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The Curbsiders Internal Medicine Podcast

#513 Pituitary Incidentalomas

The Curbsiders Internal Medicine Podcast

The Curbsiders Internal Medicine Podcast

Education, Health & Fitness, Higher Education, Medicine, Science

4.83.3K Ratings

🗓️ 2 February 2026

⏱️ 84 minutes

🧾️ Download transcript

Summary

Dr. Fleseriu schools us on managing the unexpected

Become a master of pituitary incidentalomas. Learn about the hormonal workup and management of pituitary microadenomas, macroadenomas and empty sella syndrome and when surgery may be needed. We’re joined by Dr. Maria Fleseriu, @MariaFleseriu (Oregon Health and Science University)

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Show Segments

  • Intro
  • Rapid fire questions/Picks of the Week
  • Case 1
  • Defining Pituitary Incidentalomas
  • What is the difference between micro adenoma, macroadenoma and functional vs non-functional adenomas
  • Hormonal workup of microadenoma (assessing for hypopituitarism and hormonal excess)
  • Decided when to reimage patients and long term follow up of microadenomas
  • Case 2
  • Hormonal workup for pituitary macroadenoma
  • Deciding when surgery should be considered
  • Discussing the role of visual field testing
  • Case 3
  • Defining empty sella syndrome
  • Discussing hormonal assessment of empty sella syndrome
  • Treatment options for hyperprolactinemia caused by empty sella syndrome
  • Outro

Credits

  • Producer, writer, show notes, and CME: Mobeen Ahmad MD
  • Infographic and cover art: Kate Grant MBChb, MRCGP
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
  • Reviewer: Emi Okamoto MD
  • Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Technical Production: PodPaste
  • Guest: Dr. Maria Fleseriu


Disclosures

Dr. Fleseriu reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

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Transcript

Click on a timestamp to play from that location

0:00.0

Hey, before we get to the show, I wanted to remind you to check out our Patreon at patreon.com

0:05.4

slash curbsiders.

0:06.6

If you haven't signed up yet, sign up now to get ad-free episodes, twice-monthly bonus episodes,

0:11.8

and a whole bunch of other cool stuff at patreon.com slash curbsiders.

0:18.7

Hey, Paul.

0:20.6

A friend of mine tried to annoy me with some bird puns.

0:30.2

I feel like I'm not going to get this one.

0:31.7

All right, lay it on me.

0:33.2

But I soon realized that two can play at that game.

0:37.6

I would never have gotten there.

0:39.1

All right.

0:39.3

It's not bad.

0:39.7

I don't mind it.

0:42.0

I liked it.

0:43.2

Yeah, you know, obviously I was thinking of cereal when I said that one.

0:51.4

The curbsiders podcast is for entertainment, education, and information purposes only. And the topics discussed should not be used solely to diagnose, treat, cure, or prevent any diseases or conditions. For the more of the views and statements expressed on this podcast are solely those of the host and should not be interpreted to reflect official policy or position of any entity. Aside from possibly cash like more a hospital and affiliate outreach programs, if indeed there are any. In fact, there are none. Pretty much we are responsible if you screw up. You should always do your own homework and let us know when we're wrong.

1:18.5

Welcome back to the curbsiders. I'm Dr. Matthew Frank Guado here with my great friend in America's primary care physician, Dr. Paul Nelson Williams.

1:24.2

Hi, Paul. Hey, Matt. How are you?

1:27.1

Paul, I'm doing well well we had a fantastic conversation

1:30.2

brain holes are going to be filled everywhere after this episode pa i hate that we talked about

1:37.8

pituitary incidentalomas with a fantastic guest dr maria flasheri, and Paul, I'm really excited for people to hear this,

1:46.8

but before they hear this, before you tell them about our wonderful co-host and producer for this

...

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