An Overview of Pituitary Incidentalomas: Diagnosis, Clinical Features, and Management

Pituitary incidentalomas are tumors or mass lesions of the pituitary gland. These are incidentally discovered during imaging studies for symptoms that are not causally related to pituitary diseases. The most common symptom that triggers an examination is headache, and the most common type of pituita...

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Bibliographic Details
Published in:Cancers 2022-09, Vol.14 (17), p.4324
Main Authors: Tahara, Shigeyuki, Hattori, Yujiro, Suzuki, Koji, Ishisaka, Eitaro, Teramoto, Shinichiro, Morita, Akio
Format: Article
Language:English
Subjects:
Adenoma
Age
Autopsies
Brain tumors
Care and treatment
Classification
Compression
Cysts
Diagnosis
Disease
Head injuries
Headaches
Lesions
Magnetic resonance imaging
Medical screening
Neuroendocrine tumors
Optic chiasm
Patients
Pituitary
Pituitary gland
Pituitary gland tumors
Population
Review
Tomography
Trauma
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Description
Summary:Pituitary incidentalomas are tumors or mass lesions of the pituitary gland. These are incidentally discovered during imaging studies for symptoms that are not causally related to pituitary diseases. The most common symptom that triggers an examination is headache, and the most common type of pituitary incidentalomas are pituitary neuroendocrine tumors (PitNETs) and Rathke cleft cysts. The existing treatment strategy is controversial; however, surgical resection is recommended in cases of clinically non-functioning PitNETs with optic chiasm compression. In contrast, cystic lesions, such as Rathke cleft cysts, should be followed if the patients are asymptomatic. In this case, MRI and pituitary function tests are recommended every six months to one year; if there is no change, the follow-up period should be extended. The natural history of PitNET is partially known, and the management of pituitary incidentalomas is determined by this history. However, the pathogenesis of PitNET has significantly changed with the new World Health Organization classification, and follow-up is important based on this new classification. Therefore, a high level of evidence-based research is needed to consider treatment guidelines for pituitary incidentalomas in the future.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers14174324