Pituitary macroadenoma
pituitary neuroendocrine tumor greater than 10 mm in size and are approximately twice as common as pituitary microadenomas.
Pituitary macrocadenomas are the most common suprasellar mass in adults, and responsible for the majority of transsphenoidal hypophysectomies.
Clinical features
see pituitary neuroendocrine tumor clinical features.
Headache possible due to elevated intrasellar pressure.
Presentation may be the result of: endocrine syndromes, mass effect, incidental finding (essentially only with macroadenomas).
Biomarkers
Biomarkers of aggressive behavior have been identified in the pathology literature, including the proliferative marker MIB1.
Diagnosis
Differential Diagnosis
Treatment
The goal of treatment is complete cure. When this is not attainable, reducing tumor mass, restoring hormone function, and restoring normal vision are attempted using medications, surgery, and radiation. Pituitary macroadenomas often require surgical intervention for cure. The exceptions to this rule are the macroprolactinomas, which usually have an excellent response to medical therapy. The tumor size may be diminished but often does not disappear completely. Medical treatment can play a role in reducing tumor size, controlling hormonal excess, or correcting hormonal deficiency.