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J Endocrinol Invest. 2015 Nov;38(11):1191-7. doi: 10.1007/s40618-015-0361-0. Epub 2015 Jul 28.

Retrospective observational analysis of non-irradiated non-functioning pituitary adenomas.

Author information

1
Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Ospedale S. Giovanni Battista-Molinette, C.so Dogliotti 14, 10126, Turin, Italy.
2
Neuroscience Department, University of Turin, Turin, Italy.
3
Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Ospedale S. Giovanni Battista-Molinette, C.so Dogliotti 14, 10126, Turin, Italy. ninagro@yahoo.it.

Abstract

PURPOSE:

The management of choice of non-functioning pituitary adenomas (NFPAs) remains debulking surgery when symptomatic. However, patient series systematically reporting the NFPAs outcome that were not treated either surgically, medically or with radiotherapy during long follow-up thereby giving an indication of their natural history are limited. Aim of the present study was to evaluate the natural course of presumed NFPAs, the outcome of confirmed NFPAs during a long follow-up period.

METHODS:

Between 1993 and 2013, 84 patients with presumed NFPA were studied retrospectively. Patients were enrolled based on the following criteria: imaging suggestive of pituitary adenoma, absence of any biochemical/clinical evidence of hormonal excess, exclusion of prolactinomas and at least one sequential imaging during the follow-up. Repeated assessment of the pituitary function, visual fields and imaging was performed at regular intervals. The follow-up duration was evaluated from the first and last imaging dates.

RESULTS:

In group F (follow-up without surgery, 33 patients), the macroadenomas showed a 15% probability of tumor growth and reduction. Similar tumor size alterations were observed also for the microadenomas. In group S (surgery, 51 patients), both residual tumors (>1 and <1 cm) following initial surgical resection remain mainly stable until the last imaging.

CONCLUSIONS:

Based on the given lack of approved medical treatment and the possible risks of surgical intervention in presence of significant comorbidities, our study proposes a conservative approach with a careful follow-up in patients with NFPAs without visual or neurological abnormalities.

KEYWORDS:

Conservative approach; Outcome; Pituitary adenoma; Tumor growth

PMID:
26215449
DOI:
10.1007/s40618-015-0361-0
[Indexed for MEDLINE]

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