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Pituitary Surgery Complications

Two classes of pituitary tumors exist: secretory, in which the tumors produce excess quantities of pituitary hormones; or non-secretory, which do not secrete excess hormones, but whose size or location may necessitate removal. While medications are often initially recommended for pituitary tumor treatment, surgery often is recommended if the tumor does not respond well to treatment.

  1. Surgical Procedure

    • The pituitary gland is located in the sella, which is located in the base of the skull. Therefore, the surgical approach in many cases is through the sphenoid sinus, which is a sinus cavity located behind the nose. A surgeon will then insert a small, thin endoscope with a camera on the end in order to visualize the area and pinpoint the pituitary gland. If the tumor is large, it is cut into smaller pieces and then drawn out through the sinus cavity.

    Damage to the Pituitary Gland

    • According to The Neuroendocrine Clinical Center & Pituitary Tumor Center at Harvard University, the most common complication associated with pituitary surgery is damage to the pituitary gland itself. Because a tumor can sometimes insinuate itself around the nerves of the pituitary gland, removing the tumor can harm the gland itself. If damage occurs, a surgeon may prescribe hormone medications, such as cortisol, growth hormone, estrogen or testosterone.

    Diabetes Insipidus

    • If the tumor was located on the back portion of the pituitary gland, damage to the area can cause a condition known as diabetes insipidus. This condition occurs in 1 to 2 percent of pituitary gland surgery patients, according to The Neuroendocrine Clinical Center & Pituitary Tumor Center. Symptoms of this condition include frequent need to urinate and excessive thirst. These symptoms can be controlled with medications, and often go away within the first 1 to 2 weeks after surgery, according to the American Cancer Society.

    Carotid Artery Damage

    • While this occurs in a very small fraction of pituitary surgery cases, the carotid arteries can be damaged during surgery. The arteries are located on either side of the pituitary gland and can lead to stroke or even death if not treated promptly.

      In addition to bleeding of the carotid artery, sometimes not all of the tumor can be removed due to its location on the sella. When this occurs, the tumor may sometimes bleed into the sella, which can cause blood clots that result in temporary vision loss. Another surgical procedure often is required to remove the clots.

    Spinal Fluid Leak

    • If a pituitary tumor must be removed from the spinal fluid, the fluid can leak into the membranes that are around the brain (meninges), which causes an infection known as meningitis. This type of leak requires additional surgery to repair. According to The Neuroendocrine Clinical Center & Pituitary Tumor Center, the spinal fluid leak occurs in an estimated 1 percent of all pituitary tumor removal surgeries.

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