Michael is a 48 year old man who came to our office with complaints of fatigue and changes in his vision. His endocrinologist found that several of his hormone levels were low such as testosterone, cortisol, and the thyroid hormone TSH. An MRI was done that showed a large pituitary tumor. His ophthalmologist did a visual field test that showed mild loss of peripheral vison.
There are two basic ways to think about a pituitary tumor–size and hormone production. In Michael’s case, he had a large tumor which crowded the pituitary gland causing it to poorly function. Large tumors can also put pressure on the optic nerves, which are directly above the pituitary glad.
Some tumors actually produce hormones. Cushing’s disease for example occurs when a pituitary tumor produces too much cortisol. Michael’s tumor did not produce hormones.
Michael underwent surgery. We accessed the tumor through the nose. The surgery took about an hour and a half. He spent a day in the hospital and went home. His symptoms have significantly improved due to, in part, the surgery but also hormone replacement therapy. His visual function has also improved.
Disclaimer: Although this is a real patient, I have used a different name for privacy protection and added a few details for educational purposes. This patient gave consent to have his case shared.