PITUITARY TUMORS (NYC)

Minimally Invasive Approaches • Skull Base Expertise • Multidisciplinary Endocrine Care

Overview

Pituitary tumors—also called pituitary adenomas—are growths that arise from the pituitary gland at the base of the brain. Many are benign, but they can cause significant symptoms by altering hormone levels or compressing nearby structures such as the optic nerves.

As a neurosurgical oncologist at Lenox Hill Hospital in Manhattan and a surgeon experienced in minimally invasive cranial techniques, Dr. Randy S. D’Amico evaluates and treats patients with pituitary tumors in collaboration with a specialized multidisciplinary team. His focus is on preserving visual, hormonal, and neurological function while using the least disruptive surgical approach possible.

Types of Pituitary Tumors Treated

  • Non-functioning pituitary adenomas

  • Prolactinomas

  • Growth hormone–secreting tumors (acromegaly)

  • ACTH-secreting tumors (Cushing disease)

  • Thyrotropin-secreting tumors (rare)

  • Pituitary apoplexy

  • Recurrent or residual pituitary tumors

Each subtype requires a tailored plan involving endocrinology, imaging, and surgical evaluation.

Common Symptoms

Symptoms may result from hormonal imbalance or compression of nearby structures:

Hormone-Related Symptoms

  • Fatigue and weakness

  • Weight gain or weight loss

  • Menstrual irregularities

  • Loss of libido

  • Milk discharge from breasts

  • Mood changes

  • Uncontrolled blood pressure or blood sugar

Compression Symptoms

  • Vision loss or blurry vision (classically “bitemporal hemianopsia”)

  • Headaches

  • Nausea or vomiting (in apoplexy)

  • Double vision or eye movement problems

Pituitary apoplexy—a sudden bleed into the pituitary—is a medical emergency.

Diagnosis & Evaluation

Evaluation typically involves:

  • MRI of the pituitary/sella

  • Complete endocrine blood workup

  • Visual field testing (when vision is affected)

  • High-resolution imaging to assess tumor extension

  • Multidisciplinary review with endocrinology

A precise diagnosis guides whether observation, medication, or surgery is needed.

Treatment Options

Observation

Small, asymptomatic tumors may be monitored with periodic MRI and endocrine testing.

Medical Therapy

Some functioning tumors—particularly prolactinomas—can often be treated with medication instead of surgery.

Surgery

For tumors causing vision loss, hormonal imbalance, or growth, the primary treatment is surgery.

Radiation Therapy

Used selectively for residual or recurrent tumors—especially atypical or aggressive subtypes.

Surgical Approach

Minimally Invasive Endonasal (Transsphenoidal) Surgery

Most pituitary tumors can be removed through the nose, without external incisions.
Dr. D’Amico collaborates with experienced ENT skull base surgeons to perform minimally invasive endonasal resections with:

  • High-definition endoscopic visualization

  • Precise tumor removal

  • Protection of normal pituitary tissue

  • Rapid recovery compared to traditional craniotomy

Craniotomy for Complex Tumors

Certain tumors (giant adenomas, tumors invading above the optic chiasm or deep into the cavernous sinus) may require an open cranial approach.
Connectomics-guided planning helps map critical pathways near the surgical corridor.

Management of Recurrent Tumors

Recurrent tumors may require:

  • Repeat endonasal surgery

  • Radiosurgery

  • Endocrine therapy

  • Long-term monitoring

Multidisciplinary Care

Pituitary tumors require coordinated management, often involving:

  • Endocrinology

  • Ophthalmology

  • Radiation oncology

  • Neuroradiology

  • Neuro-oncology (for aggressive subtypes)

  • Rehabilitation and symptom management

Dr. D’Amico works closely across specialties to create a unified, personalized plan for each patient.

When to Seek a Second Opinion

A second opinion is valuable when:

  • Vision is declining

  • Hormonal abnormalities are worsening

  • Medication is not controlling symptoms

  • The diagnosis is unclear (adenoma vs hyperplasia vs metastasis)

  • There is recurrent tumor growth

  • Surgery has been recommended and you want to confirm approach and safety

  • You want to discuss minimally invasive options

Second opinions are often available quickly.

Serving New York City & the Tri-State Area

Patients with pituitary tumors receive care at Lenox Hill Hospital, conveniently located on the Upper East Side of Manhattan (100 E 77th St, New York, NY 10075). The practice serves:

  • Manhattan

  • Brooklyn

  • Queens

  • The Bronx

  • Long Island

  • Westchester

  • Northern New Jersey

Next Steps

If you or a loved one has a pituitary tumor:

  • Request a Consultation

  • Seek a Second Opinion

  • Refer a Patient

  • Return to Conditions Treated for additional pages