Pituitary tumors: recommendations for service provision and guidelines for management of patients

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This guideline was published in 1997.

Patients with pituitary tumours require specialist investigation and treatment and life-long follow-up, with considerable lifetime use of NHS resources. The initial presentation may involve several clinical disciplines, and in many instances there is evidence of repetition of expensive investigations with repeated visits to several specialist clinics, leading to ineffective use of resources. It follows that one group, normally clinical endocrinologists, should assume responsibility for co-ordination of investigations, treatment decision-making, follow-up and outcome assessment.

There is a need for more data on long-term outcomes of treatment, particularly factors which affect mortality, and for future plans to be modified in the light of these data. Registers and accurate documentation of morbidity/mortality are central to this objective.

The issues concerning management of patients with pituitary tumours have been considered by a working party of clinical endocrinologists, pituitary surgeons, neuroradiologists, radiotherapists, a general practitioner and patients. Their guidelines and recommendations are set out in this document which is intended to inform health care purchasers and providers of care of patients. They should be interpreted in the context of individual patients' specific circumstances, which may be variable.

Contents

  • Introduction and methods
  • Recommendations for service provision for patients with pituitary tumours
  • Guidelines
  • Management points appropriate for patients will all types of pituitary tumour
  • Management of non-functioning tumours
  • Functional testing and replacement therapy
  • Craniopharyngiomas and peripituitary tumours
  • Diagnosis and management of Cushing's syndrome
  • Diagnosis and management of acromegaly
  • Investigation and management of hyperprolactinaemia

Copies available on request.

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