Pituitary incidentaloma: an endocrine society clinical practice guideline.
J Clin Endocrinol Metab
; 96(4): 894-904, 2011 Apr.
Article
em En
| MEDLINE
| ID: mdl-21474686
ABSTRACT
OBJECTIVE:
The aim was to formulate practice guidelines for endocrine evaluation and treatment of pituitary incidentalomas. CONSENSUS PROCESS Consensus was guided by systematic reviews of evidence and discussions through a series of conference calls and e-mails and one in-person meeting.CONCLUSIONS:
We recommend that patients with a pituitary incidentaloma undergo a complete history and physical examination, laboratory evaluations screening for hormone hypersecretion and for hypopituitarism, and a visual field examination if the lesion abuts the optic nerves or chiasm. We recommend that patients with incidentalomas not meeting criteria for surgical removal be followed with clinical assessments, neuroimaging (magnetic resonance imaging at 6 months for macroincidentalomas, 1 yr for a microincidentaloma, and thereafter progressively less frequently if unchanged in size), visual field examinations for incidentalomas that abut or compress the optic nerve and chiasm (6 months and yearly), and endocrine testing for macroincidentalomas (6 months and yearly) after the initial evaluations. We recommend that patients with a pituitary incidentaloma be referred for surgery if they have a visual field deficit; signs of compression by the tumor leading to other visual abnormalities, such as ophthalmoplegia, or neurological compromise due to compression by the lesion; a lesion abutting the optic nerves or chiasm; pituitary apoplexy with visual disturbance; or if the incidentaloma is a hypersecreting tumor other than a prolactinoma.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
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Tipos_de_cancer
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Outros_tipos
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Hipofisárias
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Adenoma
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Guias de Prática Clínica como Assunto
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Achados Incidentais
Tipo de estudo:
Diagnostic_studies
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Guideline
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Observational_studies
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Prognostic_studies
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Qualitative_research
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Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
J Clin Endocrinol Metab
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Estados Unidos