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Evaluation and management of pituitary incidentalomas—revisiting an acquaintance

Nature Clinical Practice Endocrinology & Metabolism volume 2, pages 138–145 (2006)Cite this article

Abstract

Incidentalomas of the pituitary gland have been described with increasing frequency, paralleling the advances in diagnostic imaging modalities. Several approaches have been proposed in order to appropriately evaluate their impact on patients, some recommending extensive investigations, while others advocate a more focused and potentially more cost-effective approach. The first part of this article will review current data about the prevalence, natural history and potential morbidity associated with these tumors. The second part will focus on imaging and hormonal evaluation of the incidental mass and suggest an updated management algorithm.

Key Points

  • Pituitary incidentalomas are common and their course is usually benign

  • There is a broad spectrum of approaches to evaluation and management

  • Extensive testing carries risks, as does purely expectant management

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Figure 1: Simplified algorithm for the evaluation and management of a patient with an incidentally discovered pituitary mass

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Author information

Authors and Affiliations

  1. resident in Internal Medicine at University Hospitals of Cleveland and the Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH, USA

    Armand Krikorian

  2. Case Western Reserve University School of Medicine,

    David Aron

  3. Veterans Affairs Health Services Research & Development Center for Quality Improvement Research at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH, USA

    David Aron

Authors
  1. Armand Krikorian
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  2. David Aron
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Correspondence to David Aron.

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The authors declare no competing financial interests.

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Krikorian, A., Aron, D. Evaluation and management of pituitary incidentalomas—revisiting an acquaintance. Nat Rev Endocrinol 2, 138–145 (2006). https://doi.org/10.1038/ncpendmet0122

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  • DOI: https://doi.org/10.1038/ncpendmet0122

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