Suspected when either hypopituitarism or hypersecretion of a pitiutary hormone is clinically manifest. The classic symptom is a frontal headache and sign is bitemporal hemianopia or third nerve palsy.
The commonest pituitary tumour is an adenoma. This is followed by metastatic spread of breast cancer, lung cancer, colon cancer and prostate cancer. Craniopharyngiomas which arise in adjacent tissue are in the differential diagnosis. Cystic structures will also act like a tumour so Rathke cleft cyst and arachnoid cysts have similar presentations.
Although now found usually when hypopituitarism or one of the classic hypersecretion syndromes is suspected, or incidentally on cranial imaging, the first presentation can be the emergency of pituitary apoplexy.
- ECr, FBC, CRP, TFTs
- If hyponatraemia, serum osmolarity and urine sodium and osmolarity
- Insulin-like growth factor 1
- Luteinising hormone
- Follicle stimulating hormone
- Testosterone (males)
- Oestradiol (females)
- Imaging - usually MRI and/or CT
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