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Pituitary adenoma surgery in Tijuana
Pituitary tumours cause symptoms in two ways: they compress the visual pathway or they disturb hormones. Surgery is decided together with endocrinology and ophthalmology, never alone.
Two reasons to operate: vision and hormones
The pituitary sits directly beneath the crossing of the optic nerves. When an adenoma grows upward, the first thing lost is peripheral vision on both sides: patients start clipping door frames or missing cars approaching from the side. That pattern, bitemporal hemianopsia, is a clear surgical indication.
The other reason is hormonal. An adenoma can oversecrete — prolactin, growth hormone, ACTH — causing galactorrhoea, infertility, acromegaly or Cushing's syndrome; or it can compress the healthy gland and cause undersecretion, with fatigue, loss of libido and hypothyroidism. Each scenario has its own treatment, and not all of them start in theatre.
When medication comes before surgery
Prolactinoma is the important exception: most respond to dopamine agonists, which shrink the tumour and normalise prolactin without an operation. That is why the full hormone panel is requested before anything is scheduled — operating a prolactinoma that a tablet would have resolved is an avoidable mistake.
For the remaining adenomas surgery is first-line treatment when there is visual compression, when the tumour grows, or when hypersecretion is not controlled. The transsphenoidal approach — through the nose and sphenoid sinus — avoids opening the skull; very large tumours or those with lateral extension may still need a cranial approach.
What the procedure involves
When it is indicated
- Macroadenoma compressing the optic chiasm with visual field loss
- Growth hormone secreting adenoma (acromegaly)
- ACTH secreting adenoma (Cushing's disease)
- Prolactinoma unresponsive to or intolerant of medical treatment
- Pituitary apoplexy with acute visual deterioration
- Non-functioning adenoma with documented growth
Techniques and resources
- Transsphenoidal approach
- Operating microscope
- Endoscope where available
- Sellar MRI
- Computerised perimetry
- Serial hormone panels
Frequently asked questions about pituitary adenoma surgery
For most adenomas, no. The transsphenoidal approach goes through the nose and reaches the sellar floor through the sphenoid sinus, with no craniotomy and no visible scar. Only very large tumours, or extensions the nasal corridor cannot reach, require a cranial approach.
When visual field loss is recent, recovery after decompressing the chiasm is usually good. When it has been present for years, part of the optic nerve damage may be permanent. That is why a field defect is not left to mature — it is a reason not to postpone.
Not always. It depends on how much healthy gland remained before surgery and how much is preserved. Endocrinology reassesses the hormonal axis after the operation and replaces only what is actually needed.
Bring your imaging and settle the question
One consultation with your MRI or CT in hand is worth more than ten internet searches. Book by phone or through the form and you will be told what is there, what it means and what your options are.