Diagnosis, Management, and Prognosis of Pituitary Tumors

Abstract

The identification and management of a pituitary tumor is straightforward once the potential diagnosis is entertained. The greatest difficulty in clinical medicine is the delay in diagnosis because of a nonspecific clinical feature, such as headache, which is attributed to “stress” or a migraine syndrome. Similarly, nonspecific complaints of decreased energy, libido, and weight gain may be attributed to depression or aging. Thus, the greatest challenge to the physician is to entertain the possibility that a patient’s symptoms may be related to a pituitary tumor and/or pituitary dysfunction. Because of excellent imaging technology, magnetic resonance imaging (MRI), many patients are now found to have a pituitary lesion incidentally—the study was obtained to “rule out” intracranial pathology because of trauma or headaches. Once a pituitary tumor is considered or found, it is then necessary to determine the type of tumor (secretory, nonsecretory), pituitary function (hypo- and hyperfunction), the need for hormone replacement, and the status of the visual system before recommending appropriate therapy.