Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar;23(2):129-134.
doi: 10.7861/clinmed.2023-0020.

Management of pituitary incidentalomas

Samuel J Westall  1 , Ei Thuzar Aung  2 , Helmine Kejem  2 , Christina Daousi  2 , Sravan K Thondam  2
Affiliations

Management of pituitary incidentalomas

Samuel J Westall et al. Clin Med (Lond). 2023 Mar.

Abstract

Pituitary incidentalomas are common findings with increasing use of modern neuroradiological imaging undertaken for symptoms unrelated to pituitary disease. The prevalence of these lesions is ∼10% in autopsy studies and the incidence varies from 10% to 38% on magnetic resonance imaging in the published literature. They are almost always benign in nature and most are non-functioning (non-secreting) adenomas. Although many individuals are asymptomatic at diagnosis, some with functioning (secreting) pituitary adenomas or larger non-functioning adenomas have symptoms. All identified cases should have a thorough clinical and endocrinological evaluation to help with precise management, which depends on the size of the lesion, hormonal status (functioning versus non-functioning adenoma) and the presence of visual deficits resulting from optic nerve compression by the pituitary adenoma. Here, we provide an overview of the initial assessment and management of pituitary incidentalomas for clinicians not routinely involved in the management of pituitary disease.

Keywords: Pituitary incidentalomas; pituitary adenomas; pituitary lesions; pituitary tumours.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Magnetic resonance images with gadolinium contrast. (a) Pituitary microadenoma on the left side of pituitary shown as a hypoenhancing lesion (arrow). (b) Pituitary macroadenoma with suprasellar extension causing mild compression to the optic chiasm above (arrow). The adenoma also extends into the left cavernous sinus.
Fig 2
Fig 2
Evaluation and management of pituitary incidentalomas. MRI = magnetic resonance imaging.
See this image and copyright information in PMC

References

    1. Feldkamp J, Santen R, Harms E, et al. Incidentally discovered pituitary lesions: high frequency of macroadenomas and hormone-secreting adenomas - results of a prospective study. Clin Endocrinol (Oxf) 1999;51:109–113. - PubMed
    1. Arita K, Tominaga A, Sugiyama K, et al. Natural course of incidentally found nonfunctioning pituitary adenoma, with special reference to pituitary apoplexy during follow-up examination. J Neurosurg. 2006;104:884–891. - PubMed
    1. Sanno N, Oyama K, Tahara S, Teramoto A, Kato Y. A survey of pituitary incidentaloma in Japan. Eur J Endocrinol. 2003;149:123–127. - PubMed
    1. Day PF, Guitelman M, Artese R, et al. Retrospective multicentric study of pituitary incidentalomas. Pituitary. 2004;7:145–148. - PubMed
    1. Reincke M, Allolio B, Saeger W, Menzel J, Winkelmann W. The “incidentaloma” of the pituitary gland. Is neurosurgery required? JAMA. 1990;263:2772–2776. - PubMed