Aggressive Pituitary Adenomas and Carcinomas

Endocrinol Metab Clin North Am. 2020 Sep;49(3):505-515. doi: 10.1016/j.ecl.2020.05.008. Epub 2020 Jul 8.


A subset of pituitary tumors present an aggressive behavior that remains difficult to predict, and in rare cases they metastasize. The current European Society for Endocrinology (ESE) guidelines for the management of aggressive pituitary tumors and carcinomas provide valuable guidance, but several issues remain unaddressed because of the scarcity of data in the literature. This article presents key clinical aspects regarding aggressive pituitary tumors and carcinomas, and also discusses some of the unanswered questions of the ESE guidelines, focusing on both diagnosis and treatment.

Keywords: Aggressive pituitary tumor; Definition; Diagnosis; Pituitary carcinoma; Stupp protocol; Temozolomide; Treatment; Tumor growth.

Publication types

  • Review

MeSH terms

  • Adenoma / diagnosis
  • Adenoma / pathology
  • Adenoma / therapy*
  • Carcinoma / diagnosis
  • Carcinoma / pathology
  • Carcinoma / therapy*
  • Endocrinology / methods
  • Endocrinology / standards
  • Europe
  • Humans
  • Medical Oncology / methods
  • Medical Oncology / standards
  • Neoplasm Invasiveness
  • Neoplasm Metastasis
  • Pituitary Neoplasms / diagnosis
  • Pituitary Neoplasms / pathology
  • Pituitary Neoplasms / therapy*
  • Practice Guidelines as Topic / standards
  • Societies, Medical / standards