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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Management of pituitary incidentalomas
Samuel J Westall1, Ei Thuzar Aung2, Helmine Kejem2
1Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK sam.westall@nhs.net.
Clinical Medicine (London, England)
|March 23, 2023
Summary
Pituitary incidentalomas, common findings on brain imaging, are usually benign and non-secreting. Initial clinical and endocrinological evaluation guides management based on size, function, and visual impact.
Area of Science:
- Endocrinology
- Neurology
- Radiology
Background:
- Pituitary incidentalomas are frequently discovered due to advanced neuroimaging.
- Prevalence ranges from 10% in autopsies to 38% in MRI studies.
- Most incidentalomas are benign and non-functioning adenomas.
Purpose of the Study:
- To provide an overview of the initial assessment and management of pituitary incidentalomas.
- To guide clinicians not specializing in pituitary disease management.
- To clarify diagnostic and therapeutic strategies for these common findings.
Main Methods:
- Review of current literature on pituitary incidentalomas.
- Analysis of diagnostic criteria and evaluation protocols.
- Discussion of management strategies based on lesion characteristics.
Main Results:
- Pituitary incidentalomas are common, with most being asymptomatic benign adenomas.
- Functioning adenomas or large non-functioning adenomas can cause symptoms.
- Management decisions depend on size, hormonal activity, and visual compromise.
Conclusions:
- A thorough clinical and endocrinological evaluation is essential for all pituitary incidentalomas.
- Management should be individualized based on lesion characteristics and patient symptoms.
- This overview aims to standardize initial assessment and management approaches.
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