Pituitary Adenoma
Pituitary adenomas are benign neoplasms arising from the hormone-secreting cells of the anterior pituitary gland. They are classified by size (microadenoma under 1 cm, macroadenoma 1 cm or larger) and by hormonal activity (functional vs non-functional), with prolactinomas being the most common subtype.
Understanding Pituitary Adenomas
Pituitary adenomas account for 10–15 per cent of all intracranial neoplasms. The pituitary gland sits within the sella turcica at the base of the skull, surrounded by critical structures: the optic chiasm superiorly, the cavernous sinuses laterally (containing the internal carotid arteries and cranial nerves III, IV, V, and VI), and the sphenoid sinus inferiorly. As a pituitary adenoma enlarges, it may compress the optic chiasm, producing visual field deficits, or invade the cavernous sinus, limiting surgical resectability. Hormonally active adenomas cause distinct clinical syndromes depending on the hormone secreted: prolactin, growth hormone (acromegaly), ACTH (Cushing's disease), TSH, or gonadotropins.
Transsphenoidal surgery is the first-line treatment for most pituitary adenomas except prolactinomas, which are primarily managed medically. Istanbul provides access to elite pituitary surgeons who perform high-volume transsphenoidal resections with outcomes comparable to leading international centres.
Treatment Options for Pituitary Adenoma
View All ProceduresGamma Knife Radiosurgery in Turkey
Gamma Knife radiosurgery is a non-invasive stereotactic procedure that delivers 192 intersecting cobalt-60 radiation beams to a single focal point inside the brain with sub-millimetre accuracy. Each individual beam is too weak to damage the tissue it passes through; only at the convergence point does the accumulated dose become therapeutically powerful enough to destroy a tumour or lesion, with no incision, no cutting, and no general anaesthetic required.
arrow_forwardPituitary Tumour Treatment in Turkey
The pituitary gland (a pea-sized organ at the base of the brain) is the body's master hormonal regulator, controlling thyroid function, growth, cortisol production, reproductive hormones, and more. Pituitary tumours (adenomas) are almost always benign, but they can cause significant problems through two mechanisms: hormonal overproduction (secreting excess growth hormone, cortisol, or prolactin) and mass effect (compressing the optic nerves, causing visual field loss, or pressing on the brain).
arrow_forwardCraniotomy (Brain Surgery) in Turkey
A craniotomy is the surgical opening of the skull to access the brain for the removal of tumours, clipping of aneurysms, resection of arteriovenous malformations (AVMs), or decompression of swollen brain tissue. A bone flap is temporarily removed, the intracranial procedure is performed under microscope guidance, and the bone is secured back in place at closure. It remains the definitive approach for lesions that cannot be treated with less invasive methods such as Gamma Knife radiosurgery.
arrow_forwardSymptoms of Pituitary Adenoma
Clinical presentation follows three patterns: mass effect, hormonal excess, and hormonal deficiency. Mass effect symptoms include headache, visual field deficits (classically bitemporal superior quadrantanopia progressing to bitemporal hemianopia from chiasmal compression), and hypopituitarism from compression of normal pituitary tissue. Pituitary apoplexy — haemorrhage or infarction of the adenoma — presents with sudden severe headache, visual loss, ophthalmoplegia, and haemodynamic collapse requiring emergency surgical decompression. Hormonal excess syndromes include hyperprolactinaemia (galactorrhoea, amenorrhoea, infertility), acromegaly, and Cushing's disease.
Diagnostic Pathways
Pituitary MRI with thin-section gadolinium-enhanced sequences is the essential imaging study, defining the adenoma's size, signal characteristics, cavernous sinus invasion (Knosp grade), and relationship to the optic chiasm. Formal visual field testing (Humphrey perimetry) documents any chiasmal or optic nerve compression. Hormonal evaluation includes prolactin, IGF-1, ACTH, cortisol, TSH, free T4, FSH, LH, and in males, testosterone. Transsphenoidal biopsy may be needed for non-functioning adenomas where tissue diagnosis is required to guide management.
Advanced Treatment Options at Vellum Select
Transsphenoidal Adenomectomy
Pituitary Tumour Treatment in Turkey via transsphenoidal approach is the first-line treatment for most non-prolactinoma pituitary adenomas. Prof. Dr. Türker Kılıç performs both microscopic and fully endoscopic transsphenoidal resection using intraoperative image guidance to maximise resection while preserving normal pituitary function. Remission rates for functional microadenomas exceed 85 per cent. Hospital stay is typically 24–48 hours with no external incision.
Craniotomy
For large adenomas with significant suprasellar extension not amenable to transsphenoidal surgery, Craniotomy (Brain Surgery) in Turkey may be necessary.
Gamma Knife Radiosurgery
For residual or recurrent adenomas not amenable to surgical re-resection, Gamma Knife Radiosurgery in Turkey offers effective tumour control and can normalise hormone hypersecretion in functioning adenomas.
To discuss your pituitary adenoma diagnosis with Prof. Dr. Türker Kılıç, view his profile or contact Vellum Select to arrange a consultation.
