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Typically benign, slow-growing tumors that arise from cells in the pituitary gland:
- Pituitary adenomas have been identified as the 3rd most frequent intracranial tumor; accounts for 10–25%.
- Autopsy and radiologic data suggest that 1/6 have pituitary “incidentalomas.”
- Subtypes (hormonal): Prolactinoma (PRL) 50%, nonfunctioning pituitary adenomas 30%, somatotroph adenoma (growth hormone [GH]) 15–20%, corticotroph adenoma (adrenocorticotrophic hormone [ACTH]) 5–10%, thyrotroph adenoma (thyroid-stimulating hormone [TSH]) <1%, gonadotropinoma (luteinizing hormone/follicle-stimulating hormone [LH/FSH]), mixed
- Defined as microadenoma <10 mm and macroadenoma ≥10 mm
- May secrete hormones and/or cause mass effects
- Predominant age: Age increases incidence
- Predominant sex: Female > Male (3:2) for microadenomas (often delayed diagnosis in men)
- Autopsy studies have found microadenomas in 3–27% and macroadenomas in <0.5% of people without any pituitary disorders.
- Clinically apparent pituitary tumors are seen in 18/100,000 persons.
Multiple endocrine neoplasia IGenetics
- Carney complex
- Familial isolated pituitary adenomas: ∼15% have mutations in the aryl hydrocarbon receptor-interacting protein gene (AIP). Present at a younger age and are larger in size.
- McCune-Albright syndrome
- Multiple endocrine neoplasia type 1 (MEN-1)-like phenotype (MEN-4): Germline mutation in the cyclin-dependent kinase inhibitor 1B (CDKN1B)
- Monoclonal adenohypophysial cell growth
- Hormonal effects of functional microadenomas often prompt diagnosis before mass effect.
- Prolactin increased by functional prolactinomas or inhibited dopaminergic suppression by stalk effect