Pituitary Adenomas

Pituitary adenomas are benign neoplasms originating from parenchymal cells of the anterior pituitary gland. Most pituitary tumors are slow-growing. They are classified based on size or cell of origin. Clinical presentation of pituitary adenoma varies based on tumor size and hormone secreted. Tumor mass effect can cause headaches, visual deficits by compression of the optic pathway, and partial or complete hypopituitarism. Hormone-secreting pituitary adenomas can cause several forms of specific syndromes, which include Cushing’s disease, acromegaly, hyperprolactinemia, or thyrotropin-dependent hyperthyroidism, depending on the type of hormone secreted. Transsphenoidal resection is the preferred treatment option for most pituitary adenoma. An exception are prolactinomas, which can usually be treated medically with dopamine agonists. Surgical treatment is very effective and safe when performed by a skilled neurosurgeons. Medical treatment is helpful in hormone-secreting pituitary adenomas. Radiotherapy is also an effective treatment modality in the adjuvant setting. Stereotactic radiosurgery is the preferred radiation technique for pituitary adenomas. The optimal treatment of pituitary adenomas may be complex and should be managed in a high-volume center by a multidisciplinary team that should include endocrinologists, neurosurgeons, ophthalmologists, pathologists, and radiotherapists.