Abstract

Pituitary lesions are present in >10% ofthe population. Approximately one in 1000 people has a symptomatic pituitary tumour, which may cause clinical problems from mass effect, hormonal hypersecretion and impairment of normalpituitary function. The aim of this article is to outline thepotential causes of a sellar and parasellar mass, with an emphasis onthe presenting clinical features andscreening investigations that areapplicable to doctors working intheprimary care setting. There is a broad range of causes ofasellar/parasellar mass. Pituitary adenomas and Rathke's cleft cysts arethe most frequently encountered. Prolactinomas are the most common functioning tumour and tend to present as macroadenomas in men, while hyperprolactinaemia is associated with 15% of secondary amenorrhoea in women. Acromegaly and Cushing's disease are rare but important diagnoses to detect. Pituitary disease isoptimally managed in a specialist centre in the context of an established multidisciplinary team.

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