Perspective in pituitary adenomas: an end of the century review of tumorigenesis, diagnosis, and treatment.

Significant advances have been made in the molecular biological understanding of pituitary tumorigenesis. These advances will have an impact on the gene therapy of pituitary tumors in the coming century. Transsphenoidal surgery remains the mainstay of treatment for the majority of pituitary adenomas, with endoscopic surgery being used at some centers in select patients. Pharmacotherapy of pituitary adenomas has made great strides in the management of prolactinomas and GH-secreting pituitary adenomas. Finally, radiosurgery has become a very important adjuvant therapy in the treatment of hypersecreting pituitary adenomas.