Evidence map›Paper›PMID 42050282›Full record

SynthesisPituitary2026

Pituitary stalk biopsy - A systematic review of the safety and efficacy of stalk lesion biopsy.

Ryan Beerling Dolovac, Ann McCormack, Lachlan R Evans, James A King, Christopher Ovenden, Jeremy Kam, Tony Goldschlager, Mendel Castle-Kirszbaum

Abstract readSystematic Review
In one paragraph

Synthesis in Pituitary, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ryan Beerling DolovacSchool of Medicine, University of Western Australia, Perth, Australia.
Ann McCormackNeuroendocrine Research Group, Applied Medical Research Centre, Department of Endocrinology, St Vincent's Hospital, Sydney, Australia.
Lachlan R EvansDepartment of Neurosurgery, The Royal Melbourne Hospital, Parkville, Australia.
James A KingDepartment of Neurosurgery, The Royal Melbourne Hospital, Parkville, Australia.
Christopher OvendenDepartment of Neurosurgery, Royal Adelaide Hospital, Adelaide, Australia.
Jeremy KamDepartment of Neurosurgery, Monash Health, 246 Clayton Road, Clayton VIC, 3168, Melbourne, Australia.
Tony GoldschlagerDepartment of Neurosurgery, Monash Health, 246 Clayton Road, Clayton VIC, 3168, Melbourne, Australia.
Mendel Castle-KirszbaumDepartment of Neurosurgery, Monash Health, 246 Clayton Road, Clayton VIC, 3168, Melbourne, Australia. mdck.journal@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionA myriad of pathological process may involve the pituitary stalk (infundibulum), and despite extensive investigations, biopsy is often required. Due to the rarity of the procedure, the risks and yield of stalk biopsy are not well known, with important implications for clinical decision making.

methodsA systematic review was performed in accordance with the PRISMA statement. Studies that reported diagnostic yield and complication rates after stalk biopsy were included. Bias was assessed using ROBINS-V2.

resultsA total of 13 studies, including 832 patients and 406 biopsies were included. Mean time from diagnosis to biopsy was 11 months. Preoperative visual symptoms were seen in 29.1%, AVP-deficiency (diabetes insipidus) in 71.0%, and hypopituitarism in 66.3%. Biopsy was predominately performed through the endoscopic transsphenoidal approach (70.9%). Diagnostic yield was 95.8%, and complications included postoperative CSF leak (1.6%), visual worsening (1.6%), new cranial nerve palsy (1.2%), new permanent AVP-deficiency (9.0%), new hypopituitarism (15.7%), and meningitis (2.7%).

conclusionPituitary stalk biopsy is a high yield and safe diagnostic test, with low periprocedural morbidity. The rate of new endocrinopathy compares favourably to the natural history of progressive stalk disease. Stalk biopsy could be considered earlier in the workup of undifferentiated progressive or symptomatic stalk lesions to avoid unnecessary delays in diagnosis and treatment.

Indexed as

Pituitary GlandBiopsyHumansHypopituitarismBiopsyEndoscopicGerm cell tumourHypophysitisInfundibulumPituitaryPituitary stalk

Identifiers

PMID42050282
PMCPMC13124891

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.