Neoplasm of the pituitary gland
Meaning of neoplasm of the pituitary gland: For the purposes of this Statement of Principles, neoplasm of the pituitary gland: (a) means a primary neoplasm, either benign or malignant, arising from the cells of the pituitary gland; and (b) includes: (i) tumours of the anterior pituitary (adenohypophysis); (ii) tumours of the posterior pituitary (neurohypophysis); and (iii) tumours of the pituitary stalk (infundibulum); and (c) excludes: (i) soft tissue sarcoma; (ii) carcinoid tumour; (iii) non-Hodgkin lymphoma; (iv) Hodgkin lymphoma; (v) tumours of the hypothalamus; (vi) tumours of the sella turcica of the sphenoid bone; and (vii) tumours of the diaphragma sellae. (3) While neoplasm of the pituitary gland attracts ICD-10-AM codes C75.1, D35.2, or D44.3, in applying this Statement of Principles the meaning of neoplasm of the pituitary gland is that given in subsection (2). (4) For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospi
Balance of Probabilities (BoP) — Statement of Principles No. 71 of 2024
4 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, neoplasm of the pituitary gland or death from neoplasm of the pituitary gland is connected with the circumstances of a person's relevant service:
- (1)having undergone bilateral adrenalectomy for the treatment of Cushing syndrome due to a corticotroph pituitary adenoma before the clinical worsening of corticotroph pituitary adenoma;
Note: Bilateral adrenalectomy is the excision of both adrenal glands.
Note: Cushing disease is Cushing syndrome due to a corticotroph pituitary adenoma.
Note: A corticotroph is a cell of the anterior pituitary that secretes corticotropin (adrenocorticotrophic hormone (ACTH)), a hormone that stimulates secretion of corticosteroids from the adrenal cortex.
Note: An example of clinical worsening is Nelson syndrome.
- (2)taking one of the following gonadotropin-releasing hormone (GnRH) agonists at the time of pituitary apoplexy of a pre-existing pituitary adenoma: (a) goserelin; (b) leuprorelin/leuprolide; (c) nafarelin; or (d) triptorelin;
Note: Pituitary apoplexy is a clinical worsening of a pre-existing pituitary adenoma.
Note: Pituitary apoplexy is the sudden loss of blood supply to the pituitary gland, leading to tissue necrosis and loss of function.
- (3)taking one of the following hormones as part of a dynamic endocrine test, within the 4 days before pituitary apoplexy of a pre-existing pituitary adenoma: (a) gonadotropin-releasing hormone (GnRH) (b) growth hormone-releasing hormone (GHRH); (c) thyrotropin-releasing hormone (TRH); or (d) corticotropin-releasing hormone (CRH);
Note: Pituitary apoplexy is a clinical worsening of a pre-existing pituitary adenoma.
Note: Pituitary apoplexy is the sudden loss of blood supply to the pituitary gland, leading to tissue necrosis and loss of function.
Note: Dynamic endocrine tests assess the dynamic response of hormonal axes to aid diagnosis of endocrine disorders.
- (4)inability to obtain appropriate clinical management for neoplasm of the pituitary gland before clinical worsening;
