Pituitary adenoma (typically nonfunctioning macroadenoma) causing compressive mass effect...

Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.

ID	`RF-PITUITARY-MASS-EFFECT-VISUAL-COMPROMISE`
Тип	Тривожна ознака
Статус	переглянуто 2026-07-11 \| очікує клінічного підпису
Хвороби	`DIS-PITUITARY-ADENOMA`
Джерела	`SRC-NCCN-CNS-2025`

Походження тривожної ознаки

Визначення	Pituitary adenoma (typically nonfunctioning macroadenoma) causing compressive mass effect — visual field deficit / optic chiasm compression, new cranial neuropathy, or hypopituitarism attributable to sellar/suprasellar compression — indicating surgical resection is required rather than observation.
Клінічний напрям	intensify
Категорія	organ-dysfunction
Змінює алгоритм	ALGO-PITUITARY-ADENOMA-1L

Логіка спрацьовування

{
  "any_of": [
    {
      "finding": "visual_field_deficit",
      "value": true
    },
    {
      "finding": "optic_chiasm_compression",
      "value": true
    },
    {
      "finding": "pituitary_mass_effect_symptoms",
      "value": true
    },
    {
      "condition": "Macroadenoma with radiographic optic chiasm/nerve compression, new cranial neuropathy, or hypopituitarism attributable to mass effect"
    }
  ],
  "type": "symptom_composite"
}

Нотатки

STUB pending clinical co-lead signoff (CHARTER §6.1 — dev-mode-exempted). Per the Disease narrative, nonfunctioning pituitary adenoma is managed with surgery only for mass effect / visual compromise; asymptomatic non-compressive NFPA is appropriate for observation with surveillance imaging and is deliberately not modeled as an active-therapy Indication in this KB (mirrors the existing "active surveillance, not a separate indication" pattern used in ALGO-GI-NET-ADVANCED-1L). "visual_field_deficit", "optic_chiasm_compression", and "pituitary_mass_effect_symptoms" are new free-form finding keys — no engine-side data-collection wiring confirmed to exist yet for these keys; the `condition:` free-text leaf in the trigger preserves the clinical criterion regardless of finding wiring status, consistent with existing KB precedent (e.g. RF/algorithm notes in ALGO-RCC-METASTATIC-1L for unwired finding keys).

Де використовується

Algorithms

ALGO-PITUITARY-ADENOMA-1L - ALGO-PITUITARY-ADENOMA-1L

Indications

IND-PITUITARY-ADENOMA-1L-NFPA-SURGERY-MASS-EFFECT - IND-PITUITARY-ADENOMA-1L-NFPA-SURGERY-MASS-EFFECT