1- PITUITARY SPACE-OCCUPYING LESIONS AND TUMORS

• Overproduction

  • GH excess
  • Prolactin excess
  • ACTH excess
• GH excess


  • Gigantism or acromegaly
• Prolactin excess

  • Galactorrhea, amenorrhea, erectile dysfunction, etc.
• ACTH excess

  • Cushing's disease
• Local effects/pressure on

  • Optic chiasm
  • Cavernous sinus
  • Bone and meninges
  • Hypothalamic centers
  • Ventricles
• Optic chiasm


  • Bitemporal hemianopia
• Cavernous sinus

  • III, IV, VI CN lesions
• Bone and meninges


  • Headache
• Hypothalamic centers

  • Obesity, altered appetite & thirst, precocious puberty
• Ventricles

  • Interruption of CSF flow à hydrocephalus
• Mass lesion is most commonly adenoma
• Confirm with MRI and R/O other rarer causes (craniopharyngioma, secondary deposits, sarcoidosis, Wegner's)
• Incidentaloma


  Pituitary tumor in asymptomatic patient
• Management of incidentaloma

  • < 1 cm: prolactin level and yearly MRI
  • > 1 cm: prolactin level, yearly MRI, TSH, T4, LH, FSH, IGF, visual fields testing for OC compression