Mimickers of pituitary tumors

Enlargement of the pituitary gland and/or its surrounding structures on brain or sellar imaging is a frequent finding. The distinction between clinically relevant and incidental changes can be challenging. Furthermore, the assumption that sellar lesions reflect a true neoplasm must be rigorously questioned to avoid inappropriate treatment or unnecessary surveillance plans. Here we review wide-ranging conditions that can mimic primary pituitary tumors. We outline a suggested approach to rational decision-making.