Clinical management of pituitary carcinomas.

Pituitary carcinomas are defined as malignant primary neoplasms of the adenohypophysis with either systemic or craniospinal metastases. Although pituitary adenomas are common, pituitary carcinomas only make up 0.1% to 0.2% of all pituitary tumors. Prognosis is very poor with approximately 66% mortality in the first year of diagnosis. Although effective medical and surgical treatments are available for pituitary adenomas, pituitary carcinomas require a multimodality treatment including surgery, hormonal therapy, cytotoxic chemotherapy, and radiation with limited success. Here we review the clinical behavior and pathologic characteristics of pituitary carcinomas and the recent advances in potential therapies for this malignant disease.