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The editors have sought to create a user friendly handbook for the trainee in the specialties that treat these disorders and have succeeded admirably. They give the view of the joint pituitary clinic at the National Hospital, Queen Square, which mirrors the consensus guidelines published recently by the Royal College of Physicians. It is essential that pituitary tumours are managed by a multidisciplinary team—the days of competition between the disciplines should be past. The authors are not afraid to tackle the difficult issue of subspecialisation. There is only sufficient workload for one neurosurgeon in any region of 2-3 million to look after the microadenomas, invasive macroadenomas, giant adenomas, craniopharyngiomas, and third ventricular tumours. Only endocrinologists and neurologists with a specialised interest in neuroendocrinology should he managing the endocrine problems of pituitary patients beyond the initial diagnosis. Have you heard the story of the eminent neurologist who could not understand why a young lady’s prolactin level continued to rise despite escalating doses of bromocriptine until all was revealed during the third trimester!
The transatlantic authorship covers the subject in 11 readable chapters devoted to pathophysiology, clinical and visual assessment, imaging, medical and surgical management, radiotherapy, miscellaneous lesions, and controversial issues. The imaging section is particularly useful for explaining the findings of MRI. The sections on results and third ventricular tumours are a little too brief.
This handbook is complimentary to the much larger, definitive textbook published also by Churchill Livingstone—Pituitary Adenomas— by Landolt, Vance, and Reilly (1996). I recommend both unreservedly to their respective audiences.
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