Pituitary Mass Effects - Pathogenesis and Clinical Findings

 • Pituitary turnors are almost always a benign adenoma. Pituitary adenomas are very common - approximately 1 in 6 individuals. These are usually asymptomatic and are found incidentally. Symptomatic pituitary adenomas that require treatment are much less common and affect approximately I in 1000 individuals.

 • For pituitary masses of all sizes, it is important to determine whether the pituitary tumor is secreting (70%) or non-secreting (30%) as secreting tumors can be targeted with medication. The most common secreting tumors secrete prolactin (most common), growth hormone, and ACTH.

 • Typically (but not always) the anterior hormones will be lost in the following order; GH, LH, FSH, TSH, ACTH, PRL. This order (with the exception of prolactin) is the order of least-essential to most essential hormones needed for survival. A good mnemonic to remember the order the hormones are is, "Go Look For The Adenoma Please".

Signs / Symptoms / Complications: 

 • Hyperprolactinemia

 • Diabetes insipidus

 • Loss of pituitary hormones

 • Headaches

 • Nausea and vomiting

 • Hypothalamic dysfunction

 • Bitemporal hemianopsia

 • Hydrocephalus

 • Diplopia

 • Post-nasal drip

 • Meningitis



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