Georgia Ntali1, John A Wass2. 1. Department of Endocrinology, Diabetes and Metabolism, Evangelismos Hospital, Athens, Greece. georgiantali@yahoo.com. 2. Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford, UK.
Abstract
PURPOSE: Non-functioning pituitary adenomas (NFPAs) are benign pituitary neoplasms that do not cause a hormonal hypersecretory syndrome. An improved understanding of their epidemiology, clinical presentation and diagnosis is needed. METHOD: A literature review was performed using Pubmed to identify research reports and clinical case series on NFPAs. RESULTS: They account for 14-54% of pituitary adenomas and have a prevalence of 7-41.3/100,000 population. Their standardized incidence rate is 0.65-2.34/100,000 and the peak occurence is from the fourth to the eighth decade. The clinical spectrum of NFPAs varies from being completely asymptomatic to causing significant hypothalamic/pituitary dysfunction and visual field compromise due to their large size. Most patients present with symptoms of mass effect, such as headaches, visual field defects, ophthalmoplegias, and hypopituitarism but also hyperprolactinaemia due to pituitary stalk deviation and less frequently pituitary apoplexy. Non-functioning pituitary incidentalomas are found on brain imaging performed for an unrelated reason. Diagnostic approach includes magnetic resonance imaging of the sellar region, laboratory evaluations, screening for hormone hypersecretion and for hypopituitarism, and a visual field examination if the lesion abuts the optic nerves or chiasm. CONCLUSION: This article reviews the epidemiology, clinical behaviour and diagnostic approach of non-functioning pituitary adenomas.
PURPOSE: Non-functioning pituitary adenomas (NFPAs) are benign pituitary neoplasms that do not cause a hormonal hypersecretory syndrome. An improved understanding of their epidemiology, clinical presentation and diagnosis is needed. METHOD: A literature review was performed using Pubmed to identify research reports and clinical case series on NFPAs. RESULTS: They account for 14-54% of pituitary adenomas and have a prevalence of 7-41.3/100,000 population. Their standardized incidence rate is 0.65-2.34/100,000 and the peak occurence is from the fourth to the eighth decade. The clinical spectrum of NFPAs varies from being completely asymptomatic to causing significant hypothalamic/pituitary dysfunction and visual field compromise due to their large size. Most patients present with symptoms of mass effect, such as headaches, visual field defects, ophthalmoplegias, and hypopituitarism but also hyperprolactinaemia due to pituitary stalk deviation and less frequently pituitary apoplexy. Non-functioning pituitary incidentalomas are found on brain imaging performed for an unrelated reason. Diagnostic approach includes magnetic resonance imaging of the sellar region, laboratory evaluations, screening for hormone hypersecretion and for hypopituitarism, and a visual field examination if the lesion abuts the optic nerves or chiasm. CONCLUSION: This article reviews the epidemiology, clinical behaviour and diagnostic approach of non-functioning pituitary adenomas.
Authors: Nasrin Fatemi; Joshua R Dusick; Carlos Mattozo; David L McArthur; Pejman Cohan; John Boscardin; Christina Wang; Ronald S Swerdloff; Daniel F Kelly Journal: Neurosurgery Date: 2008-10 Impact factor: 4.654
Authors: Georgia Ntali; Cristina Capatina; Violet Fazal-Sanderson; James V Byrne; Simon Cudlip; Ashley B Grossman; John A H Wass; Niki Karavitaki Journal: Eur J Endocrinol Date: 2015-11-06 Impact factor: 6.664
Authors: Navid Redjal; Andrew S Venteicher; Danielle Dang; Andrew Sloan; Remi A Kessler; Rebecca R Baron; Constantinos G Hadjipanayis; Clark C Chen; Mateo Ziu; Jeffrey J Olson; Brian V Nahed Journal: J Neurooncol Date: 2021-02-21 Impact factor: 4.130
Authors: Abhiraj D Bhimani; Alexander J Schupper; Gregory D Arnone; Deeksha Chada; Anisse N Chaker; Nicki Mohammadi; Costas G Hadjipanayis; Ankit I Mehta Journal: J Neurol Surg B Skull Base Date: 2020-09-10
Authors: Bin Zhu; Ming Gao; Lei Zhang; Juan Wang; Lei Wang; Ling Ling Qin; Xi Xiong Kang; Zhi Gang Zhao Journal: Metab Brain Dis Date: 2019-01-03 Impact factor: 3.584
Authors: Karol Piotr Sagan; Elżbieta Andrysiak-Mamos; Ernest Tyburski; Leszek Michał Sagan; Anhelli Syrenicz Journal: J Clin Med Date: 2021-04-26 Impact factor: 4.241