Pituitary incidentaloma: An endocrine society clinical practice guideline

Pamela U. Freda, Albert M. Beckers, Laurence Katznelson, Mark E. Molitch, Victor M. Montori, Kalmon D. Post, Mary Lee Vance

Research output: Contribution to journalArticle

246 Scopus citations

Abstract

Objective: The aim was to formulate practice guidelines for endocrine evaluation and treatment of pituitary incidentalomas. Consensus Process: Consensus was guided by systematic reviews of evidence and discussions through a series of conference calls and e-mails and one in-person meeting. Conclusions: We recommend that patients with a pituitary incidentaloma undergo a complete history and physical examination, laboratory evaluations screening for hormone hypersecretion and for hypopituitarism, and a visual field examination if the lesion abuts the optic nerves or chiasm.Werecommendthat patients with incidentalomas not meeting criteria for surgical removal be followed with clinical assessments, neuroimaging (magnetic resonance imaging at 6 months for macroincidentalomas, 1 yr for a microincidentaloma, and thereafter progressively less frequently if unchanged in size), visual field examinations for incidentalomas that abut or compress the optic nerve and chiasm (6 months and yearly), and endocrine testing for macroincidentalomas (6 months and yearly) after the initial evaluations. We recommend that patients with a pituitary incidentaloma be referred for surgery if they have a visual field deficit; signs of compression by the tumor leading to other visual abnormalities, such as ophthalmoplegia, or neurological compromise due to compression by the lesion; a lesion abutting the optic nerves or chiasm; pituitary apoplexy with visual disturbance; or if the incidentaloma is a hypersecreting tumor other than a prolactinoma.

Original languageEnglish (US)
Pages (from-to)894-904
Number of pages11
JournalJournal of Clinical Endocrinology and Metabolism
Volume96
Issue number4
DOIs
StatePublished - Apr 2011

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

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    Freda, P. U., Beckers, A. M., Katznelson, L., Molitch, M. E., Montori, V. M., Post, K. D., & Lee Vance, M. (2011). Pituitary incidentaloma: An endocrine society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism, 96(4), 894-904. https://doi.org/10.1210/jc.2010-1048