Introduction:Available data on pituitary incidentalomas mostly derive from small-scale studies, with heterogeneous inclusion criteria and limited follow-up. No paper has focused specifically on clinically nonfunctioning pituitary in-cidentalomas (CNFPIs).Objective:To describe the charac-teristics and the natural history of patients diagnosed with CNFPIs.Methods:Retrospective multicenter cohort study evaluating hormonal, imaging, and visual field characteristics at diagnosis and during follow-up of CNFPIs investigated in 2 Pituitary Centers.Results:Three hundred and seventy-one patients were included (50.9% microadenomas, 35.6% males). Men were older and more likely to have a macroadenoma (p< 0.01). Totally, 23.7% of patients presented secondary hormonal deficits (SHDs), related to tumor size (higher in macroadenomas;p< 0.001) and age (higher in older patients;p< 0.001). Hypogonadism was the most frequent SHD (15.6%). Two hundred and ninety-six patients had follow-up data, 29.1% required surgery after first evaluation, and 97 had at least 3 years of follow-up. In total, 15.3% adenomas grew (more macroadenomas), but only in microadenomas patients with longer follow-up showed a higher growth trend. Totally, 5.2% of patients developed new SHDs (micro- vs. macroadenomasp= 1.000), and in 60% of them this was not associated with an increase in tumor size. Thirteen additional patients required surgery during follow-up (1 microadenoma at diagnosis).Conclusions:Macroadenomas and age are risk factors for SHD in CNFPIs, which occur at diagnosis in a quarter of patients. During follow-up, macroadenomas tend to grow more often, but microadenomas display higher growth trend as follow-up increases. Deterioration of pituitary function is not always related to adenoma growth.
Clinically non-functioning pituitary incidentalomas: characteristics and natural history / A.S. Tresoldi, G. Carosi, N. Betella, G. Del Sindaco, R. Indirli, E. Ferrante, E. Sala, C. Giavoli, E. Morenghi, M. Locatelli, D. Milani, G. Mazziotti, A. Spada, M. Arosio, G. Mantovani, A. Lania. - In: NEUROENDOCRINOLOGY. - ISSN 1423-0194. - 110:7-8(2020 Jul 01), pp. 595-603.
|Titolo:||Clinically non-functioning pituitary incidentalomas: characteristics and natural history|
MANTOVANI, GIOVANNA (Penultimo) (Corresponding)
|Parole Chiave:||Pituitary incidentaloma; Nonfunctional pituitary adenomas; Nonfunctioning pituitary incidentalomas; Natural history; Hypopituitarism|
|Settore Scientifico Disciplinare:||Settore MED/13 - Endocrinologia|
|Data di pubblicazione:||1-lug-2020|
|Data ahead of print / Data di stampa:||13-set-2019|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1159/000503256|
|Appare nelle tipologie:||01 - Articolo su periodico|