Pituitary Tumors: What Are They and How Are They Treated?
Keywords:
Pituitary, TSA, ESBS, TumorAbstract
The pituitary gland (hypophysis) is a very small, pea-sized gland located inside the skull, specifically beneath the brain and above the back of the nasal cavity. However, if the gland grows beyond its normal size (tumor), it can compress and damage the brain and nerves, leading to hormonal disorders and even blindness. Most pituitary tumors are benign. Their symptoms vary depending on the type of tumor and the areas around the pituitary gland that are affected. Many patients present with visual disturbances or even blindness. Although benign, progressive growth can cause symptoms that significantly affect the patient's quality of life. Management of pituitary tumors may include radiotherapy, medication, and surgery. Surgery is the primary treatment for pituitary tumors. Currently, the Endoscopic Skull Base Surgery (ESBS), Transsphenoidal Approach (TSA), has become one of the techniques that offers advantages such as shorter stays in the ICU and hospital ward, reduced risks and minimal bleeding during surgery, faster recovery, and no facial incisions (better cosmetic outcome).
References
Dai C, Kang J, Liu X, Yao Y, Wang H. How to Classify and Define Pituitary Tumors: Recent Advances and Current Controversies. Front Endocrinol. 2021;12(March):1-6.
Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement. 2023;19(December).
Tahapary DL, Oswari S, Kusumawati M, Lubis DA, Minuljo TT, Yunus RE, et al. Feature Article A Consensus for Pituitary Adenoma Diagnosis in Indonesia. 2025;40(1):8-13.
Tsukamoto T, Miki Y. Imaging of pituitary tumors: an update with the 5th WHO Classifications - part 1. Pituitary neuroendocrine tumor (PitNET)/pituitary adenoma. Jpn J Radiol. 2023;41(8):789-806. doi: 10.1007/s11604-023-01400-7
Huang X, Jiang X. Mini Review Advances in Neuroendoscopic Treatment of Pituitary Tumors. 2025;1(1):39-43. doi: 10.14218/NSSS.2024.00008
Sophia Russ, Catherine Anastasopoulou, Ismat Syafiq. Adenoma Hipofisis. NCBI. 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554451/
Graffeo CS, Yagnik KJ, Carlstrom LP, Lakomkin N, Bancos I, Davidge-Pitts C, et al. Pituitary Adenoma Incidence, Management Trends, and Long-term Outcomes: A 30-Year Population-Based Analysis. Mayo Clin Proc. 2022;97(10):1861-71.
Daly AF, Beckers A. The Epidemiology of Pituitary Adenomas. Endocrinol Metab Clin North Am. 2020;49(3):347-55.
Westall SJ, Aung ET, Kejem H, Daousi C, Thondam SK. Management of pituitary incidentalomas. Clin Med. 2023;23(2):129-34.
Candy NG, Jukes AK, Van Der Veken J, Torpy DJ, Vrodos N, Santoreneos S, et al. The Learning Curve for Endoscopic Endonasal Transsphenoidal Pituitary Surgery: Evaluating Endocrine Outcomes. J Clin Neurosci. 2024;120:14-22.
Savik R, Ozturk Y, Yangi K, Bozkurt I, Kalayci M. Comparison of Microscopic and Endoscopic Transsphenoidal Surgery for Pituitary Adenomas. Cureus. 2025;17(3). Available from: https://pubmed.ncbi.nlm.nih.gov/40213724/
Aaron Cohen-Gadol MD. Surgery for Pituitary Tumors. 2025. Available from: https://www.aaroncohen-gadol.com/en/patients/pituitary-tumor/treatment/surgery
Della Fitricana, Ardianto, Alwi Shahab, Yuliato Kusnadi, Ratna Maila Dewi, Anugrah Onie, Yoan Levia Magdi, Arie Zainul Fatoni. Makroadenoma Hipofisis Fungsional Dengan Manifestasi Akromegali Dan Diabetes Melitus Tipe Lain Yang Tidak Terkontrol. 2022;9(12). Available from: https://majalahfk.ub.ac.id/index.php/mkfkub/article/download/626/320/3193
Graffeo CS, et al. Pituitary adenoma incidence and outcomes. Mayo Clin Proc. 2022;97:1861-1871.
Daly AF, Beckers A. Epidemiology of pituitary adenomas. Endocrinol Metab Clin North Am. 2020;49:347-355.
Tsukamoto T, Miki Y. Imaging of pituitary tumors. Jpn J Radiol. 2023;41:789-806.
Tjornstrand A, et al. Long-term outcomes in acromegaly. Eur J Endocrinol. 2021;184.
Dekkers OM, et al. Mortality in Cushing's disease. J Clin Endocrinol Metab. 2020;105.
Minniti G, et al. Radiotherapy for pituitary adenomas. Clin Endocrinol. 2020;92.
Dai C, et al. Classification of pituitary tumors. Front Endocrinol. 2021;12.
Lopes MBS. The 2022 WHO classification of pituitary tumors. Endocr Pathol. 2022;33:6-26.
