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Pituitary Adenomas

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Oncology of CNS Tumors

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Abstract

Pituitary adenomas are the most frequent tumors of the sellar region. The adenomas can be divided into hormone-secreting and nonfunctioning adenomas. Clinical symptoms are dependent on either the overproduction of a specific hormone, leading to typical disease states (acromegaly, Cushing’s disease, hyperprolactinemia, secondary hyperthyroidism) or compression symptoms due to tumor growth. The common compressive symptoms include visual disturbance and visual field defects, as well as pituitary insufficiencies. Headaches as an unspecific symptom are also common. Cavernous sinus syndrome with palsy of the third, fourth, or sixth cranial nerve is uncommon in the absence of apoplexy. After the diagnosis of a pituitary lesion by CT or, more frequently, MR imaging, an endocrinological assessment is necessary to identify hormone-secreting lesions as well as to rule out pituitary insufficiency. Except for prolactinomas, surgical resection is the first-line treatment for symptomatic adenomas. In case of residual disease, pharmacotherapy and/or radiotherapy may be necessary. Due to the potential complex character of pituitary adenomas, the patient care may require a multidisciplinary cooperation of family medicine, gynecology, endocrinology, ophthalmology, radiology, radiotherapy, neurology, and neurosurgery. After diagnosis of symptomatic adenomas, long-term follow-up of patients is recommended.

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Authors and Affiliations

  1. Hypophysenchirurgie/Klinik für Neurochirurgie, Universitätskrankenhaus Hamburg-Eppendorf, Hamburg, Germany

    Jörg Flitsch

  2. Department of Neurosurgery, University of Virginia Health System, Charlottesville, VA, USA

    Davis G. Taylor & John A. Jane Jr

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  1. Jörg Flitsch
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  2. Davis G. Taylor
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  3. John A. Jane Jr
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Correspondence to Jörg Flitsch .

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Editors and Affiliations

  1. Department of Neurosurgery, University of Munich Department of Neurosurgery, Munich, Germany

    Jörg-Christian Tonn

  2. Dana-Farber Cancer Institute Center, Harvard University, Boston, USA

    David A. Reardon

  3. SickKids Hospital, University of Toronto, Toronto, ON, Canada

    James T. Rutka

  4. Department of Neurosurgery, University of Hamburg, Hamburg, Germany

    Manfred Westphal

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Flitsch, J., Taylor, D.G., Jane, J.A. (2019). Pituitary Adenomas. In: Tonn, JC., Reardon, D., Rutka, J., Westphal, M. (eds) Oncology of CNS Tumors. Springer, Cham. https://doi.org/10.1007/978-3-030-04152-6_12

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