Medical management of pituitary adenomas

In this chapter current medical therapies in pituitary tumors other than prolactinomas, as well as their interactions with other modalities of treatmentare described. Current protocols for the role of medical therapy in the management of non-prolactin producing pituitary tumors are systematically reviewed; indications, contraindications, interactions, and adverse effects are analyzed. Adjuvant medical therapy plays an important part in controlling hormonal production/metabolism in tumors secreting growth hormone, adrenocorticotropin, or thyroid stimulating hormone. In addition, in some select cases, drug therapy can be used to promote tumor volume reduction prior to surgery and/or radiotherapy. These roles are not as prominent in the management of nonfunctioning adenomas and those secreting luteinizing hormone/follicle stimulating hormone. Surgery remains the main therapeutic modality in the treatment of the majority of functional pituitary adenomas other than prolactinomas; medical therapy is especially useful in controlling hormonal hypersecretion and its effects when surgery does not produce cure.