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Related Concept Videos

The Pituitary Gland01:17

The Pituitary Gland

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The pituitary is a small endocrine organ in the sphenoid bone under the hypothalamus. Primarily, the pituitary in adults has two distinct anatomical and functional regions— the anterior and posterior lobes. During human fetal development, a third pituitary gland region called the pars intermedia atrophies and disappears. However, some of its cells migrate and exist adjacent to the anterior pituitary in adults.
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Multiple Pituitary Adenomas: A Systematic Review.

Renata M Budan1, Carmen E Georgescu2

  • 1Department of Endocrinology, "Iuliu Hatieganu" University of Medicine and Pharmacy , Cluj-Napoca , Romania.

Frontiers in Endocrinology
|February 13, 2016
PubMed
Summary
This summary is machine-generated.

Multiple pituitary adenomas (MPA) are distinct tumors often small and non-functional. Diagnosis and classification remain challenging, impacting treatment and surgical outcomes for this rare condition.

Keywords:
Cushing’s diseaseacromegalydouble pituitary adenomasimmunohistochemistrymagnetic resonance imagingmultiple pituitary adenomaspituitary transcription factor

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Area of Science:

  • Endocrinology
  • Neurosurgery
  • Pathology

Background:

  • Multiple pituitary adenomas (MPA) are rare, characterized by morphologically distinct tumors.
  • Pathogenesis is unclear, leading to varied classification criteria.
  • Small size and hormonal non-functionality contribute to low detection rates.

Purpose of the Study:

  • To systematically review the literature on synchronous double or multiple pituitary adenomas.
  • To highlight diagnostic and classification challenges.
  • To discuss clinical presentation, management difficulties, and diagnostic modalities.

Main Methods:

  • Systematic literature search of PubMed, Scopus, and Web of Science Core Collection.
  • Review of studies reporting synchronous double or multiple pituitary adenomas.
  • Analysis of clinical presentation, diagnostic imaging, and pathological classification.

Main Results:

  • Prolactin (PRL)-immunopositive adenomas are common but often non-functional.
  • Cushing's syndrome is the most frequent presentation, linked to ACTH-producing adenomas.
  • Magnetic resonance imaging (MRI) sensitivity is low (25%) for detecting distinct multiple tumors.

Conclusions:

  • MPA presents significant diagnostic and therapeutic challenges, including high surgical failure rates.
  • Postoperative immunohistochemistry and transcription factor analysis are crucial for accurate classification.
  • Standardized classification criteria and improved imaging sensitivity are needed for better patient management.