First German Guideline on Diagnostics and Therapy of Clinically Non-Functioning Pituitary Tumors

Deutschbein T, Jaursch-Hancke C, Knappe UJ, Saeger W, Flitsch J, Bojunga J, Buchfelder M, Ditzen B, Gerlach R, Gertzen E, Honegger J, Horstmann GA, Koch A, Kreitschmann-Andermahr I, Kunz M, Lagreze WA, Nicolay NH, Paulus W, Reincke M, Schmidt M, Weber MM, Wilhelm H, Fassnacht M (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Experimental and Clinical Endocrinology and Diabetes Thieme Publishing

Book Volume: 129

Pages Range: 250-264

Journal Issue: 3

DOI: 10.1055/a-1386-9145

Abstract

Although non-functioning pituitary tumors are frequent, diagnostic and therapeutic concepts are not well standardized. We here present the first German multidisciplinary guideline on this topic. The single most important message is to manage the patients by a multidisciplinary team (consisting at least of an endocrinologist, a neurosurgeon, and a (neuro-) radiologist). The initial diagnostic work-up comprises a detailed characterization of both biochemical (focusing on hormonal excess or deficiency states) and morphological aspects (with magnetic resonance imaging of the sellar region). An ophthalmological examination is only needed in presence of symptoms or large tumors affecting the visual system. Asymptomatic, hormonally inactive tumors allow for a 'wait and scan' strategy. In contrast, surgical treatment by an experienced pituitary surgeon is standard of care in case of (impending) visual impairment. Therapeutic options for incompletely resected or recurrent tumors include re-operation, radiotherapy, and observation; the individual treatment plan should be developed multidisciplinary. Irrespective of the therapeutic approach applied, patients require long-term follow-up. Patient with larger pituitary tumors or former surgery/radiotherapy should be regularly counseled regarding potential symptoms of hormonal deficiency states.

Authors with CRIS profile

Michael Buchfelder Lehrstuhl für Neurochirurgie Manuel Schmidt Department of Neuroradiology

Involved external institutions

Ludwig-Maximilians-Universität (LMU) DE Germany (DE) Albert-Ludwigs-Universität Freiburg DE Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) DE Germany (DE) Charité - Universitätsmedizin Berlin DE Germany (DE) Eberhard Karls Universität Tübingen DE Germany (DE) Universität Duisburg-Essen (UDE) DE Germany (DE) Julius-Maximilians-Universität Würzburg DE Germany (DE) HELIOS Kliniken DE Germany (DE) Ruprecht-Karls-Universität Heidelberg DE Germany (DE) Universitätsklinikum Frankfurt am Main (KGU) DE Germany (DE) Johannes Gutenberg-Universität Mainz (JGU) DE Germany (DE) Universitätsklinikum Münster DE Germany (DE) Niels-Stensen-Kliniken GmbH DE Germany (DE) Ruhr-Universität Bochum (RUB) DE Germany (DE)

How to cite

APA:

Deutschbein, T., Jaursch-Hancke, C., Knappe, U.J., Saeger, W., Flitsch, J., Bojunga, J.,... Fassnacht, M. (2021). First German Guideline on Diagnostics and Therapy of Clinically Non-Functioning Pituitary Tumors. Experimental and Clinical Endocrinology and Diabetes, 129(3), 250-264. https://doi.org/10.1055/a-1386-9145

MLA:

Deutschbein, Timo, et al. "First German Guideline on Diagnostics and Therapy of Clinically Non-Functioning Pituitary Tumors." Experimental and Clinical Endocrinology and Diabetes 129.3 (2021): 250-264.

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