title: Retrospective observational analysis of non-irradiated non-functioning pituitary adenomas.
abstract: OBJECTIVE
  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.
authors.affiliation: 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.
authors.forename: I
authors.initials: I
authors.lastname: Karamouzis
authors.affiliation: 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.
authors.forename: R
authors.initials: R
authors.lastname: Berardelli
authors.affiliation: 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.
authors.forename: N
authors.initials: N
authors.lastname: Prencipe
authors.affiliation: 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.
authors.forename: A
authors.initials: A
authors.lastname: Berton
authors.affiliation: 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.
authors.forename: C
authors.initials: C
authors.lastname: Bona
authors.affiliation: Neuroscience Department, University of Turin, Turin, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Stura
authors.affiliation: Neuroscience Department, University of Turin, Turin, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Corsico
authors.affiliation: 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.
authors.forename: V
authors.initials: V
authors.lastname: Gasco
authors.affiliation: 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.
authors.forename: M
authors.initials: M
authors.lastname: Maccario
authors.affiliation: 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.
authors.forename: E
authors.initials: E
authors.lastname: Ghigo
authors.affiliation: 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.
authors.forename: S
authors.initials: S
authors.lastname: Grottoli
mesh_terms: D000236:Adenoma / Q000150:complications / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies
keywords: Conservative approach; Outcome; Pituitary adenoma; Tumor growth