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Objective: Pituitary tumours comprise a pathologically and clinically diverse group of neoplasms. Classification frameworks have changed dramatically in the past two decades, reflecting improving understanding of tumour biology. This narrative review examines the evolution of pituitary tumour classification, from a clinical perspective. Results: In 2004, pituitary tumours were classified as ‘typical’ or ‘aty pical’, based on the presence of markers of proliferation, Ki67, mitotic count and p53. In 2017, the new WHO marked a major paradigm shift, with a new focus on lineage- based classification, determined by transcription factor and hormonal immunohistochemistry. The terms ‘typical’ and ‘atypical’ were omitted, though the importance of proliferative markers Ki67 and mitotic count was acknowledged. The recent WHO 2022 classification incorporates further refinements, specifically recognising some less common types that may represent less well-differentiated tumours. Whilst ‘high risk’ tumour types have been identified, further work is still required to improve prognostication. Conclusions: Recent WHO classifications have marked significant progress in the diagnostic evaluation of pituitary tumours, though shortcomings and challenges remain for both clinicians and pathologists in managing these tumours.

‘What’s in a name? That which we call a rose/By any other name would smell as sweet’ (Juliet, from Romeo and Juliet by William Shakespeare). Shakespeare’s implication is that a name is nothing but a word, and it therefore represents a convention with no intrinsic meaning. While this may be relevant to romantic literature, disease names do have real meanings, and consequences, in medicine. Hence, there must be a very good rationale for changing the name of a disease that has a centuries-old historical context. A working group of representatives from national and international endocrinology, and pediatric endocrine societies now proposes changing the name of ‘diabetes insipidus’ to ‘arginine vasopressin deficiency (AVP-D)’ for central etiologies, and ‘arginine vasopr essin resistance (AVP-R)’ for nephrogenic etiologies. This article provides both the historical context and the rationale for this proposed name change.

BackgroundEndocrinology has one of the highest proportions of female specialists and trainees, however females have traditionally been underrepresented in leadership positions and as speakers at scientific meetings.HypothesisFemales would represent less than half of invited speakers (plenary, symposium sessions) at endocrinology conferences and in leadership positions of endocrinology societies.MethodAn audit of Australian diabetes and endocrinology societies and their respective annual scientific meetings between 2016 – 2020. Analysis of the gender of conference speakers across oral, symposium and plenary sessions, session chairs, program organising committees and society committees.ResultsA total of 1638 speakers (females 856, 52.3%) across 550.4 hours (females 273.6, 49.7%) of presentations at the conferences were identified. Among plenary sessions of all 3 societies there were more male (61%) than female speakers. A total of 608 session chairs were identified, with 313 (51.5%) females. The majority of organising committee members (n=116) were female (56%), however the representation across each organising committee varied. There was a low proportion of society female council members (39% female).ConclusionThere was an equal representation of females and males as conference speakers and session chairs. However, there was an underrepresentation of women in more prestigious roles of plenary speakers and society council members. We implore conscious efforts to address this disparity.

Aggressive pituitary tumors (APTs) are associated with significant morbidity and mortality, and effective treatment options are limited. Immune checkpoint inhibitors (ICIs) have revolutionized clinical cancer care; however, there is little experience with these agents in the management of APTs. Vascular endothelial growth factor (VEGF) targeted therapy has reported success in a small number of APT case reports. Here we describe a case of pituitary carcinoma responding to ICI therapy and subsequently VEGF inhibition. We discuss the possible mechanisms and experience with ICI therapy and VEGF inhibitors in the management of APTs, biomarkers that may predict response, and the potential role of combination therapies including ICIs and temozolomide.