title: Management of clinically non-functioning pituitary adenoma.
abstract: Clinically NFPA is currently the preferred term for designing all the pituitary adenomas which are not hormonally active (in other words, not associated with clinical syndromes such as amenorrhea-galactorrhea in the context of prolactinomas, acromegaly, Cushing's disease or hyperthyroidism secondary to TSH-secreting adenomas). They account for 15-30% of pituitary adenomas. Diagnosis is usually made either in the context of mass effect due to a macroadenoma or, increasingly, fortuitously during imaging performed for some unrelated purpose; the latter case is known as pituitary incidentaloma. Surgery is indisputably indicated in case of tumoral syndrome, but other aspects of NFPA (hormonal work-up, follow-up, and especially postoperative follow-up, management of remnant or recurrence, the special case of incidentaloma, or apoplexy) remain controversial. The French Endocrinology Society (SFE) therefore set up an expert working group of endocrinologists, neurosurgeons, ophthalmologists, neuroradiologists, pathologists and biologists to draw up guidelines, at the 2012 SFE Congress in Toulouse, France. The present article presents the guidelines suggested by this group of French-speaking experts.
authors.affiliation: Service d'endocrinologie et des maladies de la reproduction, hôpital de Bicêtre, Assistance publique-Hôpitaux de Paris, 94275 Le Kremlin-Bicêtre, France; UMR S1185, faculté de médecine Paris-Sud, université Paris-Sud, 94276 Le Kremlin-Bicêtre, France; INSERM U1185, 94276 Le Kremlin-Bicêtre, France. Electronic address: philippe.chanson@bct.aphp.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Chanson
authors.affiliation: Fédération d'endocrinologie, groupement hospitalier Est, hospices civils de Lyon, 69372 Lyon, France; INSERM U1028, CNRS UMR5292, centre de recherche neuroscience, université de Lyon, 69372 Lyon, France.
authors.forename: Gerald
authors.initials: G
authors.lastname: Raverot
authors.affiliation: Service d'endocrinologie, hôpital de la Timone, Assistance publique-hôpitaux de Marseille, université Aix-Marseille, Marseille, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Castinetti
authors.affiliation: Service d'endocrinologie-métabolisme, CHU de Lille, 59000 Lille, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Cortet-Rudelli
authors.affiliation: Service d'endocrinologie, de diabétologie et de nutrition, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Galland
authors.affiliation: Service d'endocrinologie et des maladies de la reproduction, hôpital de Bicêtre, Assistance publique-Hôpitaux de Paris, 94275 Le Kremlin-Bicêtre, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Salenave
mesh_terms: D000236:Adenoma / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D032921:Consensus; D006801:Humans; D010899:Pituitary Apoplexy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy; D010911:Pituitary Neoplasms / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*
keywords: Adénomes gonadotropes; Adénomes hypophysaires non fonctionnels; Adénomes hypophysaires non sécrétants; Adénomes hypophysaires silencieux; Apoplexie hypophysaire; Chirurgie hypophysaire; Gonadotroph adenoma; Incidentalomes hypophysaires; Non-functioning pituitary adenoma; Non-secreting pituitary adenoma; Pituitary apoplexy; Pituitary incidentaloma; Pituitary surgery; Radiation therapy; Radiothérapie; Silent pituitary adenoma