Not all pituitary tumors require surgery. Many are small and don't affect hormone function or surrounding structures. These can be followed over time with MRI scans and as long as they don't grow larger, they can be left alone. Some tumors can be stopped from growing and even shrink with medical treatment, particularly tumors secreting the hormone prolactin. Sometimes medical treatment can even be curative, but sometimes surgery becomes necessary.
Most pituitary tumors can be removed in surgery that is performed through the nose. With the patient under anesthesia, one of Carilion's highly skilled neurosurgeons, with or without the assistance of an otolaryngologist, passes instruments up the nose andinto a sinus that lies behind the nose. A sinus is an air-filled pocket in the bones of the skull. Under a microscope or television endoscope, it looks a bit like a cavern. The tumor is removed piece by piece until no further tumor can be found. Often television endoscopes are used to help look for left over tumor pieces. After the surgery, the patient recovers in the ICU and usually goes home within a couple of days.