title: Optimal management of non-functioning pituitary adenomas.
abstract: Transsphenoidal surgery is the treatment of choice for large non-functioning pituitary adenomas (NFPA) and symptomatic patients. The therapeutic strategies for the management of NFPA after surgery, i.e., watchful waiting, irradiation, or medical therapy have not been compared by randomized controlled trials. Slow re-growth is common, but the natural history of untreated tumors is variable. Conservative follow-up is associated with progression rates of over 40 %. Radiation is highly effective in preventing residual tumor growth, but has serious long-term side effects. Finally, no medications are currently approved for the treatment of NFPA. In this review, we present our view of the optimal management of these tumors, which includes risk stratification for the identification of high-risk patients suitable for active intervention, leaving low-risk patients for careful monitoring.
authors.affiliation: Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, yonagr@tlvmc.gov.il.
authors.forename: Yona
authors.initials: Y
authors.lastname: Greenman
authors.forename: Naftali
authors.initials: N
authors.lastname: Stern
mesh_terms: D000236:Adenoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D019468:Disease Management; D006801:Humans; D010911:Pituitary Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*