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Pituitary Adenoma

Reviewed 06/2018
 


BASICS

DESCRIPTION

Typically benign, slow-growing tumors that arise from cells in the pituitary gland 
  • Pituitary adenomas have been identified as the third most frequent intracranial tumor; accounts for...

DIAGNOSIS

HISTORY

  • Common

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

    • Headache (sellar expansion)

    • Visual disturbances: bitemporal hemianopsia

  • Less common

    • Hypersomat...

TREATMENT

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

MEDICATION

First Line

  • Hyperprolactinemia: Dopamine agonists increase dopaminergic suppression of PRL.

    • Caberg...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

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

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

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 OvidMedline]
2
Georgitsi M, Raitila ...

SEE ALSO

Cushing Disease and Cushing Syndrome; Galactorrhea 

CODES

ICD10

D35.2 Benign neoplasm of pituitary gland 

ICD9

227.3 Benign neoplasm of pituitary gland and craniopharyngeal duct 

SNOMED

  • 254956000 Pituitary adenoma (disorder)

  • 134209002 Prolactinoma (disorder)

  • ...

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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