Pituitary tumor endocrinopathies and their endocrine evaluation

Pituitary tumors, depending on their respective cell type, manifest various endocrinopathies. Prolactinomas may present as hypogonadism and galactorrhea and can be diagnosed by measuring morning prolactin levels. Gonadotropinomas rarely cause gonadal hyperstimulation, and dynamic thyrotropin-releasing hormone stimulation testing is often required to elicit a diagnostic gonadotropin and/or subunit secretory response. Acromegaly is a multisystemic debilitating disease for which early diagnosis and treatment are crucial. Diagnostic criteria include a lack of plasma growth hormone suppression during the oral glucose tolerance test and elevation of age- and sex-matched insulin growth factor-1 levels. Patients harboring corticotropin-secreting adenomas characheristically present with signs and symptoms of hypercortisolism. Inferior petrosal sinus sampling for corticotropin may be required for microadenoma localization. Thyrotropinomas produce inappropriate thyrotropin (TSH) secretion and hyperthyroidism. The new third-generation TSH assay has improved the rate of detection of these lesions at an earlier stage.