How are pituitary stalk lesions treated Because of the rarity of hypophysitis and pituitary stalk lesions, much of the treatment recommendations are based on nonrandomized, retrospective series and are as follows Treatment Recommendations for Pituitary Stalk Lesions. PITUITARY STALK LESIONS TREATMENT RECOMMENDATIONS Congenital lesions • No treatment indicated• Replete deficient pituitary hormones, as indicated Pituitary stalk neoplasms …
How should biopsy/resection of a pituitary stalk lesion be performed? The TSS approach to resection/biopsy of a pituitary stalk lesion should only be performed by an experienced neurosurgeon. Depending on the suspected pathology, the neurosurgical approach might include a planned gross total resection, a subtotal/decompressive surgery, or biopsy alone. Complete resection of a presumed inflammatory …
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When is biopsy/resection of a pituitary stalk lesion indicated? In general, biopsy of the pituitary stalk is recommended for the indications listed in the below table. Indications for Biopsy of Pituitary Stalk Lesions. 1 Pituitary stalk lesions (> 6.5 mm) 2 Central diabetes insipidus and/or hypopituitarism, or progressive clinical or radiographic disease 3 Diagnosis unclear from extensive investigations …
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How should patients with pituitary stalk lesions be monitored? For relatively smaller pituitary stalk lesions not associated with immunomodulatory drugs or significant mass effects, clinical review and repeat pituitary hormone testing within 3 to 6 months are recommended. Pituitary MRI re-imaging is also recommended every ≈ 6 to 12 months during the first 2 to …
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What is a pituicytoma? Pituicytoma is a rare tumor of the sellar and suprasellar regions (< 0.5% of sellar tumors) originating from specialized glial cells in the neurohypophysis and the infundibulum. These slow growing, benign stalk tumors generally occur in females > males and in the fourth to sixth decades of life. Patients typically present …
What cancers can cause pituitary stalk thickening? Possible neoplastic etiologies of abnormal pituitary stalk thickening are multiple and include: 1. Craniopharyngiomas 2. Posterior pituitary tumors—pituicytomas, spindle cell oncocytomas, ependymomas 3. Neuronal/paraneuronal tumors—gangliocytomas, neurocytomas, paragangliomas, neuroblastomas 4. Germ cell tumors—germinomas, mixed germ-cell tumors, nongerminomatous tumors 5. Metastatic cancers—most commonly lung or breast primary cancers In conjunction …
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What is the treatment options for and natural history of IH? Physiologic or supraphysiologic glucocorticoid therapy has been frequently used to treat IH, although evidence is lacking that this changes the natural history of the inflammatory process, or improves long-term pituitary function. In general, a brief course of higher dose steroids is recommended for hypophysitis …
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