Management Surgical therapy, medicinal therapy or radiotherapy are the three treatment options for pituitary adenomas. Since the late 1970s, the transphenoidal surgical approach has been the preferred procedure for removal of tumors. Surgery is indicated if there is evidence of tumor enlargement, especially when growth is accompanied by compression of the optic chiasm, cavernous sinus invasion, or the development of pituitary hormone deficiencies. Visual improvement following treatment is often dramatic, with the greatest degree of improvement occurring within the first few months. Perimetry and MRI occupy an important role in the post treatment monitoring of patients.
Medicinal treatment is limited to prolactinomas.
Bromocriptine, a dopamine agonist, is useful in shrinking the sizes of these tumors. Low dose therapy of Bromocriptine is maintained for life. If the drug therapy is discontinued, there is often regrowth and enlargement of the adenoma. Conventional radiotherapy is usually added adjunctively to prevent tumor regrowth. Pituitary apoplexy is a potentially life-threatening condition.