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Management of Pituitary Incidentalomas

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Diagnosis and Management of Pituitary Disorders

Part of the book series: Contemporary Endocrinology ((COE))

Summary

Pituitary incidentalomas are circumscribed regions of decreased opacity observed in pituitary CT or MRI exams performed in the absence of suspected pituitary disease. Most incidentalomas are pituitary adenomas, although they can be virtually any type of sellar mass. Most are <1 cm in diameter and can be considered microincidentalomas. The incidence of incidentalomas in MRI studies is approximately 10%, similar to the overall incidence of microadenomas in autopsy series. Only a very small percentage (<1%) of incidentalomas are hormonally active, with the most common being prolactinomas. The progression of incidentalomas to clinically significant lesions is infrequent but appears to be greater for nonfunctioning tumors than for pituitary cysts. Screening for hormonal hyperfunction should be based on the clinical suspicion of pituitary disease, and prolactin measurement alone appears to be the most cost-effective strategy for microincidentalomas. Macroincidentalomas have greater growth potential and are more frequently associated with hypopituitarism. Management of incidentalomas unassociated with hormonal disturbances and no increase in size can be conservative. In those with hormonal deficiencies, a more-proactive role can be justified because hypopituitarism is often reversible with removal of the tumor.

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Authors
  1. Lawrence A. Frohman MD
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Editor information

Editors and Affiliations

  1. Department of Neurosurgery Massachusetts, General Hospital Harvard Medical School, Boston, MA, USA

    Brooke Swearingen MD

  2. Neuroendocrine Unit Department of Medicine, Massachusetts General Hospital Harvard Medical School, Boston, MA, USA

    Beverly M. K. Biller MD

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© 2008 Humana Press, Totowa, NJ

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Frohman, L.A. (2008). Management of Pituitary Incidentalomas. In: Swearingen, B., Biller, B.M. (eds) Diagnosis and Management of Pituitary Disorders. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59745-264-9_21

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  • DOI: https://doi.org/10.1007/978-1-59745-264-9_21

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-922-2

  • Online ISBN: 978-1-59745-264-9

  • eBook Packages: MedicineMedicine (R0)

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