Pituitary incidentaloma: a Pituitary Society international consensus guideline statement

IF 40 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
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
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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.

Abstract Image

垂体偶发瘤:垂体学会国际共识指南声明
这篇垂体学会共识文章提出了关于垂体偶发瘤处理的循证共识,偶发瘤定义为在影像学研究中偶然发现的意外鞍或鞍旁瘤,而不是临床怀疑的垂体病变。当大腺瘤、微腺瘤、囊性病变和空鞍需要进行内分泌学、神经外科和眼科会诊、垂体专用成像、垂体激素检测和视觉评估时,以及当偶发垂体腺瘤和囊性病变需要手术切除时,提出建议。多发1型内分泌肿瘤患者、儿童和青少年、老年人和孕妇的特殊注意事项。共识研讨会的结论是,诊断和治疗方法应个性化的特殊临床背景下偶然发现的垂体病变。当出现新的或恶化的病变特异性体征或症状时,应考虑咨询多学科垂体肿瘤卓越中心,特别是当正在考虑手术或其他辅助干预时,以及当对最适当的后续管理存在不确定性时。
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来源期刊
Nature Reviews Endocrinology
Nature Reviews Endocrinology 医学-内分泌学与代谢
CiteScore
42.00
自引率
0.70%
发文量
158
审稿时长
6-12 weeks
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.
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