Maria Fleseriu, Mark Gurnell, Ann McCormack, Hidenori Fukuoka, Andrea Glezer, Fabienne Langlois, Theodore H. Schwartz, Yona Greenman, Nidhi Agrawal, Amit Akirov, Irina Bancos, Cristina Capatina, Frederic Castinetti, Michael Catalino, Mirjam Christ-Crain, Liza Das, Andjela Drincic, Pamela U. Freda, Monica R. Gadelha, Andrea Giustina, Felicia Hanzu, Ken K. Y. Ho, Kristina Isand, Susana Mallea-Gil, Adam N. Mamelak, Hani J. Marcus, Meliha Melin Uygur, Mark Molitch, Lisa B. Nachtigall, Elisabeth Nowak, Alberto M. Pereira, Maria M. Pineyro, Ismat Shafiq, Luis Syro, Yutaka Takahashi, Elena V. Varlamov, Greisa Vila, Gabriel Zada, Niki Karavitaki, Shlomo Melmed
{"title":"Pituitary incidentaloma: a Pituitary Society international consensus guideline statement","authors":"Maria Fleseriu, Mark Gurnell, Ann McCormack, Hidenori Fukuoka, Andrea Glezer, Fabienne Langlois, Theodore H. Schwartz, Yona Greenman, Nidhi Agrawal, Amit Akirov, Irina Bancos, Cristina Capatina, Frederic Castinetti, Michael Catalino, Mirjam Christ-Crain, Liza Das, Andjela Drincic, Pamela U. Freda, Monica R. Gadelha, Andrea Giustina, Felicia Hanzu, Ken K. Y. Ho, Kristina Isand, Susana Mallea-Gil, Adam N. Mamelak, Hani J. Marcus, Meliha Melin Uygur, Mark Molitch, Lisa B. Nachtigall, Elisabeth Nowak, Alberto M. Pereira, Maria M. Pineyro, Ismat Shafiq, Luis Syro, Yutaka Takahashi, Elena V. Varlamov, Greisa Vila, Gabriel Zada, Niki Karavitaki, Shlomo Melmed","doi":"10.1038/s41574-025-01134-8","DOIUrl":null,"url":null,"abstract":"<p>This Pituitary Society Consensus article presents an evidence-based consensus on the management of pituitary incidentaloma, defined as an unexpected sellar or parasellar finding incidentally discovered on an imaging study that was not performed for a clinically suspected pituitary lesion. Recommendations are offered for when endocrinology, neurosurgery and ophthalmology consultation, dedicated pituitary imaging, pituitary hormone testing and visual assessment are warranted for macroadenomas, microadenomas, cystic lesions and empty sella, as well as when surgical resection is indicated for incidental pituitary adenomas and cystic sellar lesions. Special considerations in patients with multiple endocrine neoplasia type 1, children and adolescents, older people, and pregnant women are addressed. The Consensus workshop concluded that diagnostic and management approaches should be individualized to the specific clinical context of an incidentally discovered pituitary lesion. Consultation with a multidisciplinary pituitary tumour centre of excellence should be considered in the presence of new or deteriorating lesion-specific signs or symptoms, particularly when surgical or other adjuvant interventions are being considered and when there is uncertainty about the most appropriate subsequent management.</p>","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":"38 1","pages":""},"PeriodicalIF":40.0000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nature Reviews Endocrinology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41574-025-01134-8","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
This Pituitary Society Consensus article presents an evidence-based consensus on the management of pituitary incidentaloma, defined as an unexpected sellar or parasellar finding incidentally discovered on an imaging study that was not performed for a clinically suspected pituitary lesion. Recommendations are offered for when endocrinology, neurosurgery and ophthalmology consultation, dedicated pituitary imaging, pituitary hormone testing and visual assessment are warranted for macroadenomas, microadenomas, cystic lesions and empty sella, as well as when surgical resection is indicated for incidental pituitary adenomas and cystic sellar lesions. Special considerations in patients with multiple endocrine neoplasia type 1, children and adolescents, older people, and pregnant women are addressed. The Consensus workshop concluded that diagnostic and management approaches should be individualized to the specific clinical context of an incidentally discovered pituitary lesion. Consultation with a multidisciplinary pituitary tumour centre of excellence should be considered in the presence of new or deteriorating lesion-specific signs or symptoms, particularly when surgical or other adjuvant interventions are being considered and when there is uncertainty about the most appropriate subsequent management.
期刊介绍:
Nature Reviews Endocrinology aspires to be the foremost platform for reviews and commentaries catering to the scientific communities it serves. The journal aims to publish articles characterized by authority, accessibility, and clarity, enhanced with easily understandable figures, tables, and other visual aids. The goal is to offer an unparalleled service to authors, referees, and readers, striving to maximize the usefulness and impact of each article. Nature Reviews Endocrinology publishes Research Highlights, Comments, News & Views, Reviews, Consensus Statements, and Perspectives relevant to researchers and clinicians in the fields of endocrinology and metabolism. Its broad scope ensures that the work it publishes reaches the widest possible audience.