| Popis: |
Introduction and Purpose: Pituitary neuroendocrine tumors (PitNETs), commonly known as pituitary adenomas, are tumors originating from the adenohypophysis. The purpose of this review was to provide a comprehensive overview of the latest classification, clinical presentation, diagnosis and treatment options for different types of PitNETs. Description of state of knowledge: The World Health Organization (WHO) 2022 guidelines introduced a new classification system for PitNETs, emphasizing the importance of immunohistochemistry in diagnosing these tumors and identifying key transcription factors like PIT1, TPIT, and SF1. Clinical presentation of PitNETs vary widely, with symptoms ranging from mass effect related issues like headaches and visual disturbances to hormone excess syndromes such as hyperprolactinemia, acromegaly, and Cushing’s disease. Magnetic resonance imaging (MRI) is the gold standard for diagnosing adenomas. Treatment approaches depend on tumor type, with dopamine agonists being the first-line treatment for prolactinomas, while endoscopic transsphenoidal surgery (EETS) is the preferred treatment for other PitNETs. EETS achieves high rates of gross total resection and low recurrence. For patients with persistent or recurrent disease, reoperation, medical therapy, or radiotherapy may be required. Conclusions: Pituitary neuroendocrine tumors represent a diverse group of tumors that require an individualized, multidisciplinary approach for accurate diagnosis and effective treatment, aimed at optimizing patient outcomes. |
