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'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''


{{Infobox_Disease |
{{Pituitary adenoma}}
  Name          = {{PAGENAME}} |
  Image          = Illu pituitary pineal glands.jpg  |
  Caption        = |
  DiseasesDB    = |
  ICD10          = {{ICD10|D|35|2|d|10}} |
  ICD9          = {{ICD9|237.0}} |
  ICDO          = {{ICDO|8140|0}} |
  OMIM          = |
  MedlinePlus    = |
  MeshID        = D010911 |
}}


{{Pituitary adenoma}}
{{CMG}} {{AE}} {{AAM}}


{{CMG}}
{{SK}}: Pituitary macroadenoma; Pituitary microadenoma; Pituitary adenomas, Adenoma of the pituitary gland; Pituitary non-functioning adenoma; Gonadotropic adenoma; Thyrotropic adenoma; TSH-oma; Plurihormonal pituitary adenoma; Null cell adenomas


==[[Pituitary adenoma overview|Overview]]==
==[[Pituitary adenoma overview|Overview]]==
==[[Pituitary adenoma historical perspective|Historical Perspective]]==


==[[Pituitary adenoma classification|Classification]]==
==[[Pituitary adenoma classification|Classification]]==


==Diagnosis==
==[[Pituitary adenoma pathophysiology|Pathophysiology]]==
==[[Pituitary adenoma history and symptoms|History & Symptoms]]==


==[[Pituitary adenoma physical examination|Physical Examination]]==
==[[Pituitary adenoma causes|Causes]]==


The diagnosis is generally entertained either on the basis of visual difficulties arising from the compression of the [[optic nerve]] by the tumor, or on the basis of manifestations of excess hormone secretion: the specifics depend on the type of hormone. The specific area of the visual pathway at which compression by these tumours occurs is at the [[optic chiasma]].
==[[Pituitary adenoma differential diagnosis|Differentiating Pituitary adenoma from other Diseases]]==


The anatomy of this structure causes pressure on it to produce a defect in the temporal visual field on both sides, a condition called [[bitemporal hemianopsia|bitemporal hemianopia]]
==[[Pituitary adenoma epidemiology and demographics|Epidemiology and Demographics]]==


Tumors which cause visual difficulty are likely to be ''macroadenomata'' greater than 10 mm in diameter; tumors less than 10 mm are ''microadenomata''.
==[[Pituitary adenoma risk factors|Risk Factors]]==


Some tumors secrete more than one hormone, the most common combination being GH and prolactin.


Prolactinomas are frequently diagnosed during pregnancy, when the [[hormone]] [[progesterone]] increases the tumor's growth rate.
==[[Pituitary adenoma natural history, complications, and prognosis|Natural History, Complications and Prognosis]]==
Headaches may be present. The diagnosis is confirmed by testing hormone levels, and by radiographic imaging of the pituitary (for example, by [[CT scan]] or [[MRI]]).
 
==Diagnosis==
 
[[Pituitary adenoma history and symptoms|History and Symptoms]] | [[ Pituitary adenoma physical examination|Physical Examination]] | [[Pituitary adenoma laboratory tests|Laboratory Findings]] | [[Pituitary adenoma CT|CT]] | [[Pituitary adenoma MRI|MRI]] | [[Pituitary adenoma echocardiography or ultrasound|Ultrasound]] | [[Pituitary adenoma other imaging findings|Other Imaging Findings]] | [[Pituitary adenoma other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
[[Pituitary adenoma medical therapy|Medical Therapy]] | [[Pituitary adenoma surgery |Surgery]] | [[Pituitary adenoma primary prevention|Primary Prevention]] | [[Pituitary adenoma secondary prevention|Secondary Prevention]] | [[Pituitary adenoma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] |  [[Pituitary adenoma future or investigational therapies|Future or Investigational Therapies]]


Treatment options depend on the type of tumor and on its size:
==Case Studies==
* '''[[Prolactinoma]]s''' are most often treated with [[bromocriptine]] or more recently, [[cabergoline]] which, unlike bromocriptine, decreases tumor size as well as alleviates symptoms, both dopamine agonists, and followed by serial imaging to detect any increase in size. Treatment where the tumor is large can be with [[radiation therapy]] or surgery, and patients generally respond well.  Efforts have been made to use a progesterone [[antagonist]] for the treatment of prolactinomas, but so far have not proved successful. 
* '''Thyrotrophic adenomas''' respond to [[Somatostatin|octreotide, a long-acting somatostatin analog]], in many but not all cases according to a review of the medical literature. Unlike prolactinomas, thyrotrophic adenomas characteristically respond poorly to dopamine agonist treatment.{{ref_label|thyrotrophic|1|a}}


==References==
[[Pituitary adenoma case study one|Case #1]]
# {{note|thyrotrophic}}{{note_label|thyrotrophic|1|a}} Chanson, Philippe; Weintraub, Bruce D.; and Harris, Alan G. (1993)  [http://www.annals.org/cgi/content/full/119/3/236 Octreotide Therapy for Thyroid-Stimulating Hormone-Secreting Pituitary Adenomata]. ''Annals of Internal Medicine'' '''119''' (3), 236-240.


==See Also==
==Related Chapters==
* [[Adult brain tumors]]
* [[Adult brain tumors]]


==External links==  
==External links==  
* [http://www.cancer.gov/cancertopics/types/pituitary/ Cancer.gov: pituitary tumors]
* [http://www.cancer.gov/cancertopics/types/pituitary/ Cancer.gov: pituitary tumors]
* Case report of [http://clinicalcases.blogspot.com/2004/05/bilateral-hemianopsia-due-to-pituitary.html Bilateral Hemianopsia Due to Pituitary Adenoma]. Clinical Cases and Images.
* [http://www.netterimages.com/image/7280.htm Medical Illustration of Pituitary Adenomas by Frank H. Netter]
[[cs:Adenom hypofýzy]]
[[nl:Hypofysetumor]]
[[sk:Adenóm hypofýzy]]
[[sv:Hypofystumör]]
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Latest revision as of 19:10, 2 October 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]

Synonyms and keywords:: Pituitary macroadenoma; Pituitary microadenoma; Pituitary adenomas, Adenoma of the pituitary gland; Pituitary non-functioning adenoma; Gonadotropic adenoma; Thyrotropic adenoma; TSH-oma; Plurihormonal pituitary adenoma; Null cell adenomas

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pituitary adenoma from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

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