The effect of growth hormone on pituitary tumour growth

Abstract

Purpose of review: In the last decade there has been an increased use of growth hormone replacement in patients with pituitary insufficiency. It has been shown to improve patient's quality of life, bone mass and cardiovascular risk factors but there are concerns about its mitogenic potential.

Recent findings: The most common aetiology of pituitary insufficiency in adults is hypothalamo-pituitary tumours or as a consequence of hypophysectomy or radiotherapy to treat pituitary tumours. Long-term growth hormone replacement is well established in clinical practice. We explore the available evidence concerning growth hormone replacement and its effects on pituitary tumour growth or recurrence and we examine evidence from natural experiments.

Summary: Despite the limitation of study size, patient case selectivity and treatment modalities, present studies of growth hormone replacement do not appear to demonstrate an increase in pituitary tumour recurrence. Conclusive evidence will only be generated by long-term randomized prospective clinical trials.