Aggressive or Invasive PitNETs?

Aggressiveness and invasiveness frequently complicate the diagnosis, the prognosis, and the treatment of pituitary adenomas. These terms define two different conditions. Invasive tumors extend to the cavernous sinus and/or the sphenoid sinus. Aggressive tumors demonstrate invasiveness AND resistance to conventional treatment. Moreover, histological and molecular markers were recently added to define aggressive tumors. Carcinomas are defined by the occurrence of systemic or cerebrospinal metastases. A classification taking into account invasion, immuno-histological type, and proliferative makers is a useful tool to approach the prognosis of PitNETS and to propose the most appropriate treatment.