Diagnosis of pituitary disease

The prevalence of pituitary disease is increasing mainly because of advances in modern imaging techniques and an increased awareness among the medical community. Pituitary tumours constitute 10–15% of all diagnosed intracranial neoplasms, and their clinical manifestations result from local mass effects (mostly neurological, visual, hypopituitarism) and/or hypersecretion. Pituitary adenomas are the most common pituitary tumours and are clinically classified as functioning or non-functioning. Most are sporadic, but in rare cases they can be related to hereditary syndromes. Other lesions involving the (para)sellar region include inflammatory and infiltrative diseases, cysts, primary or metastatic neoplasms, abscesses and internal carotid artery aneurysms. The clinical manifestations of hypopituitarism depend mainly on the type, number and severity of hormonal deficits. Establishing the diagnosis requires hormonal measurements (basal or after dynamic tests), and management includes relevant hormonal replacement and life-long monitoring.