Pituitary incidentalomas are lesions which are detected incidentally during imaging procedures for unrelated causes.

Micro-incidentalomas (less than 1 cm in size) have a reported mean prevalence in normal individuals of around 10%.

The endocrinologist facing a pituitary incidentaloma has to solve two main diagnostic problems: the nature and extent of the lesion, and the hormonal excess or deficits resulting from this lesion.

Visual deficits or neurological disturbances due to compression of the optic chiasm or nerve by the incidentaloma are the strongest recommendations for surgery.

Hormonally active incidentalomas, with the exception of prolactinomas, should be also treated by surgery.