All endocrine glands are susceptible to neoplastic growth, yet the health consequences of these neoplasms differ between endocrine tissues. Pituitary neoplasms are highly prevalent and overwhelmingly benign, exhibiting a spectrum of diverse behaviors and impact on health. To understand the clinical biology of these common yet often innocuous neoplasms, we review pituitary physiology and adenoma epidemiology, pathophysiology, behavior, and clinical consequences. The anterior pituitary develops in response to a range of complex brain signals integrating with intrinsic ectodermal cell transcriptional events that together determine gland growth, cell type differentiation, and hormonal production, in turn maintaining optimal endocrine health. Pituitary adenomas occur in 10% of the population; however, the overwhelming majority remain harmless during life. Triggered by somatic or germline mutations, disease-causing adenomas manifest pathogenic mechanisms that disrupt intrapituitary signaling to promote benign cell proliferation associated with chromosomal instability. Cellular senescence acts as a mechanistic buffer protecting against malignant transformation, an extremely rare event. It is estimated that fewer than one-thousandth of all pituitary adenomas cause clinically significant disease. Adenomas variably and adversely affect morbidity and mortality depending on cell type, hormone secretory activity, and growth behavior. For most clinically apparent adenomas, multimodal therapy controlling hormone secretion and adenoma growth lead to improved quality of life and normalized mortality. The clinical biology of pituitary adenomas, and particularly their benign nature, stands in marked contrast to other tumors of the endocrine system, such as thyroid and neuroendocrine tumors.

中文翻译：

---

垂体腺瘤的临床生物学。

所有内分泌腺都容易发生肿瘤生长，但这些肿瘤对健康的影响因内分泌组织而异。垂体瘤非常普遍并且绝大多数是良性的，表现出一系列不同的行为和对健康的影响。为了了解这些常见但通常无害的肿瘤的临床生物学，我们回顾了垂体生理学和腺瘤流行病学、病理生理学、行为和临床后果。垂体前叶响应一系列复杂的大脑信号而发育，这些信号与内在的外胚层细胞转录事件相结合，共同决定腺体生长、细胞类型分化和激素产生，进而维持最佳的内分泌健康。垂体腺瘤发生在 10% 的人口中；然而，绝大多数人在一生中都是无害的。由体细胞或种系突变触发，致病性腺瘤表现出破坏垂体内信号转导以促进与染色体不稳定相关的良性细胞增殖的致病机制。细胞衰老充当机制缓冲，防止恶性转化，这是一种极为罕见的事件。据估计，所有垂体腺瘤中不到千分之一会引起具有临床意义的疾病。根据细胞类型、激素分泌活动和生长行为，腺瘤对发病率和死亡率有不同的不利影响。对于大多数临床症状明显的腺瘤，控制激素分泌和腺瘤生长的多模式疗法可改善生活质量并使死亡率正常化。垂体腺瘤的临床生物学，