Tumors of the Pituitary Gland

Abstract Tumors of the pituitary gland account for approximately 10–15% of intracranial neoplasms, with an incidence ranging from 1 to 20 cases per 100,000 per year. Pituitary tumors represent a wide range of pathologies. The 2017 World Health Organization Classification of Tumors of Endocrine Organs lists 19 different pathologies originating from cell lines intrinsic to the pituitary gland. They require an understanding of endocrinology, genetics, and surgical options in order to manage them effectively. The majority of pituitary tumors are non-functional tumors; however, that does not preclude them from affecting the hypothalamic-pituitary axis due to mass effect. A full endocrine history and workup are required as a first step when a pituitary lesion is diagnosed. From there the management largely depends on the patient’s visual exam, physical exam, medical history, and comorbidities. Treatment options range from medical management, radiation therapy, and surgical resection, to chemotherapy. The majority of pituitary tumors are best managed by a multidisciplinary team that includes the combination of a neuro-endocrinologist, neurosurgeon, neuro-oncologist, and radiation oncologist. Craniopharyngiomas represent a unique pituitary lesion that are histologically and cytologically benign but can be locally aggressive and require surgical resection for cure. They are unique in the sense that some subtype expresses a gene that may prove to be a viable target for chemotherapy.