Introduction: The widespread use of neuroimaging leads to the increased detection of asymptomatic pituitary adenomasnot causing significant mass effect. Their optimal management remains unclear.
Aim of the study: To explore the natural course of incidentally found nonfunctioning pituitary macroadenomas.
Patients and Methods: This was a longitudinal study that enrolled patients with clinically nonfunctioning pituitary macroadenomas who weren’tinitially referred to surgery either because of the relatively small tumor size or due to the increased surgical risk. Pituitary tumor size was regularly monitored with MRI. Significant increase/decrease in tumor size was defined as the increase/decrease of at least > 3 mm in tumor diameter.
Results: The study included 41 patient (15 males, median age 59 years). Median tumor size was 15 mm (11–45 mm) in the largest diameter. Median follow-up was 36 months (range from 6 to 78 months). During follow-up, three patients were referred to surgery of whom only one had significant tumor growth. In 9 patients tumor size decreased, in 5 tumor size increased (only one of them needed surgical treatment) and in the remaining 27 patients no significant change in tumor volume was detected during follow-up.
Conclusion: The results suggest that it is quite unlikely for the initially asymptomatic nonfunctioning pituitary adenoma to undergo clinically significant increase in its size. It speaks in favor of the conservative approach in the management of that group of patients.
05 Sep 2020 - 09 Sep 2020