Although usually benign, anterior pituitary tumours occasionally exhibit aggressive
behaviour, with invasion of surrounding tissues, rapid growth, resistance to conventional
treatments and multiple recurrences. In very rare cases, they metastasize and are termed
pituitary carcinomas. The time between a 'classical'pituitary tumour and a pituitary carcinoma
can be years, which means that monitoring should be performed regularly in patients with
clinical (invasion and/or tumour growth) or pathological (Ki67 index, mitotic count and/or p53 …

Aggressive pituitary tumors (APT) refer to pituitary adenomas exhibiting radiological
invasiveness and an unusually rapid tumor growth rate, or clinically relevant tumor growth
despite optimal standard treatments, with abandonment of the previous term 'atypical
pituitary adenoma'. Pituitary carcinomas (PC) are defined by non-contiguous craniospinal or
distant metastasis. Whilst PC is exceedingly rare, comprising only 0.1-0.4% of all pituitary
neoplasms, APT may account for up to 15% of all pituitary neoplasms, depending on the …