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Pituitary Macroadenoma
Karen L. Salzman, MD; Anne G. Osborn, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Macroadenoma, pituitary adenoma, prolactinoma
              • Definitions

                • Benign neoplasm of adenohypophysis

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Angiographic Findings

                      • Other Modality Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Cohen-Cohen S et al: Pituitary adenomas in the setting of multiple endocrine neoplasia type 1: a single-institution experience. J Neurosurg. 1-7, 2020
                                              2. Gerges MM et al: Long-term outcomes after endoscopic endonasal surgery for nonfunctioning pituitary macroadenomas. J Neurosurg. 1-12, 2020
                                              3. Pelsma ICM et al: Quality of care evaluation in non-functioning pituitary adenoma with chiasm compression: visual outcomes and timing of intervention clinical recommendations based on a systematic literature review and cohort study. Pituitary. ePub, 2020
                                              4. Wang H et al: Nonfunctioning pituitary adenomas in pediatric and adolescent patients: a clinical analysis of a series of 14 patients. J Neurooncol. ePub, 2020
                                              5. Doai M et al: Pituitary macroadenoma: Accuracy of apparent diffusion coefficient magnetic resonance imaging in grading tumor aggressiveness. Neuroradiol J. 32(2):86-91, 2019
                                              6. Micko A et al: Challenging Knosp high-grade pituitary adenomas. J Neurosurg. 1-8, 2019
                                              7. Lang M et al: Superiority of constructive interference in steady-state MRI sequencing over T1-weighted MRI sequencing for evaluating cavernous sinus invasion by pituitary macroadenomas. J Neurosurg. 1-8, 2018
                                              8. Nishioka H et al: New WHO classification of pituitary adenomas (4th edition): assessment of pituitary transcription factors and the prognostic histological factors. Brain Tumor Pathol. 35(2):57-61, 2018
                                              9. Lopes MBS: The 2017 World Health Organization classification of tumors of the pituitary gland: a summary. Acta Neuropathol. 134(4):521-535, 2017
                                              10. Dallapiazza RF et al: Outcomes of endoscopic transsphenoidal pituitary surgery. Endocrinol Metab Clin North Am. 44(1):105-115, 2015
                                              11. Lenzi J et al: Evaluation of trans-sphenoidal surgery in pituitary GH-secreting micro- and macroadenomas: a comparison between microsurgical and endoscopic approach. J Neurosurg Sci. 59(1):11-8, 2015
                                              12. Sakata K et al: Primary meningeal melanocytoma of the sellar region: review of the literature and differential diagnosis with special reference to angiographical features. Pituitary. ePub, 2015
                                              13. Tong T et al: Comparison of contrast-enhanced SPACE and CISS in evaluating cavernous sinus Invasion by pituitary macroadenomas on 3-T magnetic resonance. J Comput Assist Tomogr. 39(2):222-7, 2015
                                              14. Bergsneider M et al: The pituitary stalk effect: is it a passing phenomenon? J Neurooncol. 117(3):477-84, 2014
                                              15. Connor SE et al: Magnetic resonance imaging criteria to predict complete excision of parasellar pituitary macroadenoma on postoperative imaging. J Neurol Surg B Skull Base. 75(1):41-6, 2014
                                              16. Fomekong E et al: Intraoperative 3T MRI for pituitary macroadenoma resection: Initial experience in 73 consecutive patients. Clin Neurol Neurosurg. 126:143-9, 2014
                                              17. Kitajima M et al: Differentiation of common large sellar-suprasellar masses effect of artificial neural network on radiologists' diagnosis performance. Acad Radiol. 16(3):313-20, 2009
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Synonyms

                                                            • Macroadenoma, pituitary adenoma, prolactinoma
                                                          • Definitions

                                                            • Benign neoplasm of adenohypophysis

                                                          IMAGING

                                                          • General Features

                                                            • CT Findings

                                                              • MR Findings

                                                                • Angiographic Findings

                                                                  • Other Modality Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Staging, Grading, & Classification

                                                                            • Gross Pathologic & Surgical Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Cohen-Cohen S et al: Pituitary adenomas in the setting of multiple endocrine neoplasia type 1: a single-institution experience. J Neurosurg. 1-7, 2020
                                                                                          2. Gerges MM et al: Long-term outcomes after endoscopic endonasal surgery for nonfunctioning pituitary macroadenomas. J Neurosurg. 1-12, 2020
                                                                                          3. Pelsma ICM et al: Quality of care evaluation in non-functioning pituitary adenoma with chiasm compression: visual outcomes and timing of intervention clinical recommendations based on a systematic literature review and cohort study. Pituitary. ePub, 2020
                                                                                          4. Wang H et al: Nonfunctioning pituitary adenomas in pediatric and adolescent patients: a clinical analysis of a series of 14 patients. J Neurooncol. ePub, 2020
                                                                                          5. Doai M et al: Pituitary macroadenoma: Accuracy of apparent diffusion coefficient magnetic resonance imaging in grading tumor aggressiveness. Neuroradiol J. 32(2):86-91, 2019
                                                                                          6. Micko A et al: Challenging Knosp high-grade pituitary adenomas. J Neurosurg. 1-8, 2019
                                                                                          7. Lang M et al: Superiority of constructive interference in steady-state MRI sequencing over T1-weighted MRI sequencing for evaluating cavernous sinus invasion by pituitary macroadenomas. J Neurosurg. 1-8, 2018
                                                                                          8. Nishioka H et al: New WHO classification of pituitary adenomas (4th edition): assessment of pituitary transcription factors and the prognostic histological factors. Brain Tumor Pathol. 35(2):57-61, 2018
                                                                                          9. Lopes MBS: The 2017 World Health Organization classification of tumors of the pituitary gland: a summary. Acta Neuropathol. 134(4):521-535, 2017
                                                                                          10. Dallapiazza RF et al: Outcomes of endoscopic transsphenoidal pituitary surgery. Endocrinol Metab Clin North Am. 44(1):105-115, 2015
                                                                                          11. Lenzi J et al: Evaluation of trans-sphenoidal surgery in pituitary GH-secreting micro- and macroadenomas: a comparison between microsurgical and endoscopic approach. J Neurosurg Sci. 59(1):11-8, 2015
                                                                                          12. Sakata K et al: Primary meningeal melanocytoma of the sellar region: review of the literature and differential diagnosis with special reference to angiographical features. Pituitary. ePub, 2015
                                                                                          13. Tong T et al: Comparison of contrast-enhanced SPACE and CISS in evaluating cavernous sinus Invasion by pituitary macroadenomas on 3-T magnetic resonance. J Comput Assist Tomogr. 39(2):222-7, 2015
                                                                                          14. Bergsneider M et al: The pituitary stalk effect: is it a passing phenomenon? J Neurooncol. 117(3):477-84, 2014
                                                                                          15. Connor SE et al: Magnetic resonance imaging criteria to predict complete excision of parasellar pituitary macroadenoma on postoperative imaging. J Neurol Surg B Skull Base. 75(1):41-6, 2014
                                                                                          16. Fomekong E et al: Intraoperative 3T MRI for pituitary macroadenoma resection: Initial experience in 73 consecutive patients. Clin Neurol Neurosurg. 126:143-9, 2014
                                                                                          17. Kitajima M et al: Differentiation of common large sellar-suprasellar masses effect of artificial neural network on radiologists' diagnosis performance. Acad Radiol. 16(3):313-20, 2009