Introduction Most common pituitary tumor 50% cause mass hypopituitarism (mass effect) Presentation Symptoms Headache Amenorrhea Bilateral gynecomastia Galactorrhea Virilization in females Impotence/Infertility recall: prolactin supresses GnRH production leading to a reduction in FSH/LH Physical exam bilateral hemianopsia CNIII palsy Evaluation MRI / CT Treatment Dopamine agonist as first line (capergoline) recall: dopamine supresses prolactin production Transphenoidal resection for large refractory tumors Radiotherapy for nonresectable macroadenomas