Pituitary adenomas typically present with symptoms due to mass effect and hormonal disturbances. Which of the following best describes this presentation?

• A. Seizures
• B. Mass effect and hormonal excess/deficit
• C. Hydrocephalus
• D. Spinal cord compression

Answer: (B)

Pituitary adenomas grow in the sella and affect patients through two main mechanisms: mass effect on nearby structures and disturbance of pituitary hormones. As the tumor enlarges, it can press on the optic chiasm above the sella, causing visual symptoms such as loss of peripheral vision. At the same time, the tumor may secrete excess pituitary hormones or disrupt normal pituitary function, leading to hormonal excess (like prolactin elevation, excess growth hormone, or excess ACTH) or hormonal deficits (hypopituitarism). This combination of mass-related symptoms and hormonal changes is the hallmark presentation of pituitary adenomas, which is why the option describing mass effect plus hormonal excess or deficit is the best fit.

Seizures are not typical early manifestations of pituitary tumors, hydrocephalus would require a different pattern of CSF pathway obstruction, and spinal cord compression points to lesions within the spine rather than a pituitary lesion.