Preoperative Workup for Patients with Pituitary Lesions

Alexandra White; Erion Junior de Andrade; Varun R Kshettry; Raj Sindwani; Pablo F Recinos

doi:10.1016/j.otc.2021.12.001

Preoperative Workup for Patients with Pituitary Lesions

Otolaryngol Clin North Am. 2022 Apr;55(2):233-246. doi: 10.1016/j.otc.2021.12.001. Epub 2022 Mar 4.

Authors

Alexandra White¹, Erion Junior de Andrade², Varun R Kshettry², Raj Sindwani³, Pablo F Recinos⁴

Affiliations

¹ Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 9500 Euclid Avenue, CA-51, Cleveland, OH 44195, USA.
² Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 9500 Euclid Avenue, CA-51, Cleveland, OH 44195, USA; Section of Skull Base Surgery, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, 9500 Euclid Avenue, CA-51, Cleveland, OH 44195, USA.
³ Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 9500 Euclid Avenue, CA-51, Cleveland, OH 44195, USA; Section of Skull Base Surgery, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, 9500 Euclid Avenue, CA-51, Cleveland, OH 44195, USA; Section of Rhinology, Sinus, & Skull Base Surgery, Head and Neck Institute, Cleveland Clinic, 9500 Euclid Avenue, CA-51, Cleveland, OH 44195, USA.
⁴ Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 9500 Euclid Avenue, CA-51, Cleveland, OH 44195, USA; Section of Skull Base Surgery, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, 9500 Euclid Avenue, CA-51, Cleveland, OH 44195, USA; Section of Rhinology, Sinus, & Skull Base Surgery, Head and Neck Institute, Cleveland Clinic, 9500 Euclid Avenue, CA-51, Cleveland, OH 44195, USA. Electronic address: recinop@ccf.org.

PMID: 35256177
DOI: 10.1016/j.otc.2021.12.001

Abstract

The pituitary gland plays a vital role in hormonal regulation. Pituitary lesions include tumors, cysts, and inflammatory processes that require multidisciplinary care from endocrinologists, neuro-ophthalmologists, neurosurgeons, and otolaryngologists. Treatment is typically aimed at controlling hormonal hypersecretion, decompressing the optic apparatus, and reducing tumor volume, and surgery is a common first-line approach. In this article, we provide a background on the function of the pituitary gland, common pituitary lesions, and their clinical presentations, as well as a summary of the history and physical, laboratory testing, and imaging required for the workup of a pituitary lesion.

Keywords: Craniopharyngioma; Functional pituitary tumors; Hypopituitarism; Macroadenoma; Meningioma; Microadenoma.

Publication types

Review

MeSH terms

Humans
Pituitary Gland / diagnostic imaging
Pituitary Gland / pathology
Pituitary Gland / surgery
Pituitary Neoplasms* / diagnostic imaging
Pituitary Neoplasms* / pathology
Pituitary Neoplasms* / surgery