垂体瘤

A pituitary tumor is an abnormal growth in the pea‑sized hormone gland at the base of the brain that can change hormone levels and/or press on nearby structures like the vision nerves. Most are non‑cancerous and slow‑growing, and many can be controlled or cured with medicines, surgery, or both.​

1) What is this condition?

  • It is a lump of extra cells in the pituitary gland, which normally controls growth, stress response, thyroid, sex hormones, and other body functions.​

  • Most pituitary tumors (adenomas) are benign and stay in the region of the gland rather than spreading through the body.​

  • Some make too much hormone (“functioning” tumors); others mainly cause trouble by their size and pressure (“non‑functioning” tumors).​

2) How serious is it?

  • Many pituitary tumors are manageable and have an excellent outlook, especially when found early and treated at a center with experience.​

  • If not treated, they can cause vision loss, headaches, infertility, sexual problems, weight and blood pressure changes, bone loss, and other hormone‑related issues.​

  • Very rarely, pituitary tumors become cancerous and spread, but this is less than about 1 in 1,000 cases.​

3) Non‑surgical treatments

  • Hormone‑blocking or hormone‑normalizing medicines:

    • Dopamine‑like drugs (such as cabergoline, bromocriptine) can shrink prolactin‑producing tumors and often avoid surgery.​

    • Other drugs can reduce growth‑hormone or ACTH (stress hormone) effects when those tumors overproduce hormones.​

  • Hormone replacement if the gland is underactive (thyroid, cortisol, sex hormones, etc.).​

  • Radiation or focused radiosurgery when surgery and medicines are not enough or not possible.​

  • Careful observation with regular scans and blood tests for small, symptom‑free tumors.​

4) Types of surgery that may be needed

  • Endoscopic transsphenoidal surgery: going through the nose and sinus with a camera and instruments to remove the tumor without opening the skull.​

  • Microscopic transsphenoidal surgery: similar route with a small microscope‑assisted approach.​

  • Open (craniotomy) surgery through the skull is rarely needed, usually for very large or unusual tumors.​

5) Goals of surgery vs non‑surgical care

  • Non‑surgical goals:

    • Normalize hormone levels using medicines, so symptoms like milk leakage, weight gain, blood pressure changes, or abnormal growth improve.​

    • Control or shrink tumors that are too risky to remove fully, or treat remaining tumor after surgery.​

  • Surgery goals:

    • Remove tumor tissue to relieve pressure on vision nerves and brain and, when possible, correct hormone overproduction.​

    • Obtain tissue to confirm the exact tumor type.​

6) How surgery can “fix” the problem

  • By taking out the mass, surgery reduces pressure on the optic nerves and nearby brain, which can quickly improve or protect vision and headaches.​

  • Removing hormone‑producing tumor cells can drop abnormal hormone levels back toward normal, easing body‑wide symptoms.​

  • Because surgery comes in through the nose, there is usually no visible scar and less disturbance of the brain itself.​

7) Risks of surgery (general and specific)

  • General risks: bleeding, infection, blood clots, and risks from anesthesia.​

  • Pituitary‑specific risks:

    • Leak of clear brain fluid from the nose, which may need repair.​

    • New hormone shortages (low thyroid, low cortisol, low sex hormones) requiring lifelong replacement pills.​

    • Temporary or permanent diabetes insipidus (making too much urine and being very thirsty).​

    • Rarely, worsening or new vision problems if the optic nerves are affected.​

8) Chances this surgery will work

  • For many pituitary tumors, especially small ones, surgery controls or cures the tumor in about 50–90% of patients, depending on size and type.​

  • Large series show transsphenoidal surgery is generally safe and effective, with very low death rates (around 0.3% in one large report).​

  • Hormone‑producing tumors differ: some (like many growth‑hormone or ACTH tumors) need both surgery and other treatments to reach full hormone control.​

9) Possible complications from the surgery

  • Short‑term: nose congestion, headache, fatigue, mild bleeding from the nose, or temporary changes in smell or taste.​

  • Hormone problems: need for ongoing hormone replacement, temporary or permanent diabetes insipidus, or low sodium.​

  • Tumor regrowth over years, particularly if some was left behind; may require repeat surgery, medicines, or radiation.​

10) Typical recovery from the condition

  • With proper treatment, many people return to normal or near‑normal daily life, though some need long‑term hormone pills.​

  • Vision often improves if the tumor was pressing on the optic nerves and is removed early enough.​

  • Some physical changes (like bone changes from long‑term hormone excess) improve slowly or only partly.​

11) Typical recovery after surgery

  • First 1–3 days: hospital stay with monitoring of vision, hormone levels, fluid balance, and nasal drainage.​

  • First weeks: tiredness and mild headaches are common; most people avoid heavy lifting and nose‑blowing while the area heals.​

  • Over 4–6 weeks: many return to normal activities; hormone testing is repeated to adjust any needed replacement medicines.​

12) How long in the hospital

  • Most patients stay 1–3 days after standard endoscopic transsphenoidal surgery if there are no complications.​

  • Longer stays may be needed if there is a fluid leak, hormone crisis, infection, or other medical issues.​

13) Long‑term outlook

  • Overall prognosis is excellent; most pituitary tumors can be controlled or kept stable for decades with surgery, medicines, and/or radiation.​

  • Less than 0.1% become truly cancerous; long‑term issues are usually related to hormone deficits or regrowth, not spread to other organs.​

  • Many people live normal lifespans, working and functioning independently, with regular follow‑up.​

14) Need for outpatient follow‑up

  • Lifelong follow‑up with an endocrinologist (hormone specialist) and often a pituitary neurosurgeon is recommended.​

  • Regular blood tests and MRI scans watch hormone levels and check for any return or growth of the tumor.​

  • Hormone replacement doses, vision checks, and, if used, radiation effects all need periodic review and adjustment.