Pituitary adenoma pathophysiology

Pituitary adenoma Microchapters
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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]

Pathophysiology

• Pituitary macroadenomas are the most common suprasellar mass in adults
• They are defined as pituitary adenomas greater than 10 mm in size
• Macroadenomas are approximately twice as common as micoadenoma
• Most of the cases presenting due to mass effect are due to non-secreting macroadenomas and the most common structure to be compressed by a macroadenoma is the optic chiasm.
• Larger adenoma can lead to hormonal imbalance due to mass effect rather than secretion
• Hypopituitarism or moderately elevated prolactin are both seen, the later due to stalk effect; prolactin release (unlike other pituitary hormones) is tonically inhibited by prolactin inhibitory hormone (a.k.a. dopamine) and as such compression of the pituitary infundibulum can result in elevation of systemic prolactin levels due to interruption of normal inhibition.