Pituitary tumors: pathophysiology, clinical manifestations and management.
Pituitary tumors are frequently encountered intracranial neoplasms. They present with a variety of clinical manifestations that include symptoms and signs of excessive hormone secretion by the tumor, signs of hormone deficits by the normal pituitary gland and others related to expansion of the tumor mass and the resulting compression of surrounding structures such as the optic chiasm and cranial nerves. Advances in molecular biology, immunocytochemical staining and imaging, and the introduction of new treatment options have improved our understanding of the natural history of these adenomas and their management. Available treatments include surgical, medical and radiation therapy. Although the primary treatment for each tumor type may vary, it is important to consider all available options and select the most applicable for that patient. The interaction of all members of management team, including the primary care provider, the endocrinologist and the neurosurgeon in selecting the treatment course can only improve therapeutic outcome. Regardless of the initial choice of treatment,follow-up of all patients should be maintained indefinitely. The managing physician should be familiar with the natural history and long-term complications of pituitary adenomas, and with the side effects of treatments given over the years.
Arafah
B M
BM
Division of Clinical and Molecular Endocrinology, Case Western Reserve University and University Hospital of Cleveland, Cleveland, Ohio 44106, USA.
Nasrallah
M P
MP
D000172:Acromegaly / Q000209:etiology; D000236:Adenoma / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D000328:Adult; D019090:Case Management; D002648:Child; D002999:Clone Cells / Q000473:pathology; D003131:Combined Modality Therapy; D020790:Diabetes Insipidus, Neurogenic / Q000188:drug therapy / Q000209:etiology; D018491:Dopamine Agonists / Q000627:therapeutic use; D005188:False Negative Reactions; D005260:Female; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007016:Hypophysectomy / Q000009:adverse effects / Q000379:methods; D007018:Hypopituitarism / Q000188:drug therapy / Q000209:etiology; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009347:Nelson Syndrome / Q000209:etiology; D015282:Octreotide / Q000627:therapeutic use; D010901:Pituitary Function Tests; D010907:Pituitary Hormones / Q000032:analysis / Q000378:metabolism / Q000627:therapeutic use; D010911:Pituitary Neoplasms / Q000145:classification / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D010913:Pituitary-Adrenal System / Q000378:metabolism; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000628:therapy; D015995:Prevalence; D011388:Prolactin / Q000097:blood / Q000378:metabolism; D015175:Prolactinoma / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D013194:Staining and Labeling
D018491:Dopamine Agonists; D010907:Pituitary Hormones; D019382:Human Growth Hormone; D000324:Adrenocorticotropic Hormone; D011388:Prolactin; D015282:Octreotide; D006854:Hydrocortisone