Nonfunctioning pituitary adenomas: the Oxford experience.
Nonfunctioning adenomas are the second most common type of pituitary tumor. Over the past few years, our knowledge of the epidemiology, natural history, diagnosis, treatment, and recurrence rates of these tumors has improved. Here, we highlight some of these advances and speculate on future avenues of research. In addition, we describe our own experience in the clinical management of patients with nonfunctioning adenomas. Serum prolactin levels are generally <2,000 mU/l in patients with these tumors; we propose that this level be used as the cut-off to differentiate nonfunctioning from prolactin-secreting adenomas. Despite increases in size in 19% of the microadenomas we studied, none of the patients who received no intervention developed visual complications. By contrast, 50% of untreated macroadenomas enlarged and 67% of affected patients experienced worsened or new visual-field defects. Although most recurrences develop in the first 5 years, recurrence has been reported up 14 years after surgery.
Wass
John A H
JA
Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK. john.wass@orh.nhs.uk
Karavitaki
Niki
N
D000236:Adenoma / Q000097:blood / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D006801:Humans; D010911:Pituitary Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D011388:Prolactin / Q000097:blood
D011388:Prolactin
J Clin Endocrinol Metab. 2000 Apr;85(4):1420-5
10770176
J Clin Endocrinol Metab. 1998 Apr;83(4):1368-75
9543168
JAMA. 1990 May 23-30;263(20):2772-6
2332920
Reproduction. 2001 Mar;121(3):363-71
11226062
J Clin Endocrinol Metab. 2006 Dec;91(12):4769-75
16968795
J Clin Endocrinol Metab. 2006 May;91(5):1796-801
16507632
Rev Endocr Metab Disord. 2009 Jun;10(2):83-90
18651224
Clin Endocrinol (Oxf). 1999 Sep;51(3):281-4
10469006
Clin Endocrinol (Oxf). 1998 Mar;48(3):331-7
9578824
Clin Endocrinol (Oxf). 2007 Dec;67(6):938-43
17692109
Endocr Relat Cancer. 2008 Dec;15(4):905-15
18780796
Clin Endocrinol (Oxf). 2006 Oct;65(4):524-9
16984247
J Clin Endocrinol Metab. 2004 Apr;89(4):1674-83
15070930
Rev Endocr Metab Disord. 2009 Jun;10(2):111-23
18791829
Clin Endocrinol (Oxf). 2005 Jul;63(1):39-44
15963059
BMJ. 1992 May 23;304(6838):1343-6
1611331
Clin Endocrinol (Oxf). 2003 Jan;58(1):59-64
12519413
Cancer. 2004 Aug 1;101(3):613-9
15274075