1. Non-functional adenoma is divided into Non-functional microadenoma (tumor diameter <1cm): According to statistics, only 2% of such adenoma can grow into macroadenoma, and 5% of normal people will have high resolution magnetic resonance enhancement scan to suggest pituitary microadenoma, so I think non-functional pituitary microadenoma does not need treatment, follow up for one year, if there is no increase, no special treatment is needed. (>1cm): Non-functional macroadenoma has a great chance to grow, and the tumor will compress the optic nerve and cause bilateral temporal hemianopia, which can lead to blindness in serious cases, so it should be actively treated by surgery. Functional pituitary adenoma (1) Growth hormone (GH) adenoma: In children, it shows as gigantism, and in adults, it shows as acromegaly. Blood tests are performed for GH (growth hormone) and IGF-1 (insulin-like growth factor 1), and IGF-1 is more sensitive than GH. Increased GH in the body causes three pathological changes: cartilage growth, soft tissue growth, and visceral growth. The preferred treatment for growth hormone adenoma is surgery; there is no clear and effective drug therapy, and Gamma Knife is only used as a complementary treatment for postoperative residuals. The main goal of surgical treatment for growth hormone adenoma is to remove the tumor as completely as possible and to reduce GH values to normal. Clinical studies have confirmed that postoperative GH values are inversely proportional to the patient’s life expectancy, and that soft tissue swelling caused by GH can be relieved immediately after surgery. Indicators of cure: No residual tumor on MRI review and GH review in normal range. (2) Adrenocorticotropic hormone adenoma-ACTH adenoma (Cushing’s disease): manifesting as Cushing’s syndrome, the patient presents with obesity and full moon face. The diagnosis of Cushing’s disease needs to be differentiated from ectopic ACTH hyperplasia, adrenal tumors, and physiological obesity, and ACTH hyperplasia can cause many reactions in the patient’s body, seriously affecting the patient’s quality of life and health, and should be treated as soon as possible after diagnosis. Gamma knife is only a postoperative residual complementary treatment. The main goal of surgery is to remove as much of the tumor as possible and reduce the ACTH level to normal. Cure indicators: MRI review of the tumor no residual, ACTH review of normal range. (3) PRL prolactin adenoma: In female patients, it is manifested as menopause and lactation, and in male patients, it is manifested as hypoactive sexual desire. Blood tests for PRL (in general, PRL for prolactin adenoma is more than 4 times higher than normal, if it is higher than 2 times lower than 4 times, specific analysis is needed). Increased PRL in patients with prolactin adenoma can cause intractable osteoporosis for years (5-10 years) for patients without fertility requirements, which affects the quality of life of patients, and this is the main reason why prolactin adenoma must be treated and the following strategies must be adopted to restore PRL to normal levels Surgery: It is suitable for well-defined pituitary macroadenomas, microadenomas, and non-invasive prolactin adenomas. The advantage of surgery is to strive for total excision of the tumor and avoid long-term medication. In addition, surgery should be preferred for prolactin adenoma with cystic variant, which is not effective in drug treatment; surgery should be preferred for prolactin adenoma with pituitary stroke in magnetic resonance, which is not effective in drug treatment; surgery should be preferred for male patients, which is not effective in drug treatment; surgery should be preferred for mixed pituitary adenoma with mainly prolactin performance but with increased GH and ACTH in laboratory test, which is not effective in drug treatment. 2.Medication: Bromocriptine or Cartegolide. The main purpose of medication is to restore PRL to normal level, and medication can also reduce the size of tumor cells, but there is no clear evidence to confirm that medication can kill tumor cells, so medication often requires 3-5 years of treatment, and 2/3 of patients may relapse after stopping medication. Drug therapy is suitable for those aggressive prolactin adenomas or as a complementary treatment after surgical treatment. 3.Gamma knife treatment, as the last choice of treatment for prolactin adenoma. 4.Thyrotropinoma-TSH adenoma: It is rare clinically and manifests as elevated TSH, elevated T3,T4, and the patient shows hyperthyroidism, which mainly needs to be differentiated from hypothyroidism-induced TSH elevation and pituitary reactive hyperplasia.