Q:

What is the grading of a pituitary tumor?

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A 45-year-old lady presents with complaints of a progressive increase in the size of hands and feet and shoe size for past 5 years. The family members have noticed a change in her facial appearance in the form of coarsening of features and her voice has become sonorous. She also has complaints of frequent headaches for past 1 year. She complains of amenorrhea for past 5 years. She also has complaints of joint pains for past 3 years which have become more severe for the past 3 months. She is hypertensive for past 1 year and complaints of grade 2 dyspnea on exertion and her hypertension is controlled on 10 mg of cilnidipine and 40 mg of telmisartan. She is not a known diabetic and has checked her random sugars 1 week back which was normal. She is not on any other medications presently (Fig. 1.1).

What is the grading of a pituitary tumor?

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Pituitary tumor can be graded according to the size as microadenoma <10 mm, macroadenoma ≥10 mm and giant adenoma >40 mm by MRI. The tumor can be graded as grade 1a—noninvasive tumor, grade 1b—noninvasive and proliferative tumor, grade 2a—invasive tumor, grade 2b—invasive and proliferative tumor, grade 3—metastatic tumor-cerebrospinal or systemic metastasis.

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