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Health condition · Clinically reviewed

Endocrine tumours, from pituitary to adrenal to neuroendocrine.

A broad family of glandular tumours, mostly manageable and often curable with the right specialist team, targeted therapy and, where relevant, hereditary surveillance.

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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Guideline-anchored

    Cross-checked against NICE, BTA, UKINETs, ESE and specialist commissioned service standards.

  • 03

    Current for 2026

    Reflects modern UK practice including PRRT, RET-directed therapy and hereditary surveillance.

Key facts

Endocrine tumours at a glance.

The essentials, in plain English. What sits under this umbrella, how it presents, and how the UK organises specialist care.

  • What it is

    A broad group of neoplasms arising from endocrine glands and hormone-producing tissues, from pituitary to adrenal to neuroendocrine.

  • Common groups

    Pituitary adenomas, thyroid cancer, primary hyperparathyroidism, adrenal tumours, neuroendocrine tumours (NETs) and hereditary syndromes.

  • How they present

    Very variable. Hormone excess, mass effect on nearby structures, or picked up incidentally on scans done for other reasons.

  • Assessment

    Targeted hormone biochemistry, cross-sectional imaging, functional imaging (68Ga-DOTATATE, MIBG) and genetics where hereditary.

  • Hereditary risk

    MEN1, MEN2, VHL, NF1 and SDHx syndromes explain a meaningful minority. Genetic testing changes both treatment and family screening.

  • Where care sits

    Specialist commissioned endocrine, NET and MTC centres. MDT input from endocrinology, oncology, surgery and clinical genetics.

Why this guide matters

One umbrella, many pathways.

Endocrine tumours behave very differently. A structured overview helps patients and families ask the right questions and find the right centre.

  • Get the diagnosis right

    Hormone testing and targeted imaging identify the tumour type. That determines everything that follows.

  • Think about family

    Hereditary syndromes such as MEN, VHL, NF1 and SDHx change treatment and open up family surveillance.

  • Care sits in specialist centres

    Commissioned endocrine, NET and MTC networks concentrate surgery, PRRT, RET-directed therapy and genetics in one place.

How the diagnosis is made

From first suspicion to a specialist plan.

The steps a UK endocrine team will usually work through, in order, so you know what to expect and why each test matters.

  1. 01

    Assessing

    Clinical assessment

    A focused history and examination for hormone excess, mass effect and any family or syndromic clues.

  2. 02

    Assessing

    Hormone biochemistry

    Targeted panels: prolactin and pituitary axis, calcium and PTH, cortisol and aldosterone, metanephrines, chromogranin and gut hormones.

  3. 03

    Assessing

    First-line imaging

    Ultrasound of thyroid or neck, CT or MRI of adrenal, pituitary or pancreas, sized to the suspected primary.

  4. 04

    Confirming

    Functional imaging

    68Ga-DOTATATE PET-CT for NETs, MIBG for phaeochromocytoma and paraganglioma, radioiodine studies for thyroid.

  5. 05

    Confirming

    Specialist sampling

    Adrenal vein sampling for aldosteronism, inferior petrosal sinus sampling for Cushing disease, image-guided biopsy where safe.

  6. 06

    Planning

    Genetics review

    Panel testing for MEN1, RET, VHL, NF1 and SDHx where features fit, through commissioned NHS genomics services.

  7. 07

    Planning

    MDT and plan

    Specialist endocrine, NET or MTC MDT sets the treatment path and any family screening pathway.

Typical pathway: weeks to a full diagnosis, then a long-term specialist plan.

Types

The main endocrine tumour groups.

A quick map of the field, from pituitary and thyroid to adrenal, neuroendocrine tumours and the hereditary syndromes that link them.

  • Pituitary tumours

    Prolactinoma is commonest. Others include non-functioning, GH-secreting (acromegaly), ACTH (Cushing disease), TSH and craniopharyngioma.

  • Thyroid cancer

    Papillary, follicular, medullary (MTC), Hürthle cell, poorly differentiated and anaplastic subtypes with different biology and treatment.

  • Parathyroid disease

    Primary hyperparathyroidism from a single adenoma in most, hyperplasia in some, and rare parathyroid carcinoma.

  • Adrenal tumours

    Phaeochromocytoma, aldosteronoma (Conn), cortisol-secreting adenoma (Cushing), androgen-secreting tumours and adrenocortical carcinoma.

  • Neuroendocrine tumours (NETs)

    Gastrointestinal, pancreatic, bronchial and thymic NETs, from indolent carcinoid to functional insulinoma, gastrinoma, VIPoma and glucagonoma.

  • Medullary thyroid carcinoma

    MTC, sporadic or as part of MEN2A, MEN2B and familial MTC, driven by RET gene mutations.

  • MEN and hereditary syndromes

    MEN1, MEN2A, MEN2B, MEN4, VHL, NF1, SDHx paraganglioma-phaeochromocytoma and Carney complex.

  • Adrenal incidentaloma

    A common finding on scans done for other reasons. Needs targeted biochemistry and size-based follow-up.

Treatment

How endocrine tumours are treated in the UK.

Surgery is definitive for many. Targeted medical therapy, PRRT and RET-directed drugs have transformed outcomes in the last decade.

  • Surgery

    Definitive for many tumours: trans-sphenoidal for pituitary, thyroidectomy, parathyroidectomy, laparoscopic adrenalectomy, pancreatic resection for NETs. Delivered in commissioned specialist centres.

  • Dopamine agonists

    Cabergoline is first-line for most prolactinomas and can shrink tumour and normalise prolactin without surgery.

  • Somatostatin analogues

    Octreotide, lanreotide and pasireotide control hormone excess and slow growth in NETs, acromegaly and selected Cushing disease.

  • PRRT

    Peptide receptor radionuclide therapy with lutetium-177 DOTATATE for progressive somatostatin-receptor-positive NETs, delivered in commissioned centres.

  • RET-directed therapy

    Selpercatinib and pralsetinib for RET-mutant medullary thyroid cancer and RET-fusion tumours, changing outcomes for MEN2 families.

  • Targeted systemic therapy

    Everolimus and sunitinib for pancreatic NETs, vandetanib and cabozantinib for advanced MTC, belzutifan for VHL-related tumours.

  • Radioactive iodine and EBRT

    Radioiodine for differentiated thyroid cancer after surgery. External beam radiotherapy for selected pituitary and locally advanced disease.

  • Surveillance and genetics

    Structured surveillance for MEN, VHL, NF1 and SDHx families through NHS genomics and specialist commissioned services.

What this guide is based on

The sources behind every claim on this page.

UK national guidance, specialist society standards and NHS specialised commissioning standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your endocrinologist, oncologist or specialist surgeon knows your case and can tell you which parts apply to you. If in doubt, get seen.

  • NICE. Neuroendocrine tumours and thyroid cancer guidance (NG series).

  • British Thyroid Association (BTA). Guidelines for the management of thyroid cancer.

  • UKINETs. UK and Ireland Neuroendocrine Tumour Society consensus guidelines.

  • European Society of Endocrinology (ESE). Clinical practice guidelines on pituitary, adrenal and hereditary endocrine tumours.

  • NHS England. Specialised commissioning service specifications for endocrine, NET and MTC centres.

Red flags

When endocrine tumours need urgent attention.

Some presentations of endocrine disease are emergencies. These are the ones every patient and family should know.

  • Pituitary apoplexy

    Sudden severe headache, visual loss and cranial nerve palsy from bleed or infarct into a pituitary tumour. A neurosurgical emergency.

  • Hypertensive crisis

    Severe paroxysmal hypertension, palpitations, sweating and headache suggest phaeochromocytoma or paraganglioma. Needs urgent specialist care.

  • Symptomatic hypercalcaemia

    Confusion, dehydration, renal impairment or arrhythmia from severe hypercalcaemia in parathyroid disease requires emergency treatment.

  • Rapidly enlarging neck mass

    A fast-growing thyroid mass, hoarseness or airway compromise raises concern for anaplastic or aggressive thyroid cancer.

  • Carcinoid crisis

    Flushing, bronchospasm and cardiovascular instability, sometimes triggered by procedures. Prevented with octreotide cover in NET patients.

  • Severe Cushing syndrome

    Rapid weight gain, proximal weakness, psychosis, hypokalaemia and infection risk demand urgent endocrine assessment.

  • MEN2 family with new symptoms

    New neck lump, hypertension or hypercalcaemia in a MEN2 or MTC family must trigger urgent review and RET-informed care.

  • Insulinoma with hypoglycaemia

    Recurrent fasting hypoglycaemia with inappropriately high insulin. Prevent harm while workup and surgery are arranged.

  • Adrenal mass with concerning features

    Large, heterogeneous or rapidly growing adrenal lesions may be adrenocortical carcinoma and need specialist review without delay.

Living with it

A long-term relationship with a specialist team.

Most endocrine tumours are followed for years. Consistent surveillance, good hormone replacement and a named team make life predictable again.

A quiet reminder

Ask about family screening early.

A hereditary diagnosis changes life for relatives too. Cancer Genetics UK and specialist commissioned services can guide the conversation.

  1. 01 Team

    A specialist MDT

    Endocrinology, oncology, surgery, radiology, nuclear medicine, pathology and genetics steering decisions together.

  2. 02 Follow-up

    Long-term surveillance

    Hormone tests, imaging and family screening for years, tailored to tumour type and any hereditary syndrome.

  3. 03 Support

    Charity and peer support

    Neuroendocrine Cancer UK, AMEND, Butterfly Thyroid Cancer Trust and Pituitary Foundation offer practical, expert support.

  4. 04 Everyday

    Small habits, steady progress

    Regular hormone replacement, medication routines and communication with your team keep life on track between appointments.

Frequently asked

Everything we get asked about endocrine tumours.

Quick answers on hereditary risk, PRRT, pituitary treatment and where specialist care sits.

  • What counts as an endocrine tumour?

    Any neoplasm that arises from an endocrine gland or hormone-producing tissue. That includes pituitary, thyroid, parathyroid and adrenal tumours, neuroendocrine tumours of the gut, pancreas, lung and thymus, and inherited tumour syndromes such as MEN, VHL, NF1 and SDHx paraganglioma-phaeochromocytoma.

  • Are endocrine tumours cancerous?

    Many are benign, especially small pituitary and parathyroid adenomas. Others are malignant, such as adrenocortical carcinoma, anaplastic thyroid cancer and metastatic neuroendocrine tumours. The label matters less than the specific diagnosis, grade and stage, which shape treatment and prognosis.

  • When is genetic testing recommended?

    Whenever the presentation suggests a hereditary syndrome: young age, bilateral or multifocal disease, phaeochromocytoma or paraganglioma, medullary thyroid cancer, or a suggestive family history. Testing is delivered through NHS genomics and specialist commissioned genetics services.

  • What is PRRT and who is it for?

    Peptide receptor radionuclide therapy uses lutetium-177 DOTATATE to deliver targeted radiation to somatostatin-receptor-positive neuroendocrine tumours. It is offered in commissioned centres for progressive NETs after somatostatin analogues, based on imaging and MDT review.

  • How are pituitary tumours usually treated?

    Prolactinomas usually respond to cabergoline. Other functioning and non-functioning adenomas are considered for trans-sphenoidal surgery, sometimes with medical therapy or radiotherapy. Craniopharyngioma is managed in specialist neurosurgical centres with careful hormone replacement afterwards.

  • Where is specialist care delivered in the UK?

    Endocrine, NET and MTC care is concentrated in commissioned centres such as Christie, Royal Free, UCLH, Manchester and Oxford, with linked networks. Genetics, nuclear medicine and complex surgery are delivered through these networks to keep expertise together.

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