The effect of growth hormone on pituitary tumour growth.
OBJECTIVE
In the last decade there has been an increased use of growth hormone replacement in patients with pituitary insufficiency. It has been shown to improve patient's quality of life, bone mass and cardiovascular risk factors but there are concerns about its mitogenic potential.


RESULTS
The most common aetiology of pituitary insufficiency in adults is hypothalamo-pituitary tumours or as a consequence of hypophysectomy or radiotherapy to treat pituitary tumours. Long-term growth hormone replacement is well established in clinical practice. We explore the available evidence concerning growth hormone replacement and its effects on pituitary tumour growth or recurrence and we examine evidence from natural experiments.


CONCLUSIONS
Despite the limitation of study size, patient case selectivity and treatment modalities, present studies of growth hormone replacement do not appear to demonstrate an increase in pituitary tumour recurrence. Conclusive evidence will only be generated by long-term randomized prospective clinical trials.
Herring
Roselle
R
Royal Surrey County NHS Foundation Trust, Egerton Road, Guildford, GU22 7, UK. roselle.herring1@btinternet.com
Russell-Jones
David
D
D000236:Adenoma / Q000150:complications / Q000473:pathology*; D000328:Adult; D000818:Animals; D049109:Cell Proliferation / Q000187:drug effects*; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D019382:Human Growth Hormone / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000139:chemically induced; D010902:Pituitary Gland / Q000187:drug effects / Q000473:pathology; D010911:Pituitary Neoplasms / Q000150:complications / Q000473:pathology*; D047368:Tumor Burden / Q000187:drug effects*
D019382:Human Growth Hormone