HORMONAL SCREENING IN THE PATIENT WITH AN INCIDENTALLY DISCOVERED PITUITARY MASS - CURRENT PRACTICE AND FACTORS IN CLINICAL DECISION-MAKING

Scanning techniques such as magnetic resonance imaging (MRI) frequentl y identify incidental pituitary lesions in individuals without a diagn osis of an endocrine disorder. The primary objective of this study was to determine the extent of practice variation among endocrinologists in evaluating patients with an incidentally discovered pituitary mass. An indirect measure was made of practice variation in the number and types of tests recommended in response to three hypothetical scenarios . Respondents exhibited a wide range in their recommendations for the number and type of tests. The results indicate a need for study with r egard to radiologic accuracy (especially the false-positive rate), tes t characteristics of standard tests for pituitary hyperfunction in pat ients with incidentally discovered pituitary masses and in appropriate control subjects, and cost-benefit analyses based on the epidemiology of these lesions, laboratory performance, and costs of diagnosis and treatment.