Strategies for the management of nonsecreting pituitary adenomas

The two objectives of treating pituitary tumors are: (1) relief of signs and symptoms attributable to mass effect, and (2) correction of hypo - or hypersecretion of adenohypophyseal hormones.7 When nonsecreting tumors are specifically considered, correction of endocrine abnormalities may be of less consequence than hormonal excess, but continued growth of the lesion may precipitate hypopituitarism. Radioimmunoassay has revolutionized the diagnosis and management of pituitary tumors. Complementary immunocytochemical methods have rendered original morphometric histological classification methods of pituitary tumors clinically obsolete. In conjunction with advances in radiographic imaging and electron microscopy, the detection, diagnosis, and definition of these lesions have been greatly enhanced and our understanding of the nature of the production and discharge of pituitary hormones has been extended.4