[Differential diagnosis and treatment of pituitary adenomas]

HNO. 2019 Apr;67(4):307-318. doi: 10.1007/s00106-019-0629-3.
[Article in German]

Abstract

Pituitary adenomas are among the most common primary brain tumors. These tumors can produce all hormones of the anterior pituitary and thus cause endocrine diseases. Compression of the pituitary gland, the surrounding cranial nerves, or brain structures can lead to hypopituitarism, cranial nerve deficits, or diverse neurological symptoms. Visual impairment, typically with bitemporal hemianopsia, is the most common cardinal symptom. The diagnostic workup requires broad interdisciplinary cooperation. With the exception of prolactinoma, the treatment of choice for symptomatic pituitary adenoma is transnasal transsphenoidal resection. For prolactinoma, dopamine agonistic therapy is the primary treatment. Adequate hormone replacement therapy is essential in cases of hypopituitarism. Long-term follow-up is a vital part of the treatment concept.

Keywords: Diabetes insipidus, neurogenic; Endocrine diagnostic techniques; Hypophysectomy; Neurological diagnostic techniques; Pituitary irradiation.

Publication types

  • Review

MeSH terms

  • Adenoma* / diagnosis
  • Adenoma* / therapy
  • Brain Neoplasms
  • Diagnosis, Differential
  • Humans
  • Hypopituitarism*
  • Hypothalamo-Hypophyseal System / physiopathology
  • Pituitary Function Tests
  • Pituitary Neoplasms* / diagnosis
  • Pituitary Neoplasms* / therapy