Pituitary enlargement

Pituitary enlargement can be due to a number of different space occupying lesions, which include tumours derived from neural or endocrine tissues, metastatic tumours, chronic inflammatory processes, cystic lesions, or vascular aneurysms (Table 1). Lesions may be clinically silent, without endocrine, visual, or other neurological disturbances. These are discovered accidentally when skull X-ray, cranial CT, or MRI is performed for other reasons. More frequently, a variety of endocrine, ophthalmological, or neurological symptoms may allow the clinician to diagnose an enlarged sella turcica or a pituitary tumour with an intra, supra or para-sellar extension. When there are no typical endocrine features suggesting hormonally active pituitary tumours the differential diagnosis of the various causes of space occupying lesions in this area can be difficult (Table 1).