Brain Tumor Res Treat.  2023 Jul;11(3):173-176. 10.14791/btrt.2023.0015.

Pituitary Neuroendocrine Tumor: Is It Benign or Malignant?

Affiliations
  • 1Department of Neurosurgery, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Korea

Abstract

The World Health Organization (WHO) updated the classification of pituitary tumors in 2022. The new classification presents detailed histological subtyping of a pituitary neuroendocrine tumor (PitNET) based on the tumor cell lineage, cell type, and related characteristics. The immunohistochemistry for pituitary transcription factors (PIT1, TPIT, SF1, GATA3, and ERα) is routinely needed in this classifica-tion. The controversy regarding the change of behavior code of all PitNET/pituitary adenoma from “0” for benign tumors to “3” for primary malignant tumors is a topic of debate among experts, nowadays. Some authors represent that pituitary adenoma has a tendency for hemorrhage and necrosis and frequent invasion of the cavernous sinus. However, most small PitNET/pituitary adenoma do not need any treatment because of benign biologic behavior or less than 5% recurrence after gross total removal. Pituitary apoplexy is also benign nature but has a tendency of cranial nerve compression or panhypopituitarism. Most of cavernous invasion is compression of the cavernous sinus. Aggressive PitNET/ pituitary adenoma with malignant biological behavior is less than 1%.

Keyword

Pituitary gland; Neuroendocrine tumor; Pituitary adenoma

Reference

1. WHO Classification of Tumours Editorial Board. Central nervous system tumours: WHO classification of tumours. Volume 6 [Internet]. 5th ed. Lyon: International Agency for Research on Cancer;2021. p. 406–416. Accessed Nov 1, 2022. at https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours/Central-Nervous-System-Tumours-2021.
2. WHO Classification of Tumours Editorial Board. Endocrine and neuroendocrine tumours: WHO classification of tumours series. Volume 10 [Internet]. 5th ed. Lyon: International Agency for Research on Cancer;2022. Accessed Nov 1, 2022. at https://tumourclassification.iarc.who.int/.
3. Ostrom QT, Cioffi G, Waite K, Kruchko C, Barnholtz-Sloan JS. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2014-2018. Neuro Oncol. 2021; 23(12 Suppl 2):iii1–iii105. PMID: 34608945.
4. Rindi G, Klimstra DS, Abedi-Ardekani B, Asa SL, Bosman FT, Brambilla E, et al. A common classification framework for neuroendocrine neoplasms: an International Agency for Research on Cancer (IARC) and World Health Organization (WHO) expert consensus proposal. Mod Pathol. 2018; 31:1770–1786. PMID: 30140036.
5. Asa SL, Mete O, Perry A, Osamura RY. Overview of the 2022 WHO classification of pituitary tumors. Endocr Pathol. 2022; 33:6–26. PMID: 35291028.
6. Wan XY, Chen J, Wang JW, Liu YC, Shu K, Lei T. Overview of the 2022 WHO classification of pituitary adenomas/pituitary neuroendocrine tumors: clinical practices, controversies, and perspectives. Curr Med Sci. 2022; 42:1111–1118. PMID: 36544040.
7. Tsukamoto T, Miki Y. Imaging of pituitary tumors: an update with the 5th WHO classifications—part 1. Pituitary neuroendocrine tumor (PitNET)/pituitary adenoma. Jpn J Radiol. 2023; 02. 24. [Epub]. Available at: . DOI: 10.1007/s11604-023-01400-7.
8. Molitch ME. Nonfunctioning pituitary tumors. Handb Clin Neurol. 2014; 124:167–184. PMID: 25248587.
9. Hall WA, Luciano MG, Doppman JL, Patronas NJ, Oldfield EH. Pituitary magnetic resonance imaging in normal human volunteers: occult adenomas in the general population. Ann Intern Med. 1994; 120:817–820. PMID: 8154641.
10. Chong BW, Kucharczyk W, Singer W, George S. Pituitary gland MR: a comparative study of healthy volunteers and patients with microadenomas. AJNR Am J Neuroradiol. 1994; 15:675–679. PMID: 8010269.
11. Zhang X, Yang F, Han N. Recurrence rate and exploration of clinical factors after pituitary adenoma surgery: a systematic review and meta-analysis based on computer artificial intelligence system. Comput Intell Neurosci. 2022; 2022:6002672. PMID: 36275975.
12. Melmed S, Kaiser UB, Lopes MB, Bertherat J, Syro LV, Raverot G, et al. Clinical biology of the pituitary adenoma. Endocr Rev. 2022; 43:1003–1037. PMID: 35395078.
13. Ho KKY, Fleseriu M, Wass J, van der Lely A, Barkan A, Giustina A, et al. A tale of pituitary adenomas: to NET or not to NET. Pituitary. 2019; 22:569–573. PMID: 31571098.
14. Ho K, Fleseriu M, Kaiser U, Salvatori R, Brue T, Lopes MB, et al. Pituitary neoplasm nomenclature workshop: does adenoma stand the test of time? J Endocr Soc. 2021; 5:bvaa205. PMID: 33604494.
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