39 Pituitary Adenomas Pituitary adenomas

Pituitary adenomas are among the most common intracranial neoplasms, and they account for 10 to 15% of all intracranial tumors. The vast majority of pituitary adenomas (PAs) are benign and present incidentally or with hypopituitarism, hormonal hypersecretion, and local mass effect. Significant advances, including availability of more sensitive diagnostic hormonal assays, improvement in neuroimaging modalities, refinement in surgical techniques, and innovation of novel adjuvant therapeutic options, have contributed to the contemporary management of PAs. Comprehensive management of PAs includes a multidisciplinary approach involving a team of neurosurgeons, neuroradiologists, neuropathologists, medical and radiation oncologists, and endocrinologists. In this chapter, we discuss the epidemiology, pathology, classification, clinical presentation, diagnostic work-up, therapeutic options, and outcomes of PAs in the modern era of medicine.