According to US National Cancer Institute estimates, pituitary tumors account for 10-25% of all intracranial neoplasms. Most pituitary tumors are benign; however, these monoclonal adenomas may secrete specific hormones that reflect their differentiated cell of origin (for example, somatotroph adenomas secrete growth hormone). Hypersecretion of tumor-derived pituitary hormones can lead to distinct signs and symptoms in affected individuals.
Treatment options for pituitary tumors include surgery, radiotherapy and pharmacotherapy, either alone or combination. The clinical management strategy for any given patient will depend upon the type of pituitary tumor and its size, the aim of therapy being to reduce or stabilize tumor mass and attain biochemical control of hormone hypersecretion. During the past few years, research advances in the areas of tumor pathogenesis and drug development have enabled further characterization of the available pharmacotherapeutic strategies and paved the way for novel approaches. These efforts have provided important insights but also raised issues that must be analyzed and put in perspective.
The Nature Reviews Endocrinology Focus issue on pituitary tumors includes specially commissioned Reviews and opinion articles, written by leading experts in the field of pituitary research. The Focus issue provides a state-of-the-art overview of current management strategies for patients with pituitary tumors and will be a welcome resource to researchers and clinicians alike.
An NPG library of relevant Research Highlights, News & Views, Reviews, Perspectives, Case Studies and original research is also provided.
RESEARCH HIGHLIGHTS
New Endocrine Society guidelines for hyperprolactinemia—piecing together the pituitary puzzle
Linda Koch
doi:10.1038/nrendo.2011.43
Nature Reviews Endocrinology 7, 247 (2011)
Pituitary tumors: MGMT expression patterns explored
Claire Greenhill
doi:10.1038/nrendo.2011.48
Nature Reviews Endocrinology 7, 249 (2011)
Pituitary tumors: Predicting glucose metabolism after surgery for acromegaly
Vicky Heath
doi:10.1038/nrendo.2011.50
Nature Reviews Endocrinology 7, 250 (2011)
NEWS & VIEWS
Pituitary tumors: Coping with 'cured' pituitary tumors
Susan M. Webb
doi:10.1038/nrendo.2011.39
Nature Reviews Endocrinology 7, 251-252 (2011)
Pituitary tumors: Cabergoline versus bromocriptine: a meta-analysis?
Mark E. Molitch
doi:10.1038/nrendo.2011.33
Nature Reviews Endocrinology 7, 254-255 (2011)
REVIEWS
Pathogenesis of pituitary tumors
Shlomo Melmed
doi:10.1038/nrendo.2011.40
Nature Reviews Endocrinology 7, 257-266 (2011)
Pituitary tumors arising from differentiated hormone-expressing cells are commonly encountered, are mostly sporadic and are invariably benign. Improved understanding of the mechanisms that underlie pituitary tumorigenesis will enable development of tumor aggression markers as well as novel targeted therapies. This Review describes these mechanisms, which result in cell cycle dysregulation, signaling defects or loss of tumor suppressor factors.
Medical treatment of prolactinomas
Annamaria Colao & Silvia Savastano
doi:10.1038/nrendo.2011.37
Nature Reviews Endocrinology 7, 267-278 (2011)
This Review summarizes the data on medical treatment of patients with prolactinomas. In particular, the authors focus on previous findings of an association between cardiac valve disease and treatment with dopamine agonists in patients with hyperprolactinemia and on the possibility that permanent control of prolactin levels can be achieved after withdrawal from these drugs.
Management of Cushing disease
Nicholas A. Tritos, Beverly M. K. Biller & Brooke Swearingen
doi:10.1038/nrendo.2011.12
Nature Reviews Endocrinology 7, 279-289 (2011)
Transsphenoidal surgery leads to remission in 70–90% of patients with Cushing disease. However, the risk of recurrence could reach 20–25% at 10 years after surgery. This Review summarizes data on the efficacy and safety of established therapies for patients with Cushing disease and highlights agents that are being investigated as possible future therapies for patients with this condition.
Medical therapy in acromegaly
Mark Sherlock, Conor Woods & Michael C. Sheppard
doi:10.1038/nrendo.2011.42
Nature Reviews Endocrinology 7, 291-300 (2011)
Acromegaly is a rare condition, which is associated with increased morbidity and mortality, both of which can be reduced with appropriate therapy. This Review discusses the evidence for the current medical management of patients with acromegaly and outlines possible future pharmacological therapies for this patient group.
Management of pituitary tumors in pregnancy
Marcello D. Bronstein, Diane B. Paraiba & Raquel S. Jallad
doi:10.1038/nrendo.2011.38
Nature Reviews Endocrinology 7, 301-310 (2011)
Clinical advances have made pregnancy increasingly possible for many women with pituitary adenomas. However, this achievement has been accompanied by a considerable risk to both mother and fetus. This article reviews the achievements in fertility restoration and gestational and postgestational management of patients with pituitary tumors and will point out strategies to improve both efficacy and safety of the described procedures.
© 2018 Macmillan Publishers Limited, part of Springer Nature. All Rights Reserved.
