Sporadic pituitary tumours: from epidemiology to use of databases

Pituitary tumours account for 10% of intracranial neoplasms and have an ann ual incidence of about 25 per million head of population. Prolactinomas and non-functioning tumours are the most common subtypes clinically, as well a s in surgical and histopathological series. In pre-pubertal children, corti cotrophinomas, although rare, are the most common subtype, prolactinomas be ing most common in adolescents. In autopsy series, 11% of pituitaries harbo ur an adenoma. These are usually small (less than 10 mm in diameter), and w here examined, about half are prolactinomas. Computed tomography or magneti c resonance imaging examination of normal subjects reveals abnormalities of greater than 3 mm in diameter in 10% of pituitaries. Other cancers in pati ents with pituitary rumours are confined to acromegalics, in whom colonic l esions are more prevalent than in the general population. Several long-term sequelae of pituitary tumours with respect to morbidity and mortality have been identified from retrospective analyses. However, data on these are no t standardized, requiring the development of national databases and registe rs to collect clinical outcomes from large cohorts according to agreed stan dard proformas. These registers will provide a sufficient number of cases f or statistically valid conclusions on different clinical subgroups. The dev elopment of national guidelines for best practice for the management of pat ients with these tumours provides the basis for an audit of the management process and outcomes between centres. This will inform decisions on the opt imum configuration of services for such patients.