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DOI: 10.1055/s-0030-1267991
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York
Non-Functioning Pituitary Adenomas: A Single Center Experience
Publication History
received 20.07.2010
first decision 03.10.2010
accepted 22.10.2010
Publication Date:
24 January 2011 (online)

Abstract
Introduction: To describe the clinical imaging and hormonal characteristics and the natural course of patients with clinically non-functioning pituitary adenomas (NFPAs) presenting at our department from 1984 to 2009.
Materials and methods: Retrospective review of electronic medical records of patients with NFPAs. The patients underwent basal and dynamic evaluation of the hypothalamic-pituitary axis. Size and functional alterations were estimated at yearly intervals.
Results: 114 patients (55 men and 59 women, aged 47±2) were studied. The mean follow-up time was 55±6 months (range 0–240). 45% of the adenomas were incidentally discovered and 75% were macroadenomas (73% with extrasellar extension). At diagnosis, 53% had headache and 76% of those with macroadenomas had visual field defects. Disruption of ≥1 pituitary axes was identified in 31% of patients at diagnosis. Surgery was performed in 59% and radiotherapy in 9% of the cases. 88% of surgically treated patients reported improvement in headache and 59% in visual fields. However, the prevalence of permanent diabetes insipidus increased from 2% at diagnosis to 15% postoperatively. The prevalence of ≥1 pituitary deficiencies and panhypopituitarism increased significantly postoperatively. 58% of the adenomas relapsed in size. 29% of the patients were managed conservatively and tumor size remained stable in 83% of them.
Conclusions: The majority of NFPAs not selected for surgery at diagnosis remained stable in size. Pituitary dysfunction and visual defects at diagnosis were common. Surgical debulking led to clinical improvement, but relapse occurred in 2/3 of the cases.
Key words
non-functioning pituitary adenomas - pituitary incidentaloma - hypopituitarism - transsphenoidal surgery
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Correspondence
P. AnagnostisMD
Endocrinology Clinic
Hippokration Hospital
49 Konstantinoupoleos str
Thessaloniki, 54642
GREECE
Phone: 30/231/089 20 38
Fax: 30/231/084 84 53
Email: anagnwstis.pan@yahoo.gr