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CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(02): 107-111
DOI: 10.1055/s-0043-1777264
Review Article

Does New WHO 2022 Nomenclature of Pituitary Neuroendocrine Tumors Offer an Extra Edge to the Neurosurgeons for Its Management? A Narrative Review

Alok Srivastava 
1   Department of Neurosurgery, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Uttar Pradesh, India
,
Manish Singh
1   Department of Neurosurgery, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Uttar Pradesh, India
,
Awadhesh Yadav
2   Department of Neurosurgery, King George's Medical University, Lucknow, Uttar Pradesh, India
,
Chhitij Srivastava
2   Department of Neurosurgery, King George's Medical University, Lucknow, Uttar Pradesh, India
,
Anil Chandra
2   Department of Neurosurgery, King George's Medical University, Lucknow, Uttar Pradesh, India
,
Akanksha D. Srivastava
3   Department of Paediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
› Author Affiliations Funding None.
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Abstract

The new World Health Organization nomenclature of pituitary tumors was introduced in the year 2022 after much deliberation. This nomenclature clearly demarcates the anterior lobe (adenohypophyseal), posterior lobe (neurohypophyseal), and hypothalamic tumors. There is also focus on other tumors arising in the sellar region. The nomenclature has also advocated the routine use of immunohistochemistry in describing the pituitary transcription factors that plays a fundamental role in distinguishing the cell lineage of these tumors. However, the nomenclature is complex in understanding due to inclusion of pathological correlates like transcription factors, hormones, biomarkers, and various controversies that have emerged regarding the renaming of pituitary adenomas (PA) as PiTNETs (“Pituitary Neuroendocrine tumors”) because majority of the adenomas are benign and have rare metastatic behavior while classifying them as PiTNETs will create unnecessary misinterpretation of these as aggressive tumors that will lead to apprehension among the patients. The new classification gives deeper insight into the histological picture of the various pituitary tumors but other than contributing to the follow-up strategy and postsurgery management, this classification does not add anything new that could be advantageous for the neurosurgeons in clinical practice and decision making, especially in deciding the plan of action for surgery. Hence, there is need of a more comprehensive, integrated, neuroradiological-based classification with more emphasis on the invasiveness of these tumors that would assist the neurosurgeons in planning the treatment strategy and managing patients of pituitary tumors.

Keywords

pituitary tumors - PiTNETs - WHO classification - management - pituitary adenomas


Publication History

Article published online:
10 June 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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