[Frontiers in Bioscience S3, 105-116, January 1, 2011]

The pathology of pituitary adenomas from a clinical perspective

Dorota Dworakowska1,2,3, Marta Korbonits1, Simon Aylwin2, Alan McGregor2, Ashley B. Grossman1

1Centre for Endocrinology, Barts and the London School of Medicine, EC1M 6BQ London, UK,
2Department of Endocrinology, King's College Hospital, Denmark Hill, SE5 9RS London, UK, 3Department of Endocrinology and Internal Medicine, Medical University of Gdansk, 80-211 Gdansk, 7 Debinki Str., Poland


1. Abstract
2. Introduction
3. Molecular alterations in familial pituitary adenomas
4. Selected molecular alterations in sporadic pituitary adenomas
5. Prognostic value of selected molecular markers in pituitary adenomas
6. Summary and perspectives
7. References


Pituitary adenomas present with a variety of clinical endocrine manifestations and arise in a sporadic setting or rarely as part of hereditary genetic syndromes. Molecular analysis of familial pituitary adenomas has provided significant insight into pituitary tumorigenesis. Some specific genes have been identified that predispose to pituitary neoplasia, but these are rarely involved in the pathogenesis of sporadic tumors. The number of identified genes involved in pituitary tumorigenesis is progressively increasing. The possible resulting mechanisms of action involve abnormalities in signal transduction pathways, cell cycle regulators, growth factors, chromosome stability and others. Further studies are needed to evaluate the clinical significance of genetic alterations and their implications for patient prognosis, as well as to identify targets for existing and new therapeutic options. The aim of this review is to focus on the molecular pathology of pituitary adenomas from a practical perspective and discuss the possible clinical implications which may relate to particular molecular alterations. We have summarised familial syndromes related to pituitary adenomas and considered the prognostic value of selected molecular alterations in these tumors.