Screening for ACTH-dependent hypercortisolism in patients with pituitary incidentaloma

Torpy, David J.

doi:10.1530/eje-15-0058

Cited by 2 publications

(1 citation statement)

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“…The results showed pituitary hypercortisolemia in 7.3% of the patients, and ACTH positivity in 4.4% of the pathological findings [ 88 ]. However, the study refuted this, stating that tests to detect Cushing’s disease have a high false-positive rate and that careful consideration should be given to the balance of benefits and risks of performing pituitary incidentaloma surgery to treat subclinical hypercortisolemia [ 89 ]. In summary, it is advisable to measure early morning fasting basal values of GH, prolactin, ACTH, luteinizing hormone, follicle-stimulating hormone, TSH, free thyroxine, cortisol, testosterone (males), and estradiol (females) at the initial evaluation and at follow-up.…”

Section: Evaluation At the Time Of Discovery And Natural Historymentioning

confidence: 99%

An Overview of Pituitary Incidentalomas: Diagnosis, Clinical Features, and Management

Tahara

Hattori

Suzuki

et al. 2022

Cancers

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Pituitary incidentalomas are tumors or mass lesions of the pituitary gland. These are incidentally discovered during imaging studies for symptoms that are not causally related to pituitary diseases. The most common symptom that triggers an examination is headache, and the most common type of pituitary incidentalomas are pituitary neuroendocrine tumors (PitNETs) and Rathke cleft cysts. The existing treatment strategy is controversial; however, surgical resection is recommended in cases of clinically non-functioning PitNETs with optic chiasm compression. In contrast, cystic lesions, such as Rathke cleft cysts, should be followed if the patients are asymptomatic. In this case, MRI and pituitary function tests are recommended every six months to one year; if there is no change, the follow-up period should be extended. The natural history of PitNET is partially known, and the management of pituitary incidentalomas is determined by this history. However, the pathogenesis of PitNET has significantly changed with the new World Health Organization classification, and follow-up is important based on this new classification. Therefore, a high level of evidence-based research is needed to consider treatment guidelines for pituitary incidentalomas in the future.

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Section: Evaluation At the Time Of Discovery And Natural Historymentioning

confidence: 99%