Two main types
'Functional' adenomas release hormones (e.g. prolactin, growth hormone or ACTH) and cause hormonal disorders; 'non-functional' ones are usually noticed when they press on the optic nerves and cause visual field loss. Evaluation requires MRI, hormone tests and a visual exam.
Medication, surgery or surveillance?
Prolactinomas are often treated with medication rather than surgery. For most other adenomas causing visual loss or hormone release, endoscopic transsphenoidal surgery — removing the tumor through the nose without a head incision — is the standard treatment. Small, asymptomatic adenomas can be watched.
Endoscopic transsphenoidal surgery
The tumor is reached through the natural nasal route with an endoscope; there is no external incision and structures such as the optic nerves are protected under magnification. The goal is to remove the tumor, relieve the nerves and, in functional adenomas, normalize hormones. Recovery is usually quick.
After surgery
Hormone levels and vision are followed closely; some patients may need temporary or permanent hormone replacement. Follow-up with MRI and hormone tests is planned according to the adenoma type.