Pituitary tumours- are physicians necessary?

S Cudlip

Consultant Neurosurgeon, Oxford Radcliffe Infirmary

Summer School 13-16 July 2004
St Anne's College, Oxford University, UK

Patients with pituitary tumours are uncommon (20-30/million/year) and present to specialists via a multitude of clinical disciplines. These patients have often had multiple and repetitive investigations, and many clinic attendances leading to delays in diagnosis and treatment.

Management of these patients involves four steps;

1. Establishing an endocrine diagnosis.
2. Establishing an anatomical diagnosis
3. Deciding the best means of treatment
4. Assessing the response to treatment.

The basics of these steps will be discussed for the common pituitary tumours presenting to clinicians, the current management strategies for differing tumour types, and some pitfalls commonly encountered. Postoperative care of patients having pituitary surgery will be discussed, as will some of the complications of surgery and their management. Historically, the respective roles of surgeons and physicians have been blurred in the management of pituitary patients, published data has shown that when surgeons and physicians treat pituitary patients independently of each other clinical outcomes often suffer. There is a clear case for the joint management of patients with pituitary tumours involving surgeons and physicians.

The opinions expressed in this paper are those of the speaker and do not necessarily reflect the views of the Society

Revised: 05-Nov-2004