He thought that it was migraine, but worsening vision told another story: Karnataka doctors remove a giant 5 cm brain tumour
When Raghav (name changed), a middle-aged man and a non-resident of Karnataka, began experiencing persistent headaches, repeated episodes of vomiting and progressively worsening vision disturbances, he initially brushed them off as symptoms of a routine migraine or an eye-related issue. Little did he know, these seemingly common symptoms pointed to a far more serious neurological condition. He didn’t think much of these problems until they became impossible to ignore when he finally sought care. The ream of physicians evaluated Raghav’s evaluations and were surprised to find out he had a giant pituitary macroadenoma ( a 5 cm tumour located at the base of the skull).
He was referred to Dr. Praveen M Ganigi, senior consultant- Neurosurgery, who explained that one of the biggest challenges with such tumours is delayed diagnosis. “ Many patients initially consult eye specialists or general physicians because the symptoms appear unrelated to the brain. In several cases, patients may temporarily feel better after taking over-the-counter medication, causing them to delay further investigations”, said Dr. Praveen. “ Although pituitary tumours are relatively common this particular tumour was considered highly complex because it had extended into critical regions surrounding the brain and was encasing important blood vessels and nerves.
In cases like these, surgery carries potential risks including stroke, vision loss, severe hormonal disturbances, prolonged unconsciousness, and even life-threatening complications of nearby structures are damaged during the procedure,: he added.
To reduce these risks, the medical team led by Dr. Praveen and Dr. Bopanna KN< HOD & Consultant- Neurosurgery, decided to perform a rare and highly specialised single-stage dual surgical procedure. In the same operation, one surgical team approached the tumour endoscopically through the nose while another team simultaneously performed a frontal craniotomy to access the tumour from above. This combined approach allowed the neurosurgeons to safely remove the tumour from multiple directions in a single sitting.
A multidisciplinary team of specialists, including neurosurgeons, endoscopic skull base neurosurgeons, anaesthesia experts, nursing teams, and critical care staff worked together throughout the surgical procedure which lasted approximately 5 hours. Advanced surgical infrastructure, including high-end operative microscopes, navigation systems, and micro-Doppler technology, played a crucial role in helping neurosurgeons identity and preserve important blood vessels and surrounding structures during the operation.
Following surgery, Raghav remained under close observation and experiences temporary hormonal disturbances, which gradually stabilised with post-operative care and treatment. He was discharged thin 7-10 days and has since returned to normal life without major complications. He has been attending regular follow-up evaluations that have shown no evidence of tumour recurrence so far.
Dr. Praveen noted that although some giant pituitary tumours may recur if tiny remnants remain attached to critical structures, these tumours generally grow slowly and can be monitored effectively though regular MRI scans. He also emphasised the importance of early medical attention for persistent headaches and visual symptoms, as timely diagnosis can significantly improve outcomes and reduce the complexity of treatment.
This case stands as an example of how even the most complex and high-risk surgeries can be successfully managed through multidisciplinary expertise. This surgery in particular, required specialised expertise of 2 neurosurgeons working together, alongside the use of advanced medical equipment, including endoscopic and microscopic systems. The success of the procedure reflects how meticulous planning, advanced surgical architecture and collaborative teamwork go hand in hand in providing patients with positive outcomes and a safe return to normal life.