What Department Should You Visit for a Pituitary Tumor?

Patients with pituitary tumors should seek care from the neurosurgery department. Pituitary tumors, also known as pituitary adenomas, originate in the pituitary gland—a small but vital endocrine organ located at the base of the brain. Because of their location and potential impact on neurological and hormonal functions, these tumors are primarily managed by neurosurgeons. Treatment typically involves a combination of surgical intervention, medication, and long-term monitoring, depending on the tumor type and severity.

Understanding the Types of Pituitary Adenomas

Pituitary tumors are broadly classified into two main categories: non-functioning and functioning adenomas. The distinction lies in whether the tumor produces excess hormones. This classification plays a crucial role in diagnosis, symptoms, and treatment planning.

Non-Functioning Pituitary Adenomas

These tumors do not secrete active hormones, making them difficult to detect in the early stages. Often, they grow silently until they exert pressure on surrounding brain structures. Common signs include vision problems—especially loss of peripheral vision due to compression of the optic chiasm—and symptoms related to hypopituitarism, such as fatigue, low libido, weight changes, and hormonal deficiencies. Because symptoms are subtle, many patients only seek medical attention when the tumor has already reached a significant size.

Functioning Pituitary Adenomas: Early Warning Signs

Functioning tumors produce excess hormones even when small, leading to noticeable clinical syndromes that prompt earlier diagnosis. Key types include:

ACTH-Secreting Adenomas (Cushing's Disease)

These tumors cause overproduction of adrenocorticotropic hormone (ACTH), resulting in Cushing's syndrome. Early symptoms may seem benign—such as unexplained weight gain around the abdomen and face—but classic signs like a round "moon face," fatty "buffalo hump" on the back of the neck, thinning skin, easy bruising, and high blood pressure should raise red flags. Left untreated, Cushing's disease increases the risk of diabetes, osteoporosis, and cardiovascular complications. Surgical removal via transsphenoidal approach is the primary treatment.

Growth Hormone-Secreting Tumors (Acromegaly)

When a pituitary tumor secretes excessive growth hormone, it leads to acromegaly in adults. Symptoms develop gradually and include enlarged hands and feet, thickened lips, broad nose, prominent jaw, and spaced teeth. Patients may also experience joint pain, sleep apnea, and hypertension. Early detection is key to preventing irreversible physical changes and metabolic disorders. Surgery remains the first-line treatment, often followed by medication or radiation if complete resection isn't possible.

Prolactin-Secreting Tumors (Prolactinomas)

Prolactinomas are among the most common functioning pituitary tumors. In women, early signs often include irregular menstrual cycles and galactorrhea (milk discharge from breasts despite not being pregnant or nursing). Men may notice decreased libido, erectile dysfunction, or even vision issues if the tumor grows large. Interestingly, many female patients initially consult gynecologists or fertility specialists due to infertility, while others visit endocrinologists for unexplained hormonal imbalances, high blood pressure, or glucose intolerance.

However, regardless of the initial point of contact, management ultimately falls under neurosurgical care. For prolactinomas, dopamine agonists like cabergoline or bromocriptine are usually the first treatment. About 60–70% of patients respond well, experiencing reduced prolactin levels and tumor shrinkage. If medication fails after six months—either due to resistance or intolerable side effects—minimally invasive surgery becomes the next step.

Why Multidisciplinary Care Matters

While neurosurgery leads the treatment pathway, managing pituitary tumors often requires a team approach. Endocrinologists help restore hormonal balance, ophthalmologists assess visual function, and radiologists provide critical imaging support. Long-term follow-up is essential to monitor recurrence, manage hormone replacement, and ensure quality of life.

In summary, if you suspect a pituitary tumor due to hormonal disturbances, vision changes, or unexplained neurological symptoms, your best course is to consult a neurosurgeon specializing in pituitary disorders. Early diagnosis and tailored treatment can significantly improve outcomes and prevent serious complications.