Clinical Practice Guideline

Pituitary Incidentaloma

April 19, 2011

Full Guideline: Pituitary Incidentaloma: An Endocrine Society Clinical Practice Guideline
JCEM April 2011

Pamela U. Freda, Albert M. Beckers, Laurence Katznelson, Mark E. Molitch, Victor M. Montori, Kalmon D. Post, Mary Lee Vance

Objective:

The aim was to formulate practice guidelines for endocrine evaluation and treatment of pituitary incidentalomas.

Conclusions:

  • We recommend that patients with a pituitary incidentaloma undergo a complete history and physical examination, laboratory evaluations screening for hormone hypersecretion and for hypopituitarism, and a visual field examination if the lesion abuts the optic nerves or chiasm.
     
  • We recommend that patients with incidentalomas not meeting criteria for surgical removal be followed with clinical assessments, neuroimaging (magnetic resonance imaging at 6 months for macroincidentalomas, 1 yr for a microincidentaloma, and thereafter progressively less frequently if unchanged in size), visual field examinations for incidentalomas that abut or compress the optic nerve and chiasm (6 months and yearly), and endocrine testing for macroincidentalomas (6 months and yearly) after the initial evaluations.
     
  • We recommend that patients with a pituitary incidentaloma be referred for surgery if they have a visual field deficit; signs of compression by the tumor leading to other visual abnormalities, such as ophthalmoplegia, or neurological compromise due to compression by the lesion; a lesion abutting the optic nerves or chiasm; pituitary apoplexy with visual disturbance; or if the incidentaloma is a hypersecreting tumor other than a prolactinoma.

arrow Read the Full Guideline

On the Go

CPG Mobile App

App screen
Access guideline recommendations, patient information, and clinical education modules for a range of endocrine topics plus dozens of interactive decision algorithms and other point-of-care tools.

Download our CPG Mobile App

Access guideline recommendations, patient information, and clinical education modules for a range of endocrine topics plus dozens of interactive decision algorithms and other point-of-care tools.

On the Go

GUIDELINES Pocket Guides

Pocket Guides
Practical quick-reference tools to help you make accurate clinical decisions at the point of care.

Practical quick-reference tools to help you make accurate clinical decisions at the point of care.

Back to top
Short on time?

We'll come to you...

Get updates on the latest breakthroughs, clinical practice guidelines, and career development opportunities, straight to your inbox

Then take the next step: Set up your free website account and get exclusive access to even more great tools & content!