Pituitary Tumour Treatment and Surgery in Sydney

A pituitary tumour (pituitary adenoma) is a benign growth that develops in the pituitary gland, a small organ located at the base of the brain behind the nose. Although almost always non-cancerous, pituitary tumours can cause significant health problems by disrupting hormone production or pressing on nearby structures such as the optic nerves. At Central Sydney ENT, our skull base surgeons perform endoscopic transsphenoidal pituitary surgery in collaboration with neurosurgeons, offering a minimally invasive approach through the nose.

Symptoms of Pituitary Tumours

Symptoms depend on the tumour's size and whether it produces excess hormones:

Mass effect symptoms (from larger tumours):

Visual field loss, particularly peripheral vision (bitemporal hemianopia)
Persistent headaches
Double vision if the tumour compresses the nerves controlling eye movement
Pituitary hormone deficiency (hypopituitarism) causing fatigue, weight gain, cold intolerance, or reduced libido

Hormone-producing tumour symptoms:

Prolactinoma: irregular periods, infertility, galactorrhoea (milk production)
Growth hormone excess (acromegaly): enlargement of hands, feet, and facial features
Cushing's disease (excess cortisol): weight gain, round face, thinning skin, easy bruising
TSH-producing adenoma: symptoms of hyperthyroidism

Diagnosis

Blood tests: Comprehensive pituitary hormone panel to identify any hormonal excess or deficiency.

MRI of the pituitary: The primary imaging modality, providing detailed views of the tumour size, extent, and relationship to surrounding structures including the optic chiasm and cavernous sinuses.

Visual field testing: Formal perimetry to assess whether the tumour is compressing the optic pathways.

Endocrinology review: Assessment by an endocrinologist is an essential part of the multidisciplinary workup to guide treatment decisions.

Treatment Options

Observation: Small, non-functioning pituitary tumours that are not causing symptoms may be monitored with regular MRI scans and blood tests.

Medical therapy: Prolactinomas are usually treated first with dopamine agonist medications (cabergoline or bromocriptine), which can shrink the tumour and normalise prolactin levels without the need for surgery.

Endoscopic transsphenoidal surgery: The primary surgical treatment for most pituitary tumours. The ENT skull base surgeon creates the surgical corridor through the nose and sphenoid sinus using an endoscope, while the neurosurgeon removes the tumour. This approach avoids brain retraction and external incisions, with shorter recovery times compared to open surgery. Hospital stay is typically two to four days.

Radiation therapy: Stereotactic radiosurgery or fractionated radiation may be used for residual tumour after surgery, recurrent tumours, or cases where surgery is not appropriate.

Hormone replacement: If the tumour or its treatment results in pituitary hormone deficiency, lifelong hormone replacement therapy may be required under endocrinology supervision.

When to See an ENT Specialist

You have been diagnosed with a pituitary tumour requiring surgical assessment
Visual field loss or worsening headaches with a known pituitary lesion
Referral from your endocrinologist for surgical discussion
Recurrent pituitary tumour after previous surgery
CSF leak following previous pituitary surgery

Our Specialists

Pituitary tumour surgery at Central Sydney ENT is performed by our skull base surgeons, including Dr Rahuram Sivasubramaniam and Dr Alexander Zhang, in collaboration with neurosurgical colleagues. Consultations are available at our Burwood main practice and satellite locations.

Related conditions: CSF Leak • Nosebleeds (Epistaxis)

Related procedures: Skull Base Surgery • Sinus & Nasal Surgery

Frequently Asked Questions

Are pituitary tumours cancerous? +

The vast majority of pituitary tumours (over 99%) are benign adenomas. They are not cancerous and do not spread to other parts of the body. However, they can still cause significant problems by pressing on surrounding structures or producing excess hormones.

How is a pituitary tumour removed? +

Most pituitary tumours are removed using an endoscopic transsphenoidal approach, where the surgeon operates through the nose and sphenoid sinus to reach the pituitary gland. This minimally invasive technique avoids any external incisions and is performed jointly by an ENT skull base surgeon and a neurosurgeon.

What are the symptoms of a pituitary tumour? +

Symptoms depend on the tumour size and whether it produces hormones. Large tumours can cause headaches, visual field loss (particularly peripheral vision), and hormone deficiencies. Hormone-producing tumours cause specific syndromes such as acromegaly (excess growth hormone) or Cushing's disease (excess cortisol).

What is the recovery time after pituitary surgery? +

Most patients spend two to four days in hospital after endoscopic pituitary surgery. Recovery at home takes two to four weeks before returning to sedentary work. Patients need to avoid heavy lifting, straining, and nose blowing for several weeks. Long-term hormonal follow-up is arranged with an endocrinologist.

Why does an ENT surgeon perform pituitary surgery? +

ENT skull base surgeons provide the surgical approach through the nose and sinuses, using their expertise in endoscopic nasal anatomy to safely reach the pituitary gland. The procedure is typically a combined operation with a neurosurgeon who removes the tumour itself.