下垂体神経内分泌腫瘍の診断と管理：最近の進歩

Pituitary neuroendocrine tumors (PitNETs) are a heterogeneous group of neoplasms originating from anterior pituitary cells, encompassing a spectrum from indolent microadenomas to highly invasive, aggressive tumors. Their clinical presentation varies from classic endocrine hyper or hyposecretory syndromes to mass effect symptoms or incidental imaging findings. The 2022 World Health Organization classification has redefined PitNETs, emphasizing their neuroendocrine nature and the central role of transcription factor-based immunohistochemistry. Recent years have witnessed rapid progress in molecular characterization, multiomics, radiomics, and theragnostic approaches, which are reshaping the approach to these tumors either in their diagnosis, risk stratification, and management. This review provides a comprehensive and practical synthesis of current evidence, focusing on the integration of biomarkers, advanced imaging, and personalized therapies that could be useful for clinical practice, and discusses future directions in precision management of PitNETs.