Surgery of pituitary tumours 

Pituitary tumours have both endocrine and neuro-oncologic sequelae. Secretory tumours may liberate physiological hormones to pathological excess, generating a full spectrum of metabolic aberrations and hallmark clinical syndromes. Other pituitary tumours are endocrinologically inactive and generate instead a variety of compressive phenomena such as pituitary hypofunction and neurological compromise. Although advances continue to be made in the pharmacological and radiotherapeutic management of pituitary tumours, surgery remains the treatment of choice for most of these lesions. Of the available surgical options, the transsphenoidal route is the dominant surgical approach to these tumours. Shaped by the brilliant insight of individual surgeons and technological innovation, transsphenoidal surgery for the sellar and parasellar regions is a fascinating chronicle in surgical history whose evolution continues unabated. We herein review surgical approaches to pituitary tumours, emphasizing the transsphenoidal approach.