Pituitary disease: Presentation, diagnosis, and management

The diagnosis of pituitary disease is generally uncomplicated. This is despite the high prevalence of occult pituitary adenomas in the general population, the widespread use of high definition imaging techniques, and the broad range of intra- and perisellar lesions that can mimic pituitary adenomas. Follow up and optimisation of pituitary hormone replacement is also relatively straightforward, but management of visual impairment, reduced fertility, coarsened facial features, arthritis, obesity, headaches, and obstructive sleep apnoea is often much more troublesome. The Pituitary Foundation (internet search term: Pit Pat) provides important opinion and information, and reassures patients that they are not alone. In this brief overview, the presentation, classification, and general investigation of pituitary lesions is followed by a discussion of the diagnosis and management of specific secretory subtypes.