II. Pathophysiology

III. Definition: Pituitary Adenoma

  1. Benign Pituitary Neoplasm

IV. Epidemiology

  1. Pituitary Adenomas account for 10-15% of all Intracranial Masses
  2. Prevalence: 77 per 100,000 persons
    1. Prevalence suspected to be much higher (May incidentally occur in as many as 20% of all patients)

V. Types: Based on Hormone Secretion

  1. Prolactinoma (32 to 66% of Pituitary Adenomas)
    1. Lactotroph cell adenoma with Hyperprolactinemia
    2. Presents with Galactorrhea and Gynecomastia
    3. Most (90%) Prolactinomas are microadenomas
    4. Also suppresses LH secretion resulting in Erectile Dysfunction in men and Amenorrhea and Infertility in women
    5. More common in women 20 to 50 years old compared with men by 10:1 ratio
      1. After age 50 years, Prevalence is equal for men and women
  2. Non-functioning Adenoma (>28% of adenomas)
    1. Findings are related to mass effect (Headache, Vision change) or Hypopituitarism
  3. Growth Hormone Secreting adenomas (11-13% of adenomas)
    1. Somatotroph cell adenoma with Gigantism (prior to Growth Plate closure) or Acromegaly (adults)
    2. Presents with hand/foot/Mandible hypertrophy, Fatigue, proximal Muscle Weakness, Hypertension, Cardiomegaly or LVH
  4. ACTH Secreting adenomas (1-2%)
    1. Corticotroph cell adenoma with increased ACTH and Cushing Disease
    2. Presents with proximal Muscle Weakness, striae, central Obesity, moon facies, Hypertension, Acne Vulgaris, Hyperglycemia
  5. TSH-Secreting Adenoma (rare)
    1. Thyrotroph cell adenoma with increased TSH and Hyperthyroidism
  6. LH or FSH Secreting tumor (rare)
    1. Gonadotroph cell adenoma typically results in no symptoms unless mass effect (Headache, Vision change) or Hypopituitarism
    2. However Prolactinomas do suppress LH secretion resulting in Hypogonadism

VI. Types: Based on size

  1. Microadenoma (<10 mm)
    1. Symptomatic Prevalence 40 per 100,000 in U.S.
    2. More common in premenopausal women
  2. Macroadenoma (10 mm or larger)
    1. Symptomatic Prevalence 10 per 100,000 in U.S.
    2. More common in men and older, postmenopausal women
    3. Most likely to grow and manifest clinically

VII. Findings: Presentations

  1. Incidental finding on imaging (asymptomatic Pituitary Incidentaloma)
    1. Found in >10% of patients and Clinically Significant in 0.1% of patients
  2. Hormone increased secretion - typically only one of the following affected (see above)
    1. Galactorrhea in Prolactinoma (Hyperprolactinemia)
    2. Gigantism in children prior to Growth Plate fusion or Acromegaly in adults (increased Growth Hormone)
    3. Cushing Disease (increased ACTH)
    4. Central Hyperthyroidism (increased TSH, rare)
  3. Mass effect (delayed presentation, especially in non-functioning adenomas)
    1. Hypopituitarism (30% of Pituitary Adenomas)
    2. Headache
      1. Related to dural sheath Stretching
      2. Not correlated with Pituitary Adenoma size
    3. Vision change
      1. Initial compression
        1. Optic Chiasm compression from superior aspect
        2. Results in bitemporal Hemianopsia
      2. Later may expand into the Cavernous Sinus laterally with additional Cranial Nerve Involvement (as adenoma grows)
        1. Cranial Nerve III (Oculomotor Nerve)
        2. Cranial Nerve IV (Trochlear Nerve)
        3. Cranial Nerve VI (Abducens Nerve)
      3. Later expansion
        1. Cranial Nerve II (Optic Nerve)

VIII. Labs: Initial

  1. Serum Prolactin
    1. Serum Prolactin 100-200 mcg/L is typical for most Prolactin-Secreting Pituitary Microadenomas
    2. Serum Prolactin >250 mcg/L is highly suggestive of Prolactinoma
    3. Serum Prolactin >500 mcg/L is highly suggestive of macroprolactinoma (Test Specificity 98%, but poorly sensitive)
    4. Very large macroadenomas (>3 cm) may give false negative Serum Prolactin (Hook effect)
      1. False Negatives (Hook effect) result if Prolactin detecting Antibody is saturated by very high Prolactin levels
  2. Insulin-like growth factor 1 (IGF-1)
  3. Leutenizing Hormone (LH)
  4. Follicle Stiulating Hormone (FSH)
  5. Thyroid Stimulating Hormone (TSH)
  6. Thyroxine Level (T4 Free)
  7. 24 hour Urine Cortisol (or Late Night Salivary Cortisol or low dose Dexamethasone suppression)

IX. Imaging

  1. Brain MRI (with and without gadolinium, cone-down sella turcica) - preferred
    1. Test Sensitivity: 61-72% (for sella turcica mass)
    2. Test Specificity: 88-90% (for sella turcica mass)
    3. Also obtain if MRI not contraindicated and Pituitary Adenoma inicidentally found on CT Head
    4. Repeat Brain MRI in 6-12 months depending on lesion size
  2. CT Head
    1. Indicated if MRI contraindicated or not available
    2. Coronal sections of 1.5 mm or less

X. Differential Diagnosis: Incidentaloma

  1. Pituitary Adenoma
  2. Rathke Cleft Cyst
  3. Craniopharyngioma
  4. Pituitary Hyperplasia

XI. Evaluation: Approach

  1. Obtain all initial labs as above
    1. Even if asymptomatic and pituitary mass incidentally found on brain imaging
  2. Obtain Brain imaging (MRI preferred)
    1. If Pituitary Adenoma is suspected
  3. Ophthalmology and Endocrine referrals as below
    1. Suspected Pituitary Adenoma
    2. Consult ophthalmology for macroadenoma even if no visual changes are readily evident
      1. Detailed Visual Field testing (evaluate for bitemporal Hemianopsia)
      2. Detailed Eye Examination (Visual Acuity, fundus, ocular movement)

XII. Management

  1. Management directed by endocrinology
    1. Consult prior to starting management and in completing evaluation once Pituitary Adenoma is identified
  2. Prolactinoma
    1. Refer to endocrinology
    2. Refer to opthalmology (see above) for comprehensive Eye Exam including Visual Field exam
      1. Periodic Visual Field examinations are typically scheduled
    3. Pharmacotherapy (normalizes Prolactin in 75 to 90% of Prolactinomas)
      1. Titrate dosing to decrease tumor size, Prolactin level and improve gonadal function
        1. Consider no treatment in asymptomatic microadenomas (e.g. normal Menses)
      2. Dopamine Agonists (adult dosing)
        1. Cabergoline
          1. Preferred agent with more rapid improvement and better tolerated by patients
          2. Start 0.25 orally twice weekly
            1. Increase in 0.25 mg increments/month to a maximum of 1 mg twice weekly
        2. Bromocriptine (Parlodel)
          1. Preferred in pregnancy or desired fertility (due to longer established safety record)
          2. Start: 1.25 to 2.5 mg at bedtime
          3. Increase by 2.5 mg every 2-7 days typically to 2.5 to 15 mg daily (absolute max 40 mg)
      3. Miscellaneous medications
        1. Oral Contraceptives may be considered for Amenorrhea management
    4. Monitoring
      1. Follow Serum Prolactin levels every 3 months
      2. Periodic recheck of TSH and FSH levels
      3. Repeat MRI pituitary at one year (or earlier for significantly rising Serum Prolactin)
      4. Medications are continued for at least 2 years, and then tapered off if Prolactin levels normal and tumor size reduced
      5. Discontinue Medications in Pregnancy (although Bromocriptine may be used if needed)
        1. Microadenoma growth risk in pregnancy is very low (<3%)
        2. However, macroadenomas, esp with Optic Chiasm impingement, often require medication continuation
      6. Recurrence off medications occurs in two thirds of patients (esp. larger tumors)
        1. Monitor Prolactin every 3 months for first year off medication, then yearly
    5. Other measures in select refractory macroadenoma patients (see non-functioning adenoma below)
      1. Transphenoidal Surgery
        1. Patients disease free after surgery: 76%
        2. Risk of Hypopituitarism, Diabetes Insipidus, CSF Leak, local infection
      2. Radiation Therapy
  3. ACTH-Secreting Pituitary Adenoma
    1. Refer to endocrinology and neurosurgery
    2. Surgical management options
      1. Surgical Resection
      2. Radiation Therapy
      3. Bilateral adrenalectomy
    3. Adrenostatic Medications (decrease adrenal steroidogenesis)
      1. Titrate medication dosing to decrease tumor size, Cortisol level and improve pituitary function
      2. Metyrapone (Metopirone) 250 mg four times daily (up to 6000 mg/day maximum)
      3. Mefepristone (Mifeprex) 300 mg once daily (up to 1200 mg/day maximum)
      4. Mitotane (Lysodren) 500 mg three times daily (up to 9000 mg/day maximum)
      5. Ketoconazole
        1. No longer recommended due to Ketoconazole hepatotoxicity
  4. GH-Secreting Pituitary Adenoma
    1. Refer to endocrinology and neurosurgery
    2. Surgical management options
      1. Surgical Resection
      2. Radiation Therapy
    3. Somatostatin Analogues
      1. Titrate medication dosing to decrease tumor size, Growth Hormone and IGF-1 level and improve pituitary function
      2. Octreotide (Sandostatin) 50 mcg SQ three times daily (or depot 20 mg every 4 weeks)
      3. Lanreotide (Somatuline) 90 mg SQ every 4 weeks
    4. Growth HormoneAntagonists (reduce IGF-1 and associated Acromegaly symptoms)
      1. Pegvisomant (Somavert) 15-20 mg daily
  5. Non-Functioning Pituitary Adenoma
    1. Obtain ophthalmology Consultation for Visual Field testing and complete Eye Examination
      1. Indicated for Non-functioning Pituitary Macroadenoma (>1 cm)
    2. Neurosurgery Consultation indications
      1. Abnormal ophthalmology examination (especially Visual Field Deficit)
      2. Neurologic symptoms (e.g. Headache)
      3. Lesion increasing in size to abut the Optic Chiasm or growth to >1 cm (macroadenoma)
    3. Repeat MRI Brain in one year, then in 2-3 years
      1. Neurosurgery Consultation if meets criteroa
    4. Repeat labs (see above), then in 1-3 years (or as directed by endocrinology)
      1. If abnormal, treat as functioning adenoma as above

XIII. Complications: Pituitary Apoplexy

  1. Bleeding and swelling at Pituitary Adenoma
  2. Presents with Thunderclap Headache, Visual Field cut (bitemporal Hemianopsia) and cranial Neuropathy
  3. Lumbar Puncture with high opening pressure and CSF Red Blood Cells
  4. CT Head is often normal

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Pituitary Neoplasms (C0032019)

Definition (MEDLINEPLUS)

Your pituitary gland is a pea-sized gland at the base of your brain. The pituitary is the "master control gland" - it makes hormones that affect growth and the functions of other glands in the body.

Pituitary tumors are common, but often they don't cause health problems. Most people with pituitary tumors never even know they have them. The most common type of pituitary tumor produces hormones and disrupts the balance of hormones in your body. This can cause endocrine diseases such as Cushing's syndrome and hyperthyroidism.

Symptoms of pituitary tumors include

  • Headaches
  • Vision problems
  • Nausea and vomiting
  • Problems caused by the production of too many hormones

Pituitary tumors are usually curable. Treatment is often surgery to remove the tumor. Other options include medicines, radiation therapy, and chemotherapy.

Definition (NCI_NCI-GLOSS) A tumor that forms in the pituitary gland. The pituitary is a pea-sized organ in the center of the brain above the back of the nose. It makes hormones that affect other glands and many body functions, especially growth. Most pituitary tumors are benign (not cancer).
Definition (NCI) A benign or malignant neoplasm affecting the pituitary gland. The vast majority are adenomas arising from the anterior lobe of the pituitary gland.
Definition (MSH) Neoplasms which arise from or metastasize to the PITUITARY GLAND. The majority of pituitary neoplasms are adenomas, which are divided into non-secreting and secreting forms. Hormone producing forms are further classified by the type of hormone they secrete. Pituitary adenomas may also be characterized by their staining properties (see ADENOMA, BASOPHIL; ADENOMA, ACIDOPHIL; and ADENOMA, CHROMOPHOBE). Pituitary tumors may compress adjacent structures, including the HYPOTHALAMUS, several CRANIAL NERVES, and the OPTIC CHIASM. Chiasmal compression may result in bitemporal HEMIANOPSIA.
Definition (CSP) new abnormal pituitary tissue that grows by excessive cellular division and proliferation more rapidly than normal and continues to grow after the stimuli that initiated the new growth cease.
Concepts Neoplastic Process (T191)
MSH D010911
SnomedCT 127024001
English Neoplasm, Pituitary, Neoplasms, Pituitary, PITUITARY NEOPLASM NOS, pituitary neoplasm, Pituitary Neoplasms, PITUITARY NEOPL, neoplasm of pituitary gland (diagnosis), neoplasm of pituitary gland, Pituitary gland neoplasm, Pituitary neoplasm NOS, Pituitary neoplasms, Pituitary tumor NOS, Pituitary tumour NOS, Pituitary Tumors, Tumor, Pituitary, Tumors, Pituitary, Pituitary Neoplasms [Disease/Finding], Tumour;pituitary gland, pituitary tumour, pituitary tumours, tumor of pituitary gland, pituitary gland neoplasm, pituitary tumors, pituitary neoplasms, Pituitary gland--Tumors, Pituitary tumor, Pituitary tumour, Tumor of pituitary gland, Tumour of pituitary gland, Neoplasm of pituitary gland (disorder), Neoplasm of pituitary gland, pituitary tumor, tumor, pituitary, Pituitary Neoplasm, Pituitary Tumor, Neoplasm of Pituitary Gland, Neoplasm of Pituitary, Neoplasm of the Pituitary Gland, Neoplasm of the Pituitary, Pituitary Gland Neoplasm, Pituitary Gland Tumor, Tumor of Pituitary Gland, Tumor of Pituitary, Tumor of the Pituitary Gland, Tumor of the Pituitary, Tumor;pituitary gland, pituitary gland tumor, pituitary gland tumour
Italian Tumore dell'ipofisi, Tumore dell'ipofisi NAS, Tumori dell'ipofisi, Tumori pituitari, Neoplasie dell'ipofisi
Dutch hypofyseneoplasma NAO, hypofyseneoplasma, hypofysetumor NAO, hypofyseneoplasmata, hypofysetumor, Gezwel, hypofyse-, Gezwellen, hypofyse-, Hypofysegezwel, Hypofysegezwellen
French Tumeur de l'hypophyse, Tumeur épiphysaire SAI, Tumeur hypophysaire SAI, Tumeur de l'hypophyse SAI, TUMEUR PITUITAIRE SAI, Tumeur pituitaire, Tumeurs de l'hypophyse, Tumeurs hypophysaires, Tumeurs pituitaires, Tumeurs de la glande pituitaire
German Hypophysenneubildung NNB, Hypophysentumor NNB, Hypophysenneubildung, NEOPLASMA HYPOPHYSE NNB, Hypophysentumor, Neubildungen der Hypophyse, Hypophysentumoren, Hypophysenneoplasien, Hypophysenneubildungen
Portuguese Neoplasia da hipófise NE, Tumor hipofisário NE, Neoplasia da hipófise, NEOPLASIA DA HIPOFISE, Câncer da Hipófise, Câncer da Glândula Pituitária, Neoplasias da hipófise, Tumor da pituitária, Neoplasias Hipofisárias
Spanish Tumor hipofisario NEOM, Neoplasia de glándula pituitaria, Neoplasia hipofisaria NEOM, NEOPLASIA DE HIPOFISIS SE, Cáncer de la Hipófisis, Cáncer de Hipófisis, Cáncer da Glándula Pituitária, neoplasia de la glándula hipófisis (trastorno), neoplasia de la glándula hipófisis, neoplasia de la glándula pituitaria, Neoplasias hipofisarias, Tumor de hipófisis, Neoplasias Hipofisarias
Japanese 下垂体の新生物, 下垂体腫瘍NOS, 下垂体の新生物NOS, 下垂体新生物, カスイタイシンセイブツ, カスイタイシュヨウ, カスイタイノシンセイブツNOS, カスイタイノシンセイブツ, カスイタイシュヨウNOS, 下垂体腫瘍, 脳下垂体腫瘍
Swedish Hypofystumörer
Finnish Aivolisäkkeen kasvaimet
Russian GIPOFIZA NOVOOBRAZOVANIIA, ГИПОФИЗА НОВООБРАЗОВАНИЯ
Czech Nádor hypofýzy, Novotvar hypofýzy, Nádor hypofýzy NOS, Novotvar hypofýzy NOS, Nádory hypofýzy, hypofýza - nádory, nádory podvěsku mozkového, nádory hypofýzy
Croatian HIPOFIZNI TUMORI, TUMORI HIPOFIZE
Polish Nowotwory przysadki
Hungarian Hypophysis tumor, Hypophysis neoplasia k.m.n., Agyalapi mirigy tumor k.m.n., Agyalapi mirigy neoplasiája, Hypophysis tumor k.m.n., Hypophysis neoplasmák
Norwegian Hypofyseneoplasmer, Svulster i hypofysen, Neoplasmer i hypofysen, Hypofysesvulster, Hypofysetumorer, Tumorer i hypofysen

Ontology: Prolactinoma (C0033375)

Definition (NCI) An adenoma of the anterior lobe of the pituitary gland that produces prolactin. It is the most common type of pituitary gland adenomas and it is associated with hyperprolactinemia. Clinical manifestations include amenorrhea, galactorrhea, impotence, headache, and visual disturbances.
Definition (MSH) A pituitary adenoma which secretes PROLACTIN, leading to HYPERPROLACTINEMIA. Clinical manifestations include AMENORRHEA; GALACTORRHEA; IMPOTENCE; HEADACHE; visual disturbances; and CEREBROSPINAL FLUID RHINORRHEA.
Concepts Neoplastic Process (T191)
MSH D015175
ICD10 M8271/0
SnomedCT 367098005, 34337008, 134209002
English Adenoma, Prolactin-Secreting, Pituitary, Pituitary Adenoma, PRL-Secreting, Pituitary Adenoma, Prolactin-Producing, Pituitary Adenoma, Prolactin-Secreting, Pituitary Adenomas, PRL-Secreting, Pituitary Adenomas, Prolactin-Producing, Pituitary Adenomas, Prolactin-Secreting, PRL Secreting Pituitary Adenoma, PRL-Secreting Pituitary Adenoma, PRL-Secreting Pituitary Adenomas, Prolactin-Producing Pituitary Adenoma, Prolactin-Producing Pituitary Adenomas, Prolactin-Secreting Pituitary Adenomas, Prolactinomas, PROLACTINOMA, Pituitary Adenoma, Prolactin Secreting, [M] Prolactinoma, Prolactin Secreting Pituitary Gland Adenoma, PRL Producing Pituitary Gland Adenoma, prolactinoma of pituitary gland (diagnosis), prolactinoma of pituitary gland, pituitary prolactinoma, Prolactin-secret pit adenoma, PROLACTINOMA, FAMILIAL, PITUITARY ADENOMA, PROLACTIN-SECRETING, Prolactinoma, Prolactinoma [Disease/Finding], prolactinomas, adenoma prolactin secreting, pituitary prolactinomas, prolactinoma, Prolactin-Producing Pituitary Gland Adenoma, Prolactinoma, Familial, [M]Prolactinoma, Prolactinoma (morphologic abnormality), Prolactin-secreting pituitary adenoma, Prolactinoma (disorder), prolactin secreting adenoma, adenoma, prolactin secreting, prolactinoma; unspecified site, Prolactin Producing Pituitary Adenoma, Prolactin Secreting Pituitary Adenoma, Pituitary Gland Prolactinoma, Pituitary Prolactinoma, Prolactin Producing Adenoma of Pituitary Gland, Prolactin Producing Adenoma of Pituitary, Prolactin Producing Adenoma of the Pituitary Gland, Prolactin Producing Adenoma of the Pituitary, Prolactin Producing Pituitary Gland Adenoma, Prolactin Secreting Adenoma of Pituitary Gland, Prolactin Secreting Adenoma of Pituitary, Prolactin Secreting Adenoma of the Pituitary Gland, Prolactin Secreting Adenoma of the Pituitary, Prolactin Secreting Adenoma, Prolactinoma of Pituitary Gland, Prolactinoma of Pituitary, Prolactinoma of the Pituitary Gland, Prolactinoma of the Pituitary, Prolactin-Secreting Pituitary Adenoma, Lactotroph Adenomas, Lactotroph Adenoma, Adenoma, Lactotroph, Adenomas, Lactotroph
Swedish Prolaktinom
Japanese プロラクチンサンセイシュヨウ, PRL産生下垂体腺腫, プロラクチノーマ, PRL分泌下垂体腺腫(PRLブンピツカスイタイセンシュ), プロラクチン分泌下垂体腺腫(プロラクチンブンピツカスイタイセンシュ), プロラクチン産生下垂体腫瘍, プロラクチン産生下垂体腺腫, PRL分泌下垂体腺腫, PRL産生腺腫, Prolactin分泌腫瘍, Prolactin産生腫瘍, プロラクチン分泌下垂体腺腫, プロラクチン分泌腫瘍, プロラクチン産生腫瘍, プロラクチン産生腺腫, 下垂体腺腫-プロラクチン分泌, 下垂体腺腫-プロラクチン産生, 腺腫-プロラクチン分泌-下垂体
Czech prolaktinom, Prolaktinom
Finnish Prolaktinooma
Russian PROLAKTINOMA, ADENOMA PROLAKTINSEKRETIRUIUSHCHAIA GIPOFIZARNAIA, GIPOFIZARNAIA ADENOMA PROLAKTINSEKRETIRUIUSHCHAIA, PROLAKTINPRODUTSIRUIUSHCHAIA ADENOMA GIPOFIZA, PROLAKTINSEKRETIRUIUSHCHAIA ADENOMA GIPOFIZA, АДЕНОМА ПРОЛАКТИНСЕКРЕТИРУЮЩАЯ ГИПОФИЗАРНАЯ, ГИПОФИЗАРНАЯ АДЕНОМА ПРОЛАКТИНСЕКРЕТИРУЮЩАЯ, ПРОЛАКТИНОМА, ПРОЛАКТИНПРОДУЦИРУЮЩАЯ АДЕНОМА ГИПОФИЗА, ПРОЛАКТИНСЕКРЕТИРУЮЩАЯ АДЕНОМА ГИПОФИЗА
Italian Adenoma ipofisario prolattina-secernente, Adenoma lattotropo, Adenoma ipofisario PRL-secernente, Adenomi ipofisari che producono prolattina, Prolattinoma
Croatian PROLAKTINOM
Polish Prolaktynoma, Gruczolak przysadki wydzielający prolaktynę
Hungarian Prolactinoma
Norwegian Prolaktinproduserende hypofyseadenom, Prolaktinom
Spanish Adenoma Pituitario Secretorio de Prl, Adenoma Pituitario Secretorio de Prolactina, (M)prolactinoma, prolactinoma (anomalía morfológica), prolactinoma, prolactinoma (trastorno), Prolactinoma, Adenoma Pituitario Secretor de PRL, Adenoma Pituitario Secretor de Prolactina
Portuguese Adenoma Pituitário Secretório de Prolactina, Adenoma Pituitário Secretório de Prl, Prolactinoma, Adenoma Pituitário Secretor de PRL, Adenoma Pituitário Secretor de Prolactina
Dutch prolactinoom; niet gespecificeerde lokalisatie, prolactinoom, Adenoom, prolactinesecernerend hypofysair, Hypofyseadenoom, prolactinesecernerend, Prolactinoom
French Prolactinome, Adénome lactotrope, Adénome à prolactine, Adénome hypophysaire sécrétant la PRL, Adénome hypophysaire sécrétant la prolactine
German Adenom, prolaktinsezernierendes, Hypophysen-, Hypophysenadenom, prolaktinsezernierendes, PRL-sezernierendes Hypophysenadenom, Prolaktinom, Prolaktinproduzierendes Hypophysenadenom

Ontology: Non-Functioning Pituitary Gland Neoplasm (C0338078)

Definition (NCI) A hormone producing or non-producing pituitary gland adenoma not associated with a hormonal syndrome.
Definition (NCI) A hormone producing or non-producing pituitary gland adenoma or carcinoma, not associated with a hormonal syndrome.
Concepts Neoplastic Process (T191)
SnomedCT 254962005
English Non-function pituitary adenoma, Non-function pituitary tumor, Non-function pituitary tumour, non-secretory adenoma of pituitary gland (diagnosis), non-secretory adenoma of pituitary gland, pituitary non-secretory (chromophobe) adenoma, Non-functioning pituitary tumor, Non-functioning pituitary tumour, Non-secretory adenoma of pituitary, nonfunctioning pituitary tumors, Non-Functioning Pituitary Gland Neoplasm, Functionless pituitary adenoma, Null cell pituitary adenoma, Non-functioning pituitary adenoma, Functionless pituitary adenoma (disorder), nonfunctioning pituitary adenoma, pituitary adenoma, nonfunctioning, nonfunctioning pituitary tumor, non-functioning pituitary tumor, pituitary tumor, nonfunctioning, Functionless Adenoma of Pituitary Gland, Functionless Adenoma of Pituitary, Functionless Adenoma of the Pituitary Gland, Functionless Adenoma of the Pituitary, Functionless Pituitary Adenoma, Functionless Pituitary Gland Adenoma, Non-Functioning Adenoma of Pituitary Gland, Non-Functioning Adenoma of Pituitary, Non-Functioning Adenoma of the Pituitary Gland, Non-Functioning Adenoma of the Pituitary, Non-Functioning Neoplasm of Pituitary Gland, Non-Functioning Neoplasm of Pituitary, Non-Functioning Neoplasm of the Pituitary Gland, Non-Functioning Neoplasm of the Pituitary, Non-Functioning Pituitary Adenoma, Non-Functioning Pituitary Gland Adenoma, Non-Functioning Pituitary Gland Tumor, Non-Functioning Pituitary Neoplasm, Non-Functioning Pituitary Tumor, Non-Functioning Tumor of Pituitary Gland, Non-Functioning Tumor of Pituitary, Non-Functioning Tumor of the Pituitary Gland, Non-Functioning Tumor of the Pituitary, Non-Secretory Adenoma of Pituitary Gland, Non-Secretory Adenoma of Pituitary, Non-Secretory Adenoma of the Pituitary Gland, Non-Secretory Adenoma of the Pituitary, Non-Secretory Pituitary Adenoma, Non-Secretory Pituitary Gland Adenoma, Nonfunctioning Pituitary Tumor
Italian Adenoma non secernente dell'ipofisi
Japanese 非分泌型下垂体腺腫, ヒブンピツガタカスイタイセンシュ, ヒブンピガタカスイタイセンシュ
Czech Nesekreční adenom hypofýzy
Hungarian Hypophysis nem-secretáló adenoma
Spanish adenoma de hipófisis no funcionante (trastorno), adenoma de hipófisis no funcionante, Adenoma de hipófisis no secretor
Portuguese Adenoma hipofisário não secretor
Dutch niet-secretoir adenoom van de epifyse
French Adénome non sécrétant de l'hypohyse
German nicht-sekretorisches Hypophysenadenom

Ontology: Growth Hormone-Secreting Pituitary Adenoma (C0346302)

Definition (NCI) An adenoma of the anterior lobe of the pituitary gland that produces growth hormone. The vast majority of cases are hormonally functioning and are associated with either gigantism or acromegaly.
Definition (MSH) A pituitary tumor that secretes GROWTH HORMONE. In humans, excess HUMAN GROWTH HORMONE leads to ACROMEGALY.
Concepts Neoplastic Process (T191)
MSH D049912
SnomedCT 254957009
English GH-secreting pituitary adenoma, Growth Hormone Secreting Pituitary Adenoma, GH Cell Adenoma, Growth Hormone-Secreting Pituitary Adenoma, Growth Hormone-Secreting Pituitary Adenoma [Disease/Finding], Growth Hormone-Producing Pituitary Gland Adenoma, Pituitary Adenoma, Growth Hormone-Secreting, Acromegaly Due To Pituitary Adenoma, Pituitary Adenoma, Growth Hormone Secreting, pituitary adenoma somatotroph, Somatotroph adenoma (diagnosis), Somatotroph adenoma, Growth hormone-secreting pituitary adenoma, Somatotroph adenoma (disorder), Growth Hormone Producing Adenoma of Pituitary Gland, Growth Hormone Producing Adenoma of Pituitary, Growth Hormone Producing Adenoma of the Pituitary Gland, Growth Hormone Producing Adenoma of the Pituitary, Growth Hormone Producing Pituitary Adenoma, Growth Hormone Producing Pituitary Gland Adenoma, Growth Hormone Secreting Adenoma of Pituitary Gland, Growth Hormone Secreting Adenoma of Pituitary, Growth Hormone Secreting Adenoma of the Pituitary Gland, Growth Hormone Secreting Adenoma of the Pituitary, Growth Hormone Secreting Pituitary Gland Adenoma, GH Secreting Pituitary Adenoma, GH-Secreting Pituitary Adenomas, Pituitary Adenoma, GH Secreting, Pituitary Adenoma, GH-Secreting, Pituitary Adenomas, GH-Secreting, Pituitary Growth Hormone Secreting Adenoma, Pituitary Growth Hormone-Secreting Adenoma, Somatotroph Adenoma, Adenoma, Somatotroph, Adenomas, Somatotroph, GH-Secreting Pituitary Adenoma, Somatotroph Adenomas
Russian РОСТА ГОРМОН-СЕКРЕТИРУЮЩАЯ АДЕНОМА ГИПОФИЗА, ГИПОФИЗА АДЕНОМА GH-СЕКРЕТИРУЮЩАЯ, АДЕНОМА ГИПОФИЗА СОМАТОТРОПИН-СЕКРЕТИРУЮЩАЯ, GIPOFIZA ADENOMA GH-SEKRETIRUIUSHCHAIA, SOMATOTROPNAIA ADENOMA, ADENOMA GIPOFIZA SOMATOTROPIN-SEKRETIRUIUSHCHAIA, GIPOFIZA SOMATOTROPIN SEKRETIRUIUSHCHAIA ADENOMA, ROSTA GORMON-SEKRETIRUIUSHCHAIA ADENOMA GIPOFIZA, ГИПОФИЗА СОМАТОТРОПИН СЕКРЕТИРУЮЩАЯ АДЕНОМА, СОМАТОТРОПНАЯ АДЕНОМА
Swedish Tillväxthormonproducerande hypofysadenom
Czech adenom hypofýzy vylučující somatotropní hormon, adenom hypofýzy vylučující růstový hormon, adenom hypofýzy secernující růstový hormon, somatotropní adenom, adenom hypofýzy produkující růstový hormon, adenom hypofýzy vylučující STH
Finnish Kasvuhormonia erittävä aivolisäkkeen adenooma
Italian Adenoma pituitario GH-secernente, Adenoma somatotropo, Adenoma pituitario secernente l'ormone della crescita, Adenoma pituitario secernente somatotropina
Japanese 成長ホルモン産生下垂体腺腫, 腺腫-成長ホルモン産生-下垂体, 腺腫-下垂体-成長ホルモン産生, 成長ホルモン分泌下垂体腺腫, 成長ホルモン分泌性下垂体腺腫, 成長ホルモン産生性下垂体腺腫, GH産生下垂体腺腫, 下垂体腺腫-成長ホルモン産生
Polish Gruczolak przysadki wydzielający GH, Gruczolak przysadki wydzielający hormon wzrostu
Norwegian Veksthormonproduserende adenom, Adenom med veksthormonsekresjon
Portuguese Adenoma Hipofisário Produtor de GH, Adenoma Hipofisário Produtor de Hormônio do Crescimento, Adenoma Pituitário Secretor de GH, Adenoma Pituitário Produtor de Hormônio do Crescimento, Adenoma Pituitário Produtor de GH, Adenoma Somatotrófico, Adenoma Hipofisário Secretor de GH, Adenoma Hipofisário Secretor de Hormônio do Crescimento, Adenoma Pituitário Secretor de Hormônio do Crescimento, Adenoma Somatotrofo
Spanish adenoma de hipófisis secretor de hormona de crecimiento, adenoma somatotrófico (trastorno), adenoma somatotrófico, Adenoma Hipofisario Secretor de GH, Adenoma Hipofisario Secretor de Hormona del Crecimiento, Adenoma Somatotropo
German Hypophysenadenom, WH-sezernierendes, Hypophysäres Wachstumshormon-sezernierendes Adenom, Somatotropes Adenom, WH-sezernierendes Hypophysenadenom, Wachstumshormon-sezernierendes Hypophysenadenom
French Adénome hypophysaire sécrétant de l'hormone de croissance, Adénome hypophysaire à GH, Adénome somatotrope, Adénome à GH

Ontology: Thyrotroph adenoma (C0346303)

Definition (NCI) A rare adenoma of the anterior lobe of the pituitary gland that produces thyrotropin. It is usually associated with goiter and hyperthyroidism.
Concepts Neoplastic Process (T191)
SnomedCT 254959007
English Thyrotropin-secret pit adenoma, Thyroid Stimulating Hormone Secreting Pituitary Gland Adenoma, TSHoma, Thyrotroph Adenoma, Thyrotrophic Adenoma, Thyrotropin Producing Pituitary Gland Adenoma, Thyrotropinoma, thyroid stimulating hormone producing adenoma of pituitary gland (diagnosis), thyroid stimulating hormone producing adenoma of pituitary gland, TSH producing adenoma of pituitary gland, Thyrotroph adenoma, TSH-Producing Pituitary Gland Adenoma, TSH-oma, Thyrotropin-secreting pituitary adenoma, Thyrotroph adenoma (disorder), TSH producing pituitary tumor, pituitary tumor, TSH producing, TSH Producing Adenoma of Pituitary Gland, TSH Producing Adenoma of Pituitary, TSH Producing Adenoma of the Pituitary Gland, TSH Producing Adenoma of the Pituitary, TSH Producing Pituitary Adenoma, TSH Producing Pituitary Gland Adenoma, TSH Secreting Adenoma of Pituitary Gland, TSH Secreting Adenoma of Pituitary, TSH Secreting Adenoma of the Pituitary Gland, TSH Secreting Adenoma of the Pituitary, TSH Secreting Pituitary Adenoma, TSH Secreting Pituitary Gland Adenoma, Thyroid Stimulating Hormone Producing Adenoma of Pituitary Gland, Thyroid Stimulating Hormone Producing Adenoma of Pituitary, Thyroid Stimulating Hormone Producing Adenoma of the Pituitary Gland, Thyroid Stimulating Hormone Producing Adenoma of the Pituitary, Thyroid Stimulating Hormone Producing Pituitary Adenoma, Thyroid Stimulating Hormone Producing Pituitary Gland Adenoma, Thyroid Stimulating Hormone Secreting Adenoma of Pituitary Gland, Thyroid Stimulating Hormone Secreting Adenoma of Pituitary, Thyroid Stimulating Hormone Secreting Adenoma of the Pituitary Gland, Thyroid Stimulating Hormone Secreting Adenoma of the Pituitary, Thyroid Stimulating Hormone Secreting Pituitary Adenoma
Spanish adenoma de hipófisis secretor de tirotrofina, adenoma tirotrófico (trastorno), adenoma tirotrófico

Ontology: Pituitary microadenoma (C0346306)

Concepts Neoplastic Process (T191)
SnomedCT 254963000
Dutch hypofysemicroadenoom
German Hypophysenmikroadenom
Italian Microadenoma dell'ipofisi
Portuguese Microadenoma hipofisário
Spanish Microadenoma hipofisario, microadenoma hipofisario (trastorno), microadenoma hipofisario
Japanese 微小下垂体腫瘍, ビショウカスイタイシュヨウ
Czech Mikroadenom hypofýzy
English microadenomas pituitary, pituitary microadenoma, microadenoma pituitary, Pituitary microadenoma, Pituitary microadenoma (disorder)
Hungarian Hypophysis microadenoma
French Microadénome hypophysaire

Ontology: Pituitary macroadenoma (C0346308)

Concepts Neoplastic Process (T191)
SnomedCT 254965007
Dutch hypofysemacroadenoom
German Hypophysenmakroadenom
Italian Macroadenoma dell'ipofisi
Portuguese Macroadenoma hipofisário
Spanish Macroadenoma hipofisario, macroadenoma hipofisario (trastorno), macroadenoma hipofisario
Japanese 巨大下垂体腫瘍, キョダイカスイタイシュヨウ
Czech Makroadenom hypofýzy
English macroadenomas pituitary, pituitary macroadenoma, Pituitary macroadenoma, Pituitary macroadenoma (disorder)
Hungarian Hypophysis macroadenoma
French Macroadénome hypophysaire

Ontology: Secretory adenoma of pituitary (C0854486)

Definition (NCI) A hormone producing pituitary gland adenoma, associated with a hormonal syndrome.
Concepts Neoplastic Process (T191)
Italian Adenoma secernente dell'ipofisi
Japanese 分泌型下垂体腺腫, ブンピガタカスイタイセンシュ, ブンピツガタカスイタイセンシュ
English Secretory adenoma of pituitary, functioning pituitary adenoma, pituitary adenoma, functioning, Functioning Adenoma of Pituitary Gland, Functioning Adenoma of Pituitary, Functioning Adenoma of the Pituitary Gland, Functioning Adenoma of the Pituitary, Functioning Pituitary Adenoma, Functioning Pituitary Gland Adenoma (Benign), Functioning Pituitary Gland Adenoma, Secretory Adenoma of Pituitary Gland, Secretory Adenoma of Pituitary, Secretory Adenoma of the Pituitary Gland, Secretory Adenoma of the Pituitary, Secretory Pituitary Adenoma, Secretory Pituitary Gland Adenoma
Czech Sekreční adenom hypofýzy
Hungarian Hypophysis szekretoros adenoma
Portuguese Adenoma hipofisário secretor
Spanish Adenoma de hipófisis secretor
Dutch secretoir adenoom van de hypofyse
French Adénome sécrétant de l'hypophyse
German sekretorisches Hypophysenadenom

Ontology: ACTH-Secreting Pituitary Adenoma (C1306214)

Definition (NCI) An adenoma of the pituitary gland that produces corticotropin. The vast majority of cases are associated with Cushing disease. Clinical manifestations include truncal obesity with thin extremities, thinning of the skin, osteoporosis, and a tendency to bruise easily. Silent or hormonally non-functioning ACTH producing adenomas have also been described. They produce symptoms of a mass-related lesion.
Definition (MSH) A pituitary adenoma which secretes ADRENOCORTICOTROPIN, leading to CUSHING DISEASE.
Concepts Neoplastic Process (T191)
MSH D049913
SnomedCT 254958004, 21109002
English Pituitary Corticotropin Secreting Adenoma, Corticotropin Secreting Pituitary Gland Adenoma, ACTHoma, ACTH-secreting pituitary adenoma (diagnosis), ACTH producing ('basophilic') adenoma (Cushing's disease), ACTH-secreting pitu adenoma, PITUITARY ADENOMA, ACTH-SECRETING, ACTH-Secreting Pituitary Adenoma, ACTH-Secreting Pituitary Adenoma [Disease/Finding], ACTH Producing Pituitary Gland Adenoma, ACTH-Producing Pituitary Gland Adenoma, Corticotroph adenoma, ACTH-secreting pituitary adenoma, Corticotroph adenoma (disorder), ACTH secreting adenoma, adenoma, ACTH secreting, Corticotropin Secreting Adenoma of the Pituitary, Corticotropinoma, Adrenocorticotropin Producing Adenoma of Pituitary Gland, Adrenocorticotropin Producing Adenoma of Pituitary, Adrenocorticotropin Producing Adenoma of the Pituitary Gland, Adrenocorticotropin Producing Adenoma of the Pituitary, Adrenocorticotropin Producing Pituitary Adenoma, Adrenocorticotropin Producing Pituitary Gland Adenoma, Adrenocorticotropin Secreting Adenoma of Pituitary Gland, Adrenocorticotropin Secreting Adenoma of Pituitary, Adrenocorticotropin Secreting Adenoma of the Pituitary Gland, Adrenocorticotropin Secreting Adenoma of the Pituitary, Adrenocorticotropin Secreting Pituitary Adenoma, Adrenocorticotropin Secreting Pituitary Gland Adenoma, ACTH Secreting Adenoma of Pituitary, ACTH Secreting Adenoma of the Pituitary, ACTH-Secreting Adenoma of Pituitary Gland, ACTH-Secreting Adenoma of Pituitary, ACTH-Secreting Adenoma of the Pituitary Gland, ACTH-Secreting Adenoma of the Pituitary, Pituitary ACTH Secreting Adenoma, Pituitary ACTH-Secreting Adenoma, Pituitary Gland ACTH-Secreting Adenoma, Corticotroph Adenoma, Corticotroph Adenomas, Corticotropin-Secreting Adenoma, Pituitary, Corticotropin-Secreting Adenomas, Pituitary, Pituitary Adenoma, ACTH Secreting, Pituitary Adenoma, ACTH-Producing, Pituitary Adenoma, ACTH-Secreting, Pituitary Adenomas, ACTH-Producing, Pituitary Adenomas, ACTH-Secreting, Pituitary Corticotropin-Secreting Adenomas, Pituitary Corticotropin-Secreting Adenoma, ACTH Producing Pituitary Adenoma, ACTH Secreting Pituitary Adenoma, ACTH-Producing Pituitary Adenomas, ACTH-Producing Pituitary Adenoma, ACTH-Secreting Pituitary Adenomas, Adenoma, Corticotroph, Adenomas, Corticotroph
Czech adenom hypofýzy produkující ACTH, kortikotropní adenom, adenom hypofýzy vylučující ACTH, adenom hypofýzy secernující ACTH
Finnish ATCH:ta erittävä aivolisäkkeen adenooma
Italian Adenoma corticotropo, Adenoma pituitario producente ACTH, Adenoma pituitario secernente ACTH, Adenoma pituitario secernente corticotropina
Russian ADENOMA GIPOFIZA AKTG-SEKRETIRUIUSHCHAIA, GIPOFIZA KORTIKOTROPIN-SEKRETIRUIUSHCHAIA ADENOMA, AKTG-SEKRETIRUIUSHCHAIA ADENOMA GIPOFIZA, KORTIKOTROPNAIA ADENOMA, АДЕНОМА ГИПОФИЗА АКТГ-СЕКРЕТИРУЮЩАЯ, АКТГ-СЕКРЕТИРУЮЩАЯ АДЕНОМА ГИПОФИЗА, ГИПОФИЗА КОРТИКОТРОПИН-СЕКРЕТИРУЮЩАЯ АДЕНОМА, КОРТИКОТРОПНАЯ АДЕНОМА
Japanese ACTH分泌性下垂体腺腫, ACTH産生性下垂体腺腫, ACTH産生腫瘍-下垂体, ACTH分泌下垂体腺腫, 下垂体腺腫-ACTH産生, ACTH産生下垂体腺腫
Swedish ACTH-producerande hypofysadenom
Polish Gruczolak przysadki wydzielający kortykotropinę, Gruczolak przysadki wydzielający ACTH
Croatian Not Translated[ACTH-Secreting Pituitary Adenoma]
Norwegian Adenom som gir økt sekresjon av kortikotropin, ACTH-produserende adenom
Portuguese Adenoma Pituitário Produtor de ACT, Adenoma Hipofisário Produtor de ACT, Adenoma Pituitário Produtor de Corticotropina, Adenoma Pituitário Secretor de Corticotropina, Adenoma Hipofisário Produtor de Corticotropina, Adenoma Corticotrofo, Adenoma Hipofisário Secretor de ACT, Adenoma Hipofisário Secretor de Corticotropina, Adenoma Pituitário Secretor de ACT
Spanish adenoma corticotropo, adenoma corticotrófico (trastorno), adenoma corticotrófico, adenoma de hipófisis secretor de ACTH, Adenoma Corticotropo, Adenoma Hipofisario Secretor de ACTH, Adenoma Hipofisario Secretor de Corticotropina
German ACTH-bildendes Hypophysenadenom, ACTH-produzierendes Hypophysenadenom, ACTH-sezernierendes Hypophysenadenom, Hypophysenadenom, ACTH-sezernierendes, Hypophysäres Kortikotropin-sezernierendes Adenom, Kortikotropes Adenom
French Adénome corticotrope, Adénome hypophysaire corticotrope, Adénome hypophysaire à ACTH, Adénome à ACTH