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 "slug": "hyperfunction-of-pituitary-gland",
 "title": "Hyperfunction of pituitary gland",
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 "excerpt": "Hyperfunction of pituitary gland (ICD-11 5A60): excessive pituitary hormone production, mostly from hormone-secreting pituitary adenomas, causing acromegaly, gigantism, hyperprolactinaemia, and related syndromes treated by surgery, drugs, and radiation.",
 "snippet": "Hyperfunction of pituitary gland (ICD-11 5A60): excessive pituitary hormone production, mostly from hormone-secreting pituitary adenomas, causing acromegaly, gigantism, hyperprolactinaemia, and related syndromes treated by surgery, drugs, and radiation.",
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 "markdown": "# Hyperfunction of pituitary gland\n\n**Hyperfunction of pituitary gland** is a clinical status in which one or more pituitary hormones are produced in excess, mostly caused by hormone-producing pituitary adenomas. The World Health Organization's ICD-11 classifies it under code 5A60 as a disease characterized by hypersecretion of adenohypophyseal hormones such as growth hormone, prolactin, thyrotropin, luteinising hormone, follicle stimulating hormone, or adrenocorticotropic hormone.<sup>[1](https://www.icd11-code.com/5a60/)</sup> The resulting disorders, which include acromegaly, pituitary gigantism, and [hyperprolactinaemia](https://www.edgepedia.org/hyperprolactinaemia), are treated with surgery, medication, radiation therapy, or observation depending on the hormone involved and the size and behavior of the tumor.<sup>[2](https://www.cancer.gov/types/pituitary/hp/pituitary-treatment-pdq)</sup>\n\n| Key fact | Detail |\n|---|---|\n| Definition | Excessive production of one or more pituitary hormones, mostly caused by hormone-producing pituitary adenomas; ICD-11 code 5A60<sup>[1](https://www.icd11-code.com/5a60/)</sup> |\n| Hormones involved | Growth hormone, prolactin, thyrotropin, luteinising hormone, follicle stimulating hormone, or adrenocorticotropic hormone<sup>[1](https://www.icd11-code.com/5a60/)</sup> |\n| Subordinate codes | 5A60.0 acromegaly or pituitary gigantism; 5A60.1 hyperprolactinaemia; 5A60.2 syndrome of inappropriate secretion of antidiuretic hormone; 5A60.3 central precocious puberty<sup>[1](https://www.icd11-code.com/5a60/)</sup> |\n| Adenoma hormone types | Prolactin-secreting 32–51% of pituitary adenomas, growth hormone 9–11%, ACTH 3–6%, TSH-secreting and gonadotropin-secreting under 1%<sup>[3](https://pmc.ncbi.nlm.nih.gov/articles/PMC5464431/)</sup> |\n| Frequency | Clinically evident pituitary adenomas occur in approximately 1 in 1,100 persons; macroadenomas (10 mm or larger) are 48% of tumors<sup>[4](https://pubmed.ncbi.nlm.nih.gov/37097352/)</sup> |\n| Surgical outcome | For Cushing disease, about 70% to 90% of people achieve remission with surgery at an experienced surgical center<sup>[5](https://www.mayoclinic.org/diseases-conditions/pituitary-tumors/diagnosis-treatment/drc-20350553)</sup> |\n| Mainstay operation | Transsphenoidal microsurgery, reached through the nasal cavity, is the most widely used surgical approach<sup>[2](https://www.cancer.gov/types/pituitary/hp/pituitary-treatment-pdq)</sup> |\n\n## Classification\n\nICD-11 places 5A60 within the chapter on endocrine, nutritional, or metabolic diseases, under disorders of the pituitary hormone system.<sup>[1](https://www.icd11-code.com/5a60/)</sup> The category has subordinate codes for acromegaly or pituitary gigantism (5A60.0), hyperprolactinaemia (5A60.1), the syndrome of inappropriate secretion of antidiuretic hormone (5A60.2), and central precocious puberty (5A60.3).<sup>[1](https://www.icd11-code.com/5a60/)</sup>\n\nThe category also carries exclusions, conditions coded elsewhere despite involving pituitary hormone excess. These include Cushing syndrome (5A70), overproduction of pituitary ACTH (5A70.0), [Nelson syndrome](https://www.edgepedia.org/nelson-syndrome) (5A70.3), overproduction of thyroid-stimulating hormone (4B4Y), and multiple endocrine neoplasia types 1 and 4 (2F7A.0).<sup>[1](https://www.icd11-code.com/5a60/)</sup> The WHO reference guide cites 5A60 and its exclusion of Cushing syndrome as an example of how ICD-11 presents exclusions in its content.<sup>[6](https://icdcdn.who.int/icd11referenceguide/en/refguide.pdf)</sup>\n\n## Causes and epidemiology\n\nThe great majority of cases are caused by pituitary adenomas, benign clonal neoplasms of the neuroendocrine epithelial cells of the adenohypophysis, the hormone-producing anterior lobe of the gland.<sup>[7](https://www.ncbi.nlm.nih.gov/books/NBK425704/)</sup> Pituitary adenomas account for 14% of primary intracranial and central nervous system tumors, and their overall prevalence in the general population, combining radiographic and autopsy data, is estimated at 17%.<sup>[3](https://pmc.ncbi.nlm.nih.gov/articles/PMC5464431/)</sup> A review in Endocrine Reports estimates that pituitary adenomas occur in 10% of the population, but that fewer than one-thousandth of all pituitary adenomas cause clinically significant disease.<sup>[8](https://www.endocrine.org/journals/endocrine-reviews/clinical-biology-of-the-pituitary-adenoma)</sup>\n\nAmong adenomas, roughly half are hormone-secreting (46% to 64%) and the rest are nonfunctional.<sup>[3](https://pmc.ncbi.nlm.nih.gov/articles/PMC5464431/)</sup> Prolactin-secreting adenomas, called prolactinomas, are the most common functioning type; the Endocrine Society guideline states that they account for approximately 40% of all pituitary tumors.<sup>[9](https://academic.oup.com/jcem/article/96/2/273/2709487)</sup> [Growth hormone](https://www.edgepedia.org/growth-hormone)-secreting and ACTH-secreting adenomas are less common, and TSH-secreting and gonadotropin-secreting adenomas are rare, each under 1% of pituitary adenomas.<sup>[3](https://pmc.ncbi.nlm.nih.gov/articles/PMC5464431/)</sup>\n\nHyperprolactinaemia is not always tumoral. Prolactin secretion is tonically suppressed by hypothalamic dopamine, and elevation can also arise from medications, pregnancy, breast-feeding, stress, exercise, sleep, renal failure, and hypothyroidism; the Endocrine Society recommends excluding medication use, renal failure, hypothyroidism, and pituitary and parasellar tumors before attributing symptomatic hyperprolactinemia to a prolactinoma.<sup>[9](https://academic.oup.com/jcem/article/96/2/273/2709487)</sup>\n\n## Clinical syndromes\n\n**Growth hormone excess.** Secretion of growth hormone by a pituitary tumor causes acromegaly in adults and pituitary gigantism when it begins before the skeleton has finished growing, in the prepubertal period.<sup>[10](https://pmc.ncbi.nlm.nih.gov/articles/PMC11912844/)</sup> Growth hormone hypersecretion leads to overproduction of insulin-like growth factor 1 (IGF-1) and multisystem disease, with increased morbidity and mortality.<sup>[11](https://pmc.ncbi.nlm.nih.gov/articles/PMC10845214/pdf/CD013561.pdf)</sup> Physical findings include frontal bossing, an enlarged frontal sinus, and cutis gyrata.<sup>[12](https://www.ncbi.nlm.nih.gov/books/NBK278983/)</sup>\n\n**Corticotroph disease.** ACTH-secreting adenomas cause [Cushing's disease](https://www.edgepedia.org/cushings-disease), which produces weight gain, truncal obesity, a \"buffalo hump\", enlargement of the supraclavicular fat pads, moon facies, purple striae, easy bruisability, hypertension, osteoporosis, and impaired glucose metabolism.<sup>[12](https://www.ncbi.nlm.nih.gov/books/NBK278983/)</sup> In ICD-11, Cushing syndrome and pituitary ACTH overproduction are coded separately from 5A60.<sup>[1](https://www.icd11-code.com/5a60/)</sup>\n\n**Prolactin excess.** Women with prolactinomas classically present with amenorrhea or oligomenorrhea and galactorrhea, and most are in their childbearing years; men and women beyond their reproductive years more often have headache, visual symptoms, sexual dysfunction, and signs of decreased pituitary function.<sup>[12](https://www.ncbi.nlm.nih.gov/books/NBK278983/)</sup>\n\n## Diagnosis\n\nA panel of endocrinological tests can usually confirm the clinical diagnosis of a hormone-secreting pituitary adenoma. Serum growth hormone and IGF-1 levels screen for acromegaly, and failure to suppress growth hormone after an oral glucose load confirms the diagnosis.<sup>[12](https://www.ncbi.nlm.nih.gov/books/NBK278983/)</sup> An elevated age-adjusted IGF-1 level is a reliable indicator, with 90% specificity for a growth hormone-secreting pituitary adenoma.<sup>[11](https://pmc.ncbi.nlm.nih.gov/articles/PMC10845214/pdf/CD013561.pdf)</sup>\n\nFor prolactin, a single serum measurement above the upper limit of normal establishes the diagnosis of hyperprolactinemia, and dynamic testing of prolactin secretion is not recommended.<sup>[9](https://academic.oup.com/jcem/article/96/2/273/2709487)</sup> Although any macroadenoma may cause moderate prolactin elevation, levels greater than 200 ng/ml (3,600 mU/L) are highly suggestive of a prolactin-secreting adenoma; sample dilution may be needed to avoid the \"hook effect\", an assay artifact that can give falsely low values.<sup>[12](https://www.ncbi.nlm.nih.gov/books/NBK278983/)</sup>\n\nFor Cushing's disease, supportive findings include elevated ACTH, elevated late-night salivary or 24-hour urine free cortisol, loss of the normal diurnal variation in cortisol, and suppression of serum cortisol after high-dose but not low-dose dexamethasone. [Inferior petrosal sinus sampling](https://www.edgepedia.org/inferior-petrosal-sinus-sampling) after corticotropin-releasing hormone stimulation may be required to confirm and localize the pituitary source.<sup>[12](https://www.ncbi.nlm.nih.gov/books/NBK278983/)</sup>\n\n## Treatment\n\nTreatment options are surgery, radiation therapy, medical therapy, or a combination, chosen according to the tumor type, the nature of the hormonal excess, and whether the tumor extends into surrounding brain.<sup>[2](https://www.cancer.gov/types/pituitary/hp/pituitary-treatment-pdq)</sup> The goals include normalization of hormonal hypersecretion, relief of mass effect, preservation or recovery of normal pituitary function, and prevention of recurrence.<sup>[2](https://www.cancer.gov/types/pituitary/hp/pituitary-treatment-pdq)</sup><sup> • </sup><sup>[12](https://www.ncbi.nlm.nih.gov/books/NBK278983/)</sup> Most pituitary tumors are not cancer and may not need treatment if they cause no symptoms; in many cases regular monitoring is enough.<sup>[5](https://www.mayoclinic.org/diseases-conditions/pituitary-tumors/diagnosis-treatment/drc-20350553)</sup>\n\n**Surgery.** The transsphenoidal microsurgical approach, which reaches the sella through the nose, is the most widely used approach and is often successful in debulking tumors even with significant suprasellar extension.<sup>[2](https://www.cancer.gov/types/pituitary/hp/pituitary-treatment-pdq)</sup> Along with acromegaly, surgery remains the first-line therapy for ACTH-secreting tumors and Cushing disease.<sup>[12](https://www.ncbi.nlm.nih.gov/books/NBK278983/)</sup> For Cushing disease, about 70% to 90% of people achieve remission when operated on at an experienced surgical center, and about 70% to 90% of people with vision problems see improvement after removal of a tumor pressing on the visual nerves.<sup>[5](https://www.mayoclinic.org/diseases-conditions/pituitary-tumors/diagnosis-treatment/drc-20350553)</sup>\n\n**Medication and radiation.** For acromegaly, dopamine agonists, somatostatin analogs, and growth hormone receptor blockers were introduced after 1970 and can control the disease.<sup>[13](https://pubmed.ncbi.nlm.nih.gov/25572320/)</sup> [Radiation therapy](https://www.edgepedia.org/radiation-therapy) may be used after surgery or when surgery is not an option, with the beam aimed precisely so nearby healthy brain tissue receives very little radiation.<sup>[5](https://www.mayoclinic.org/diseases-conditions/pituitary-tumors/diagnosis-treatment/drc-20350553)</sup> A Cochrane review of growth hormone-secreting adenomas in adults found that the evidence comparing surgical and non-surgical management is very limited, based on eight randomized trials with 445 individuals, and that outcomes such as disease recurrence and side effects were sparsely reported.<sup>[14](https://www.cochrane.org/evidence/CD013561_surgical-and-non-surgical-procedures-management-pituitary-tumours-secrete-growth-hormones-adults)</sup>\n\n## History\n\n[Pierre Marie](https://www.edgepedia.org/pierre-marie) coined the term \"acromegaly\" in 1886 and linked it to a distinct clinical disease with a characteristic clinical picture, although he was not the first physician to give a full record of the condition; the Dutch physician Johannes Wier had preceded him.<sup>[13](https://pubmed.ncbi.nlm.nih.gov/25572320/)</sup> After Marie, pituitary enlargement was noted in almost all patients with acromegaly, and it was subsequently discovered that pituitary hyperfunction caused by a pituitary tumor was the cause.<sup>[13](https://pubmed.ncbi.nlm.nih.gov/25572320/)</sup> In 1909, [Harvey Williams Cushing](https://www.edgepedia.org/harvey-williams-cushing) introduced the concepts of \"hyperpituitarism\" and \"hypopituitarism\" and explained gigantism and acromegaly by overstimulation of growth; he was among the first to postulate growth hormone in the pituitary gland, confirming that anterior pituitary lobe hyperfunction was responsible for acromegaly.<sup>[10](https://pmc.ncbi.nlm.nih.gov/articles/PMC11912844/)</sup> The discovery of growth hormone and insulin-like growth factor I, and the demonstration of their association with hypersecretion and elevated circulating IGF-I, completed the causal account.<sup>[13](https://pubmed.ncbi.nlm.nih.gov/25572320/)</sup> From the beginning of the 20th century acromegaly could be treated by pituitary surgery or radiotherapy, and after 1970 medical therapies were added.<sup>[13](https://pubmed.ncbi.nlm.nih.gov/25572320/)</sup>\n\n## References\n\n1. [5A60 — Hyperfunction of pituitary gland, ICD-11](https://www.icd11-code.com/5a60/)\n2. [Pituitary Tumors Treatment (PDQ®), National Cancer Institute](https://www.cancer.gov/types/pituitary/hp/pituitary-treatment-pdq)\n3. [Management of hormone-secreting pituitary adenomas, PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC5464431/)\n4. [Tritos NA, Miller KK. Diagnosis and Management of Pituitary Adenomas: A Review. JAMA 2023;329(16):1386-1398](https://pubmed.ncbi.nlm.nih.gov/37097352/)\n5. [Pituitary tumors and adenomas: Diagnosis and treatment, Mayo Clinic](https://www.mayoclinic.org/diseases-conditions/pituitary-tumors/diagnosis-treatment/drc-20350553)\n6. [ICD-11 Reference Guide, World Health Organization](https://icdcdn.who.int/icd11referenceguide/en/refguide.pdf)\n7. [Pathology and Pathogenesis of Pituitary Adenomas and Other Sellar Lesions, Endotext](https://www.ncbi.nlm.nih.gov/books/NBK425704/)\n8. [Clinical Biology of the Pituitary Adenoma, Endocrine Reviews](https://www.endocrine.org/journals/endocrine-reviews/clinical-biology-of-the-pituitary-adenoma)\n9. [Diagnosis and Treatment of Hyperprolactinemia: An Endocrine Society Clinical Practice Guideline, JCEM](https://academic.oup.com/jcem/article/96/2/273/2709487)\n10. [Gigantism and Acromegaly Through History, PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC11912844/)\n11. [Cochrane Database of Systematic Reviews, CD013561 (GH-secreting adenomas)](https://pmc.ncbi.nlm.nih.gov/articles/PMC10845214/pdf/CD013561.pdf)\n12. [Surgical Treatment of Pituitary Adenomas, Endotext](https://www.ncbi.nlm.nih.gov/books/NBK278983/)\n13. [de Herder WW. The History of Acromegaly. Neuroendocrinology 2016;103(1):7-17](https://pubmed.ncbi.nlm.nih.gov/25572320/)\n14. [Surgical and non-surgical procedures for management of pituitary tumours that secrete growth hormones in adults, Cochrane](https://www.cochrane.org/evidence/CD013561_surgical-and-non-surgical-procedures-management-pituitary-tumours-secrete-growth-hormones-adults)\n\n---\n*Topic: Encyclopedia › Life and health › Human health and medicine › Diseases and injuries › Digestive, metabolic, and endocrine conditions › Pituitary, neuroendocrine, and multiple endocrine neoplasia*\n\n*Initially written Oct 21, 2026*\n\n*Copyright 2026 EdgeChat AI, a subsidiary of Biostate AI.*\n\nLicense: Edgepedia Community License 1.0, https://www.edgepedia.org/edgepedia/license\n",
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 "speakable": "Hyperfunction of pituitary gland: excessive pituitary hormone production, mostly from hormone-secreting pituitary adenomas, causing acromegaly, gigantism, hyperprolactinaemia, and related syndromes treated by surgery, drugs, and radiation."
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