Second stage of pituitary tumors is hormonal workup. Once you've been diagnosed with a pituitary tumor on your brain, MRI and CT scan of your head, you will undergo a set of hormonal blood work and sometimes urine work for your hormones. This work will be done with the help of a neurosurgeon and an endocrinologist. If you have any loss of vision, you will also benefit from seeing an ophthalmologist. Sometimes a neuro ophthalmologist will be helpful and depending on the level of visual loss or visual symptoms, there are several types of hormone-related findings, but pituitary tumors is completely dependent on the type of hormone secreted by the two tumors that secrete prolactin lead to no Menzies lactation, with a woman and men, it causes enlarged breasts and impotence. Tumors that secrete Cushing's steroids, lead to a disease called Cushing's disease, where the cortisol levels or steroid levels in the body are increased. And hence the patient gains weight as hypertension, easy bruising, no Menzies in females, changes in the skin color as well as decreased libido and osteoporosis. The third type of hormonal imbalance is thyroid imbalance, a small percentage of the pituitary tumors about 1% secrete thyroid stimulating hormone, and hence giving society palpitations and heat and tolerance and protuberant eyes to the patient. The final subgroup is the rarest it's called acromegaly or growth hormone secreting pituitary tumors. These are quite rare or about a three per 1 million and lead to increase in hand size, increase in foot size, high blood pressure, carpal tunnel syndrome, sleep apnea and glucose intolerance. Once the battery of labs is done, you will be set up to discuss surgical intervention with your neurosurgeon.