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Conclusions 1.Sollner W, DeVries A, Steixner E, Lukas P, Sprinzl G, Rumpold G & Maislinger S (2001) How successful are oncologists in identifying patient distress, perceived social support, and the need for psychosocial counselling? British Journal of Cancer, 84(2): 179-185 2.Sonino N, Ruini C, Navarrini C et al. Psychological Impairment in patients treated for pituitary disease: a controlled study. Clinical Endocrinology. 2007; 67(5): 719-26. 3.Webb S, Prieto L, Badia X et al. Acromegaly quality of life questionnaire (AcroQoL) a new health-related quality of life questionnaire for patients with acromegaly: development and psychometric properties. Clinical Endocrinology. 2002; 57(2): 251-8. 4.Webb S, Badia X & Surinach N. Validity and clinical applicability of the acromegaly quality of life questionnaire, AcroQoL: a 6-month prospective study. European Journal of Endocrinology. 2006; 155(2): 269-77. 5.Webb S, Badia X, Barahona M et al. Evaluation of health-related quality of life in patients with Cushing's syndrome with a new questionnaire. European Journal of Endocrinology. 2008; 158(5): 623-30. 6.Lovas K, Curran S, Oksnes M et al. Development of a disease-specific quality of life questionnaire in Addison’s disease. Journal of Clinical Endocrinology and Metabolism. 2009; 95(2): 545-51. Pituitary tumours, though almost always benign, are now included with other central nervous system tumours in cancer services. It therefore seems appropriate to adapt this oncology tool for use with pituitary patients. • Research has shown that high levels of patient distress may not be identified during consultations with healthcare professionals (HCPs), resulting in significant patient dissatisfaction with care and additional use of primary and secondary care services[1].

Objective: Clinical presentation of pituitary adenomas frequently involves pain, particularly headache, due to structural and functional properties of the tumour. Our aim was to investigate the clinical characteristics of pain in a large cohort of patients with pituitary disease. Design: In a cross-sectional study, we assessed 278 patients with pituitary disease (nZ81 acromegaly; nZ45 Cushing’s disease; nZ92 prolactinoma; nZ60 non-functioning pituitary adenoma). Methods: Pain was studied using validated questionnaires to screen for nociceptive vs neuropathic pain components (painDETECT), determine pain severity, quality, duration and location (German pain questionnaire) and to assess the impact of pain on disability (migraine disability assessment, MIDAS) and quality of life (QoL). Results: We recorded a high prevalence of bodily pain (nZ180, 65%) and headache (nZ178, 64%); adrenocorticotropic adenomas were most frequently associated with pain (nZ34, 76%). Headache was equally frequent in patients with macroand microadenomas (68 vs 60%; PZ0.266). According to painDETECT, the majority of the patients had a nociceptive pain component (nZ193, 80%). Despite high prevalence of headache, 72% reported little or no headache-related disability (MIDAS). Modifiable factors including tumour size, genetic predisposition, previous surgery, irradiation or medical therapy did not have significant impact neither on neuropathic pain components (painDETECT) nor on headache-related disability (MIDAS). Neuropathic pain and pain-related disability correlated significantly with depression and impaired QoL. Conclusions: Pain appears to be a frequent problem in pituitary disease. The data suggest that pain should be integrated in the diagnostic and therapeutic work-up of patients with pituitary disease in order to treat them appropriately and improve their QoL.