarely needs surgery at all. An ACTH-secreting tumour causing Cushing's disease demands surgery, potentially radiotherapy, and close adrenal monitoring for years. A non-functioning macroadenoma compressing the optic chiasm requires urgent surgery to prevent irreversible blindness.

Our approach to pituitary adenoma surgery and hormonal management in Mumbai brings these disciplines together seamlessly. Our pituitary gland specialist team (with our neurosurgeon and endocrinologist working as co-leads) reviews every case jointly before any decision is made, ensuring both the structural and hormonal dimensions of the tumour are addressed in a coordinated, patient-centred plan.

1. Comprehensive Pituitary Workup

Precise diagnostic classification forms the backbone of effective oncological decision-making. Every patient undergoes advanced imaging and diagnostic evaluation to guide treatment planning:

MRI pituitary with dedicated fine-cut sequences, essential for identifying microadenomas below 10 mm and cavernous sinus invasion
Full pituitary hormonal panel, measuring prolactin, GH, IGF-1, ACTH, morning cortisol, TSH, FSH, LH, and testosterone or oestradiol
Dynamic hormonal testing, including oral glucose suppression test for acromegaly and low-dose dexamethasone suppression test for Cushing's disease
Formal perimetric visual field testing, as bitemporal hemianopia from chiasmal compression is the hallmark vision loss from pituitary tumour pattern
Ophthalmological assessment including visual acuity and fundoscopy for all tumours with suprasellar extension
Inferior petrosal sinus sampling for Cushing's disease when MRI is negative or equivocal to lateralise the ACTH source

2. Medical Management (When Medicine Cures)

Some pituitary tumours respond so well to medication that surgery may be avoided entirely:

Cabergoline or bromocriptine for prolactinoma, normalising prolactin in over 80% and shrinking the tumour substantially
Somatostatin analogues (octreotide or lanreotide) for acromegaly to control GH and IGF-1 levels, reducing tumour size pre-operatively
Pasireotide for Cushing's disease with failed surgery or as pre-operative cortisol control
Pegvisomant (a GH receptor antagonist) for acromegaly uncontrolled on somatostatin analogues
Close monitoring of hormonal imbalance from pituitary tumour correction, with titration of medical therapy guided by hormone levels every 3 months

3. Endoscopic Transsphenoidal Surgery

The cornerstone of surgical Pituitary Tumour treatment in Mumbai, India for most pituitary adenomas:

Fully endoscopic transsphenoidal pituitary tumour diagnosis and care approach through the nostril and sphenoid sinus to the pituitary without any external incision
High-definition 4K endoscopy providing panoramic visualisation of the sella, cavernous sinuses, and suprasellar space
Intraoperative MRI or ultrasound for real-time assessment of resection completeness
Angled endoscopes for accessing tumour extensions into the cavernous sinus or suprasellar region
Fluorescein-assisted visualisation for distinguishing tumour from normal pituitary gland tissue
Extended endonasal approaches for giant adenomas or tumours with significant parasellar extension

4. Post-Operative Hormonal Management

Pituitary surgery requires meticulous post-operative hormonal monitoring:

Hourly urine output measurement for 72 hours to detect diabetes insipidus from posterior pituitary disruption
Serum sodium monitoring, as hyponatraemia from SIADH is a common and potentially serious post-operative complication
Morning cortisol at day 1 post-operatively to assess surgical cure in Cushing's disease
Hydrocortisone replacement for patients at risk of post-operative adrenal insufficiency
Long-term pituitary function reassessment at 6 weeks, 6 months, and annually to identify hypopituitarism requiring hormone replacement

5. Adjuvant Radiosurgery for Residual Disease

When surgical resection is incomplete (particularly for tumours invading the cavernous sinus):

Stereotactic radiosurgery for residual functioning adenoma, with Cushing's disease and acromegaly radiosurgery achieving remission in 50 to 70% of cases over 3 to 5 years
Fractionated radiotherapy for large residual non-functioning adenomas to prevent regrowth over the long term
Close hormonal monitoring post-radiosurgery, as radiation-induced hypopituitarism develops in up to 50% of patients within 10 years
Integration into our comprehensive pituitary adenoma surgery and hormonal management in Mumbai pathway at Shree Hospitals

6. Long-Term Endocrine Follow-Up

Continuous longitudinal care to preserve quality of life and handle disease progression promptly:

Annual MRI pituitary surveillance to detect tumour recurrence or growth of residual disease
Lifelong hormonal replacement for hypopituitary patients, providing cortisol, thyroid, growth hormone, and sex hormone replacement as required
Management of acromegaly and Cushing's disease in remission, monitoring for disease recurrence which can occur years after successful surgery
Bone density monitoring for patients with longstanding hormonal imbalance from pituitary tumour due to osteoporosis risk in hypopituitary patients
Reproductive and fertility counselling for young patients with prolactinoma or gonadotrophin deficiency

Happy Patients & Their Case Stories

A 32-year-old woman from Bandra presented with amenorrhoea, galactorrhoea, and infertility for two years. MRI identified a prolactinoma. Medical therapy with cabergoline as part of pituitary adenoma surgery and hormonal management in Mumbai normalised her prolactin within three months, and she conceived naturally one year later.

Mr. Keshav . P

This 45-year-old man had progressive visual field loss and was found to have a giant non-functioning pituitary macroadenoma compressing both optic nerves. Endoscopic transsphenoidal pituitary tumour diagnosis and care at Shree Hospitals achieved near-complete resection, and his visual fields recovered significantly within six weeks of surgery.

Mr. Raghav .P

How to Identify Pituitary Tumours?

Pituitary tumours present in two ways: through hormonal excess or deficiency, and through mass effect on surrounding structures. Many patients see multiple specialists for their symptoms before the pituitary origin is recognised:

Hormonal Symptoms (Excess):

Irregular periods, milky nipple discharge, or infertility: Prolactinoma causing elevated prolactin in women.
Erectile dysfunction and reduced libido: Prolactinoma-related prolactin elevation suppressing testosterone in men.
Enlarging hands, feet, jaw, and facial features: Acromegaly from GH-secreting tumour, often first noticed as rings no longer fitting or shoe size increasing.
Central weight gain, stretch marks, easy bruising, and facial rounding: Cushing's disease from ACTH-secreting tumour driving cortisol excess.
Palpitations, heat intolerance, and sweating: TSH-secreting tumour causing hyperthyroidism.

Hormonal Symptoms (Deficiency / Hypopituitarism):

Profound fatigue, cold intolerance, and weight change: Secondary hypothyroidism from TSH deficiency.
Loss of body hair, reduced libido, and muscle weakness: Gonadotrophin deficiency in men and women.
Dizziness, nausea, and collapse under stress: Cortisol deficiency from ACTH insufficiency, which is a life-threatening emergency.

Mass Effect Symptoms:

Bitemporal visual field loss: The classic pattern of vision loss from pituitary tumour as the growing adenoma compresses the optic chiasm from below.
Severe, sudden headache: Pituitary apoplexy (haemorrhage into the tumour) presenting as a thunderclap headache with visual loss and diplopia, forming a neurological emergency.
Double vision: Cranial nerve palsy from lateral cavernous sinus invasion.

Any unexplained hormonal disturbance or new visual field change warrants a pituitary MRI and an immediate review by a pituitary gland specialist. For Pituitary Tumour treatment in Mumbai, India, our team provides same-day endocrine and neurosurgical assessment.

Important FAQs: Pituitary Tumours

Are all pituitary tumours dangerous?

Most pituitary tumours termed adenomas are benign and do not spread. However, they can cause significant harm through hormonal imbalance from pituitary tumour effects on the entire body, or through vision loss from pituitary tumour mass effect. Early diagnosis and treatment by a pituitary gland specialist prevents most long-term complications.

Do all pituitary tumours need surgery?

No. Prolactinomas the most common functioning adenoma are treated primarily with medication and rarely require surgery. Non-functioning microadenomas with no symptoms or hormonal effects may be observed with surveillance. Surgery is indicated for vision loss from pituitary tumour, hormone excess unresponsive to medication, or significant tumour growth.

How is endoscopic pituitary surgery performed?

Our endoscopic transsphenoidal pituitary tumour diagnosis and care approach accesses the pituitary through the nostril passing through the nasal cavity and sphenoid sinus to reach the sella without any external incision. Patients typically experience less pain, shorter hospitalisation, and faster recovery than with traditional open approaches.

Can pituitary surgery cure Cushing's disease?

Surgical remission rates for Cushing's disease following transsphenoidal surgery by an experienced pituitary gland specialist range from 70 to 90% for microadenomas. Radiosurgery achieves remission in a further 50 to 70% of patients with persistent or recurrent disease as part of pituitary adenoma surgery and hormonal management in Mumbai.

When should I see a specialist for suspected pituitary symptoms?

Unexplained changes in body appearance, menstrual irregularity, infertility, visual field loss, severe headache, or symptoms of hormonal excess or deficiency all warrant pituitary assessment. For Pituitary Tumour treatment in Mumbai, India, our team offers same-day endocrine evaluation and dedicated pituitary MRI.

Treatments for Pituitary Tumours at Shree Hospitals

Maximal safe surgical removal is the primary treatment for glioma. Advanced techniques help remove as much of the tumour as possible while preserving important brain functions, improving outcomes and reducing the risk of recurrence.

Medical Dopamine Agonist Therapy

As first-line treatment for prolactinoma, cabergoline or bromocriptine normalises prolactin levels and shrinks the tumour in over 80% of patients, frequently avoiding surgery entirely. This forms a core part of pituitary adenoma surgery and hormonal management in Mumbai where medical management achieves excellent results.

Endoscopic Transsphenoidal Surgery

The gold standard surgical approach for most pituitary adenomas, performed entirely through the nostril with no external incision. Our endoscopic transsphenoidal pituitary tumour diagnosis and care programme uses 4K endoscopy, intraoperative imaging, and angled scopes to achieve complete or near-complete resection safely.

Somatostatin Analogue Therapy

Monthly depot injections of octreotide or lanreotide for acromegaly control GH and IGF-1, reducing tumour size pre-operatively and managing residual or recurrent disease post-surgery. This forms part of long-term hormonal imbalance from pituitary tumour management at Shree Hospitals.

Stereotactic Radiosurgery

For residual or recurrent functioning adenoma following surgery (particularly cavernous sinus disease inaccessible to complete resection), SRS achieves biochemical remission in Cushing's disease and acromegaly over 3 to 5 years as part of Pituitary Tumour treatment in Mumbai, India.