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Pituitary Adenoma

Anup Sabharwal, MD MBA FACC FACE FASPC FNLA FEAA Reviewed 05/2023
 


BASICS

DESCRIPTION

Typically benign, slow-growing tumors that arise from cells in the pituitary gland 
  • Presenting symptoms include neurologic deficits, visual changes including diplopia, and headaches

  • Su...

DIAGNOSIS

HISTORY

  • Common

    • Hyperprolactinemia: infertility, amenorrhea, galactorrhea, gynecomastia, impotence

    • Headache (sellar expansion)

    • Visual disturbances: bitemporal hemianopsia

  • Less common

    • Hypersomatotro...

TREATMENT

Medical therapy is primary therapy for prolactinomas and adjunct for other tumors. 

MEDICATION

First Line

  • Hyperprolactinemia: Dopamine agonists increase dopaminergic suppression of PRL.

    • Cabergol...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Follow-up MRIs at 6 and 12 months after surgery

  • Involved hormone(s) are followed postoperatively, especially after radiation because hypopituitar...

REFERENCES

1
Dworakowska  D, Grossman  AB. The pathophysiology of pituitary adenomas. Best Pract Res Clin Endocrinol Metab.  2009;23(5):525–541. [View Abstract on OvidMedli...

SEE ALSO

Cushing Disease and Cushing Syndrome; Galactorrhea 

CODES

ICD10

D35.2 Benign neoplasm of pituitary gland 

SNOMED

  • 254956000 Pituitary adenoma (disorder)

  • 134209002 Prolactinoma (disorder)

  • 254957009 Somatotroph adenoma (disorder)

  • 254958004 Corticotroph adenoma

  • 2...

CLINICAL PEARLS

  • An incidentaloma is an asymptomatic microadenoma found on imaging. General labs include PRL, GH, IGF-1, ACTH, 24-hour urinary-free cortisol/overnight DMST, β-subunit FSH, LH, TSH, and ...

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