Skip to main content
SpringerLink
Log in

Non-functioning Adenomas: Diagnosis and Treatment

  • Chapter
Book cover Diagnosis and Management of Pituitary Disorders

Part of the book series: Contemporary Endocrinology ((COE))

  • 1721 Accesses

Summary

Nonfunctioning pituitary adenomas are benign lesions that generally present secondary to mass effect on the pituitary gland or optic nerves, leading to hypopituitarism and visual field defects. Surgical removal via a transsphenoidal approach is a safe and effective treatment for the vast majority of patients with these lesions. Here we will discuss the diagnosis and treatment of nonfunctioning pituitary adenomas.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Monson JP. The epidemiology of endocrine tumours. Endocr Relat Cancer 2000;7:29–36.

    Article  PubMed  CAS  Google Scholar 

  2. Clayton RN, Stewart PM, Shalet SM, Wass JA. Pituitary surgery for acromegaly. Should be done by specialists. BMJ 1999;319:588–9.

    PubMed  CAS  Google Scholar 

  3. Asa SL, Kovacs K. Clinically non-functioning human pituitary adenomas. Can J Neuro Sci 1992;19:228–35.

    CAS  Google Scholar 

  4. Oyesiku NM. Nonfunctioning Pituitary Adenomas. In: Rengachary SS, Ellenbogen RG, editors. Principles of Neurosurgery, 2nd ed. New York: Elsevier Mosby; 2005. pp. 593–602.

    Google Scholar 

  5. Katznelson L, Alexander JM, Klibanski A. Clinically nonfunctioning pituitary adenomas. J Clin Endocrinol Metab 1993;76:1089–94.

    Article  PubMed  CAS  Google Scholar 

  6. Clayton RN. Sporadic pituitary tumours: from epidemiology to use of databases. Baillieres Best Pract Res Clin Endocrinol Metab 1999;13:451–60.

    Article  PubMed  CAS  Google Scholar 

  7. Buurman H, Saeger W. Subclinical adenomas in postmortem pituitaries: classification and correlations to clinical data. Euro J Endocrinol 2006;154:753–8.

    Article  CAS  Google Scholar 

  8. Burrow GN, Wortzman G, Rewcastle MB, Holgate RC, Kovaks K. Microadenomas of the pituitary and abnormal sellar tomograms in an unselected autopsy series. N Engl J Med 1981;304:156–8.

    Article  PubMed  CAS  Google Scholar 

  9. Arita K, Tominaga A, Sugiyama K, et al. Natural course of incidentally found nonfunctioning pituitary adenoma, with special reference to pituitary apoplexy during follow-up examination. J Neurosurg 2006;104:884–91.

    Article  PubMed  Google Scholar 

  10. Jane JA, Jr., Laws ER, Jr. The management of non-functioning pituitary adenomas. Neurology India 2003;51:461–5.

    PubMed  Google Scholar 

  11. Jane JA, Jr., Laws ER, Jr. Chapter 13: Surgical management of pituitary adenomas. In: Endotext.com; 2004.

    Google Scholar 

  12. Colin P, Jovenin N, Delemer B, et al. Treatment of pituitary adenomas by fractionated stereotactic radiotherapy: A prospective study of 110 patients Int J Radiat Oncol Biol Phys 2005;62:333–41.

    PubMed  Google Scholar 

  13. Al-Shraim M, Asa SL. The 2004 World Health Organization classification of pituitary tumors: What is new? Acta Neuropathol 2006;111:1–7.

    Article  PubMed  Google Scholar 

  14. Ragel BT, Couldwell WT. Pituitary carcinoma: a review of the literature. Neurosurg Focus 2004;16:1–9.

    Article  Google Scholar 

  15. Greenman Y, Melmed S. Diagnosis and management of nonfunctioning pituitary tumors. Annu Rev Med 1996;47:95–106.

    Article  PubMed  CAS  Google Scholar 

  16. Biousse V, Newman NJ, Oyesiku NM. Precipitating factors in pituitary apoplexy. J Neurol Neurosurg Psychiatr 2001;71:542–5.

    Article  PubMed  CAS  Google Scholar 

  17. Sibal L, Ball SG, Connolly V, et al. Pituitary apoplexy: a review of clinical presentation, management and outcome in 45 cases. Pituitary 2004;7:157–63.

    Article  PubMed  Google Scholar 

  18. Bills DC, Meyer FB, Laws ER, Jr., et al. A retrospective analysis of pituitary apoplexy. Neurosurgery 1993;33:602–9.

    Article  PubMed  CAS  Google Scholar 

  19. Ahmad FU, Pandey P, Mahapatra AK. Post operative ‘pituitary apoplexy’ in giant pituitary adenomas: a series of cases. Neurology India 2005;53:326–8.

    Article  PubMed  Google Scholar 

  20. Semple P, Laws E. Complications in a contemporary series of patients who underwent transsphenoidal surgery for Cushing’s disease. J Neurosurg 1999;91:175–9.

    PubMed  CAS  Google Scholar 

  21. Singh SK, Aggarwal R. Pituitary adenomas in childhood. Indian J Ped 2005;72:583–91.

    Article  CAS  Google Scholar 

  22. De Menis E, Visentin A, Billeci D, et al. Pituitary adenomas in childhood and adolescence. Clinical analysis of 10 cases. J Endocrinol Invest 2001;24:92–7.

    PubMed  Google Scholar 

  23. Artese R, D’Osvaldo DH, Molocznik I, et al. Pituitary tumors in adolescent patients. Neurol Res 1998;20:415–7.

    PubMed  CAS  Google Scholar 

  24. Maira G, Anile C. Pituitary adenomas in childhood and adolescence. Can J Neurol Sci 1990;17:83–7.

    PubMed  CAS  Google Scholar 

  25. Jagannathan J, Dumont AS, Jane JA, Jr. . Diagnosis and management of pediatric sellar lesions. Front Horm Res 2006;34:83–104.

    PubMed  Google Scholar 

  26. Dolinskas C, Simeone F. Transsphenoidal hypophysectomy: postsurgical CT findings. Am J Neuroradiol 1985;6:45–50.

    Google Scholar 

  27. Mikhael MA, Ciric IS. MR imaging of pituitary tumors before and after surgical and/or medical treatment. J Computer Assisted Tomogr 1988;12:441–5.

    Article  CAS  Google Scholar 

  28. Ebersold MJ, Quast LM, Laws ER, Scheithauer B, Randall RV. Long-term results in transsphenoidal removal of nonfunctioning pituitary adenomas. J Neurosurg 1986;64:713–9.

    PubMed  CAS  Google Scholar 

  29. Mortini P, Losa M, Barzaghi R, Boari N, Giovanello M. Results of transsphenoidal surgery in a large series of patients with pituitary adenoma. Neurosurgery 2005;56:1222–33.

    Article  PubMed  Google Scholar 

  30. Kaptain GJ, Vincent DA, Sheehan JP, Laws ER, Jr. Transsphenoidal approaches for the extracapsular resection of midline suprasellar and anterior cranial base lesions. Neurosurgery 2001:94–100.

    Google Scholar 

  31. Kouri JG, Chen MY, Watson JC, Oldfield EH. Resection of suprasellar tumors by using a modified transsphenoidal approach. Report of four cases. J Neurosurg 2000;92:1028–35.

    PubMed  CAS  Google Scholar 

  32. Alleyne CHJ, Barrow DL, Oyesiku NM. Combined transsphenoidal and pterional craniotomy approach to giant pituitary tumors. Surg Neurol 2002;57:380–90.

    Article  PubMed  Google Scholar 

  33. Liu JK, Weiss MH, Couldwell WT. Surgical approaches to pituitary tumors. Neurosurg Clin N Am 2003;14:93–107.

    Article  PubMed  Google Scholar 

  34. De Divitiis E, Esposito F, Cavallo LM, Cappabianca P. Chapter 14A: Pituitary Adenomas and Craniopharyngiomas. Philadelphia: Lippincott, Williams and Wilkins; 2004.

    Google Scholar 

  35. Kante AS, Dumont AS, Asthagiri AR, Oskouian RJ, Jane JA, Jr., Laws ER, Jr. The transsphenoidal approach: a historical perspective. Neurosurg Focus 2005;18.

    Google Scholar 

  36. Kabil MS, Eby JB, Shahinian HK. Fully endoscopic endonasal vs. transseptal transsphenoidal pituitary surgery. Minim Invas Neurosurg 2005;48:348–54.

    Article  CAS  Google Scholar 

  37. Cohen-Gadol AA, Liu JK, Laws ER, Jr. Cushing’s first case of transsphenoidal surgery: the launch of the pituitary surgery era. J Neurosurg 2005;103:570–4.

    PubMed  Google Scholar 

  38. Jane JA, Jr., Thapar K, Alden TD, Laws ER, Jr. Fluoroscopic frameless stereotaxy for transsphenoidal surgery. Neurosurgery 2001; 48:1302–8.

    Google Scholar 

  39. Elias WJ, Chadduck JB, Alden TD, Laws ER, Jr. Frameless stereotaxy for transsphenoidal surgery Neurosurgery 1999;45:271–5; discussion 5–7.

    Article  PubMed  CAS  Google Scholar 

  40. Jho HD, Alfieri A. Endoscopic endonasal pituitary surgery: evolution of surgical technique and equipment in 150 operations. Minim Invasive Neurosurg 2001;44:1–12.

    Article  PubMed  CAS  Google Scholar 

  41. Jho HD, Carrau RL. Endoscopic endonasal transsphenoidal surgery: experience with 50 patients. J Neurosurg 1997;87:44–51.

    Article  PubMed  CAS  Google Scholar 

  42. Trautmann JC, Laws ER, Jr. Visual status after transsphenoidal surgery at the Mayo Clinic, 1971–1982. Am J Ophthalmol 1983;96:200–8.

    PubMed  CAS  Google Scholar 

  43. Flickinger JC, Nelson PB, Martinez AJ, Deutsch M, Taylor F. Radiotherapy of nonfunctional adenomas of the pituitary gland. Results with long-term follow-up. Cancer 1989;63:2409–14.

    CAS  Google Scholar 

  44. Shimon I, Melmed S. Management of pituitary tumors. Ann Intern Med 1998;129:472–83.

    PubMed  CAS  Google Scholar 

  45. Orrego JJ, Barkan AL. Pituitary disorders. Drug treatment options. Drugs 2000;59:93–106.

    Article  PubMed  CAS  Google Scholar 

  46. Peter M, Tribolet N. Visual outcome after transsphenoidal surgery for pituitary adenomas. Br J Neurosurg 1995;9:151–7.

    Article  PubMed  CAS  Google Scholar 

  47. Powell M. Recovery of vision following transsphenoidal surgery for pituitary adenomas. Br J Neurosurg 1995;9:367–73.

    Article  PubMed  CAS  Google Scholar 

  48. Milker-Zabel S, Debus J, Thilmann C, Schlegel W, Wannenmacher M. Fractionated stereotactically guided radiotherapy and radiosurgery in the treatment of functional and nonfunctional adenomas of the pituitary gland. Int J Radiat Oncol Biol Phys 2001;50:1279–86.

    PubMed  CAS  Google Scholar 

  49. Jackson IM, Noren G. Gamma knife radiosurgery for pituitary tumours. Baillieres Best Pract Res Clin Endocrinol Metab 1999;13:461–9.

    Article  PubMed  CAS  Google Scholar 

  50. Becker G, Kocher M, Kortmann RD, et al. Radiation therapy in the multimodal treatment approach of pituitary adenoma. Strahlenther Onkol 2002;178:173–86.

    Article  PubMed  Google Scholar 

  51. Benveniste RJ, King WA, Walsh J, Lee JS, Delman BN, Post KD. Repeated transsphenoidal surgery to treat recurrent or residual pituitary adenoma. J Neurosurg 2005;102:1004–12.

    PubMed  Google Scholar 

  52. Powell JS, Wardlaw SL, Post KD, Freda PU. Outcome of radiotherapy for acromegaly using normalization of insulin-like growth factor I to define cure. J Clin Endocrinol Metab 2000;85:2068–71.

    Article  PubMed  CAS  Google Scholar 

  53. Zhang N, Pan L, Wang EM, Dai JZ, Wang BJ, Cai PW. Radiosurgery for growth hormone-producing pituitary adenomas. J Neurosurg 2000;93:6–9.

    PubMed  Google Scholar 

  54. Dekkers OM, Pereira AM, Roelfsema F, et al. Observation alone after transsphenoidal surgery for nonfunctioning pituitary macroadenoma. J Clin Endocrinol Metab 2006;91:1796–801.

    Article  PubMed  CAS  Google Scholar 

  55. Evans CO, Young AN, Brown MR, et al. Novel patterns of gene expression in pituitary adenomas identified by complementary deoxyribonucleic acid microarrays and quantitative reverse transcription-polymerase chain reaction. J Clin Endocrinol Metab 2001;86:3097–107.

    Article  PubMed  CAS  Google Scholar 

  56. Rajaraman V, Schulder M. Postoperative MRI appearance after transsphenoidal pituitary tumor resection. Surg Neurol 1999;52:592–8.

    Article  PubMed  CAS  Google Scholar 

  57. Popovic V, Damjanovic S, Micic D, et al. Increased incidence of neoplasia in patients with pituitary adenomas. Clin Endocrinol 1998;49:441–5.

    Article  CAS  Google Scholar 

Download references

Authors
  1. Carrie R. Muh MD, MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nelson M. Oyesiku MD, PHD, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Neurosurgery Massachusetts, General Hospital Harvard Medical School, Boston, MA, USA

    Brooke Swearingen MD

  2. Neuroendocrine Unit Department of Medicine, Massachusetts General Hospital Harvard Medical School, Boston, MA, USA

    Beverly M. K. Biller MD

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Humana Press, Totowa, NJ

About this chapter

Cite this chapter

Muh, C.R., Oyesiku, N.M. (2008). Non-functioning Adenomas: Diagnosis and Treatment . In: Swearingen, B., Biller, B.M. (eds) Diagnosis and Management of Pituitary Disorders. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59745-264-9_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-59745-264-9_14

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-922-2

  • Online ISBN: 978-1-59745-264-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation