• Neoplasm generated from the anterior pituitary
• 20% prevalence
  • Most asymptomatic
  • 1/1000 has symptomatic lesion
• Cannot predict which patient will have malignant spread
  • Patient requires life-long follow-up

Presentations

• Pituitary Tumor Mass Effect

• Hyper-functionality

  Most common → least common: PAC

  • Prolactinoma ↑
  • Acromegaly (↑GN), Gigantism (if childhood onset)
  • Cushing’s syndrome ↑ → Pituitary Cushing

• Hypo-functionality

  Most common → least common: “Go Look For the Adenoma Please”

  • GH - Short Stature (if childhood onset)
  • LH - Hypogonadism
  • FSH - Hypogonadism
  • TSH - Hypothyroidism ↓
  • ACTH - ↓Adrenal Insufficiency (Addison’s)
  • LOW Prolactin - indicate !Pituatory Apoplexy (destruction of the pituatory gland)

Consequences

• Acute pituitary hemorrhagic necrosis → !Pituatory Apoplexy

Treatment

• Trans-sphenoid Surgery (first line)
• Medication (for specific hormonal symptoms)
• Life-long follow-up