How are pituitary stalk lesions treated

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 LESIONSTREATMENT RECOMMENDATIONS
Congenital lesions• No treatment indicated• Replete deficient pituitary hormones, as indicated
Pituitary stalk neoplasms (e.g., pituicytoma, germinoma, craniopharyngioma, etc.)• Subtotal or gross total resection, as indicated• Radiation for residual tumors• Replete deficient pituitary hormones
Hypophysitis (primary and secondary)• Glucocorticoids, alternative immunosuppressive agents, or treatment of systemic diseases• Biopsy/Decompression as indicated (see Table 24.3 )
Immunotherapeutic drugs (e.g., ipilimumab > pembrolizumab, nivolumab > atezolizumab, avelumab and durvalumab)• Glucocorticoids• Replete additional deficient pituitary hormones, as needed• Biopsy rarely needed
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