ICD Body System
Neoplasms [140 - 239]
Date amended:
External
Statements of Principles
Current RMA Instruments

Reasonable Hypothesis SOP

70 of 2024

Balance of Probabilities SOP

71 of 2024
Changes from previous Instruments
 
ICD Coding
  • ICD-10-AM Codes: C75.1, D35.2, D44.3
Brief description

This SOP covers both benign and malignant primary neoplasms of the pituitary gland. Most pituitary neoplasms are benign pituitary adenomas and are not life-threatening. 

Confirming the diagnosis

Tumours can be identified on MRI or CT scanning, but confirmation requires histological examination from excision or biopsy of the tumour. Hormone levels (from blood testing) can give an indication of the tumour type. 

Endocrinologists, neurosurgeons, and/or oncologists are often involved in establishing the diagnosis of pituitary gland malignancies. 

Additional diagnoses covered by these SOPs
  • Gonadotroph adenoma
  • Pituitary adenoma
  • Pituitary adenocarcinoma (very rare)
  • Tumours of the anterior pituitary (adenohypophysis)
  • Tumours of the posterior pituitary (neurohypophysis)
  • Tumours of the pituitary stalk (infundibulum)
Conditions excluded from these SOPs:  
  • Carcinoid of pituitary #
  • Craniopharyngioma #
  • Hodgkin’s lymphoma of pituitary *
  • Non-Hodgkin lymphoma of the pituitary *
  • Secondary neoplasm of the pituitary - code to primary site
  • Soft tissue sarcoma of the pituitary *
  • Tumours of the hypothalamus * Malignant neoplasm of the brain
  • Tumours of the sella turcica of the sphenoid bone #
  • Tumours of the diaphragma sellae #

* another SOP applies

# non-SOP

Clinical onset

The condition may be found incidentally on imaging performed for another reason. The most common symptomatic presentation is visual defects from pressure on the optic nerve. There may be other symptoms and signs such as headaches and/or cranial nerve palsies as well as symptoms related to hormonal imbalances. 

Clinical worsening

If untreated the tumour will typically slowly enlarge and become symptomatic or there will be progression of symptoms. Surgery and sometimes radiotherapy are usually recommended treatments. Hormone replacement therapy may also be required. Ongoing monitoring for recurrence is usually undertaken. Specialist medical advice from an endocrinologist, neurosurgeon or oncologist should be sought for any considerations related possible clinical worsening.