Pituitary tumors

• Pathophysiology:
  • adenoma → excess of trophic hormone (if tumor fxnal, but 30–40% not) and potentially deficiencies in other trophic hormones due to compression;
  • cosecretion of PRL and growth hormone in 10% of prolactinomas
• Clinical manifestations:
  • specific syndromes due to oversecretion of hormones (see below) ±
  • non-specific mass effect:
    • headache,
    • visual Δs,
    • diplopia,
    • cranial neuropathies
• Workup:
  • MRI brain pituitary protocol,
  • hormone levels,
  • ± visual field testing if <10 mm,
  • no mass effect,
  • no hormone overproduction,
  • can f/up in 12 mos