Pituitary tumours 

The pituitary gland is located at the base of the brain, behind the eyes. It produces chemical messengers called hormones. These are produced by the pituitary gland and released into the blood stream. They, in turn, control other glands in the body, including the adrenal glands and thyroid gland, which then control important body functions.

Most pituitary tumours are pituitary adenomas, which are benign, slow-growing tumours that arise from cells in the pituitary gland. Symptoms of the pituitary tumour are generally caused by the tumour producing too much of a certain hormone, by preventing the normal gland from producing enough hormones or by causing pressure on the nerves to the eyes. Increasingly pituitary tumours are found on routine scans for often completely unrelated problems such as headaches.

You will need different tests to assess the size and effects of the tumour, such as eye tests, a CT scan or an MRI scan as well as an assessment of the hormones that the pituitary gland produces. Often, a specialist endocrinologist will see you and assess your hormones before any particular treatment is recommended.

If the pituitary tumour needs treatment, surgery tends to be the first line treatment in most cases. Your neurosurgeon will talk to you about the best treatment option for you, taking into consideration the scan and blood test results.

Most pituitary surgery is undertaken through the nose so you will not have a visible wound after surgery. This is called a transsphenoidal hypophysectomy as it is undertaken via the sphenoid sinus which is an air sinus that sits at the back of your nose. It is done under general anaesthetic. If the tumour is very large, your neurosurgeon might decide that the best option for you is a craniotomy (surgery through your head).

We sometimes suggest treating the pituitary tumour with medication. This is particularly if the pituitary tumour produces too much of a hormone called Prolactin. Some people will need radiotherapy after surgery or instead of surgery. Some people with very small tumours may have a specialised type of targeted radiotherapy called stereotactic radiosurgery.

You might need to take medication if your hormones have been affected either by the tumour or as a result of surgery. This is called hormone replacement.

You can find more detailed pituitary information at the pituitary foundation website www.pituitary.org.uk .

 Consultants

Dr Naomi Fersht, Consultant Clinical Oncologist

Dr Naomi Fersht

Dr Naomi Fersht coordinates care across brain tumour services at UCLH.

She is a consultant clinical oncologist at University College Hospital and the National Hospital for Neurology and Neurosurgery (NHNN). She specialises exclusively in the management of primary and secondary brain and spinal tumours. This involves the use of both conventional and innovative radiotherapy techniques and chemotherapy. 

Her special interests are: brain oligometastases; meningiomas; pituitary tumours; the management of teenagers and young adults with brain tumours (age 16-24); and advanced radiotherapy techniques including radiosurgery.

She qualified from the University of Cambridge and her specialist training was at the Royal Marsden and University College Hospitals. Naomi's doctoral thesis, supervised by Nobel Laureate Sir Paul Nurse, was in cell cycle checkpoints.

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Dr Stephanie Baldeweg, Consultant Endocrinologist

Dr Stephanie Baldeweg

Dr Stephanie Baldeweg is the Clinical Lead at the Department of Diabetes and Endocrinology at UCLH. She works as a Consultant Physician in Diabetes and Endocrinology and as Honorary Senior Lecturer at UCL.

Stephanie is interested in all aspects of diabetes and endocrinology. She has a special clinical and research interest in pituitary disease and late effects of cancer on the endocrine system. Her other interests include diabetes, thyroid and reproductive disease as well as osteoporosis, weight management and cardiovascular risk reduction.

Stephanie regularly lectures at national and international meetings as well as patient days for UK charities. She is a trustee of The Pituitary Foundation.

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Prof Pierre Bouloux, Consultant Endocrinologist

Prof Pierre Bouloux

Professor Bouloux is a general endocrinologist and internist with special interest in neuroendocrinology and andrology.

Prof Sebastian Brandner, Consultant Neuropathologist

Prof Sebastian Brandner

Sebastian Brandner is Professor of Neuropathology at UCL and Honorary Consultant Neuropathologist at the National Hospital for Neurology and Neurosurgery (NHNN) at UCLH. He leads the Division of Neuropathology and is specialised in brain tumour diagnostics including molecular diagnostics, and neurodegeneration.

He has authored and co-authored research publications on brain tumour models, book chapters in major neuropathology textbooks, and the 2016 WHO classification as well as guidelines for the Royal College of Pathologists. He serves on the National Institute of clinical excellence (NICE) guideline committee to establish guidelines for management and treatment of primary brain tumours and cerebral metastases

The Division of Neuropathology receives brain tumour referrals from the NHNN, and several major regional hospitals. The Division also provides a molecular pathology service for referrers across the United Kingdom.

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Mr Neil Dorward, Consultant Neurosurgeon

Mr Neil Dorward

Mr Dorward is a consultant neurosurgeon who performs both cranial and spinal surgery with a particular interest in endoscopic surgery, pituitary region surgery and complex spinal surgery. He specialises in minimal access spinal surgery and disc replacements.

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Miss Joan Grieve, Consultant Neurosurgeon

Miss Joan Grieve

Miss Grieve was appointed consultant neurosurgeon at the National Hospital for Neurology and Neurosurgery (NHNN) in 2002.

Her clinical interests include pituitary and parasellar pathologies; neurovascular treatment for intracranial aneurysms, arteriovenous malformations and cavernous haemangiomas; gamma knife radiosurgery; and neuro-oncology as well as general intracranial neurosurgery.

Miss Grieve was clinical lead for neurosurgery from 2007-2013. During her tenure, she oversaw the amalgamation of neurosurgical services for North Central London (then based at the NHNN and Royal Free Hospitals) into a single service at the NHNN. She also oversaw the opening of the first nationally dedicated brain tumour ward, Molly Lane Fox Brain Tumour Unit; and the provision of a single site pituitary and skull base neurosurgical service for North London at Queen Square.

She is a member of the Society of British Neurosurgeons, the British Neurovascular Group and an international member of the Congress of Neurological Surgeons.

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Dr Katherine Miszkiel, Consultant Neuroradiologist

Dr Katherine Miszkiel

Dr Miszkiel has been a consultant at The National Hospital for Neurology and Neurosurgery since 1998.

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