Reframing Pituitary Neoplasia: A Systematic Appraisal Of The Who 2022 Pitnet Taxonomy

Abstract

The reconceptualisation of pituitary adenomas as Pituitary Neuroendocrine Tumours (PitNETs) within the 2022 World Health Organization (WHO) classification constitutes an epistemological rupture, a semantic recalibration, and a translational provocation in the landscape of endocrine oncology [1]. What had long been regarded as indolent adenohypophyseal proliferations—benign by nomenclature, trivialised in comparative oncology—has now been repositioned within the wider neuroendocrine neoplastic continuum, aligning pituitary lesions with the lexicon of pancreatic, pulmonary, and gastroenteropancreatic neuroendocrine tumours [2]. This revision, far from being a superficial terminological manoeuvre, is an ontological reorientation that privileges transcription factor–based lineage fidelity (PIT1, TPIT, SF1, and ancillary GATA3/ERα) over the obsolete secretory-phenotype paradigm [3,4].