Pituitary adenoma natural history, complications, and prognosis

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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]

Pituitary adenoma natural history, complications, and prognosis

Natural history

• Pituitary adenomas are generally benign.
• Patients with micoradenoma are usually asymptomatic and diagnosed incidentally. At later stage they may show signs and symptoms of hormonal disturbances.
• Patients with macroadenoma are usually present with visual filed deficits and hormonal disturbances. Macroadenoma grows slowly and invades surrounding structure.
• Females tend to develop symptoms at an earlier stage than males due to menstrual irregularities associated with the disease.

Complications

• Complications associated with pituitary adenoma generally arise from either the mass itself or from prolonged hormonal imbalance.

• Complication may include:

• Gigantism
• Acromegaly
• Cushing's syndrome
• Hyperpituitarism
• Pituitary apoplexy
• Pituitary insufficiency
• Central diabetes insipidus
• Bitemporal hemianopia

• Anosmia
• Invasion into the cavernous sinus with occasional compression of the:

• Oculomotor nerve (CN III)
• Abducens nerve (CN VI)

• Hydrocephalus (seen in large adenoma)

Prognosis

• The prognosis of pituitary adenoma is generally good. However, recurrent symptoms require further intervention.

• Approximately 18% of patients with macroadenoma require further treatment.