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Pituitary incidentalomas
1Center for Endocrinology, Metabolism, and Molecular Medicine, Northwestern University Medical School, Chicago, Illinois, USA.
Endocrinology and Metabolism Clinics of North America
|January 16, 1998
Summary
Incidental pituitary masses require screening for hormone oversecretion. Lesions over 1 cm need monitoring for growth and potential hormone deficiencies, with surgery indicated for significant enlargement or complications.
Area of Science:
- Endocrinology
- Neurosurgery
- Radiology
Background:
- Incidental pituitary masses are frequently discovered during CT and MR imaging.
- Screening for hormone oversecretion in these incidentalomas is recommended.
- Pituitary lesions require careful evaluation due to potential for growth and hormone dysfunction.
Purpose of the Study:
- To review the management of incidental pituitary masses.
- To outline screening protocols for hormone oversecretion and deficiencies.
- To discuss observation, medical therapy, and surgical indications for pituitary lesions.
Main Methods:
- Review of current literature and clinical guidelines.
- Analysis of diagnostic criteria for hormone oversecretion and hypopituitarism.
- Evaluation of imaging surveillance protocols and treatment outcomes.
Main Results:
- Lesions >1 cm warrant screening for hypopituitarism.
- Significant growth occurs in <5% of lesions <1 cm, but >25% of lesions >1 cm.
- Medical therapy offers limited tumor size reduction (10%); surgery is reserved for enlargement with complications.
Conclusions:
- Careful surveillance with serial imaging is crucial for incidental pituitary masses.
- Hormonal screening and monitoring for growth are essential components of management.
- Treatment decisions (observation, medical, or surgical) depend on lesion size, growth, and clinical impact.