2025 Data (Information)

Prospective observational study of 118 clinically nonfunctioning pituitary adenomas: supplemental figure

Freda, Pamela U.

This is a supplemental figure for a paper reporting the outcome of a prospective, observational study of 118 clinically nonfunctioning pituitary adenomas.

Purpose: Clinically nonfunctioning pituitary adenoma (CNFPA) is the likely diagnosis in a patient presenting with a sellar mass consistent with an adenoma on imaging and no clinical or lab evidence of hormone excess. A better understanding of the outcome of observation alone for CNFPAs not requiring surgery at diagnosis is needed.

Methods: We conducted a prospective, observational study of apparent CNFPAs ≥ 6mm in diameter following Endocrine Society guidelines for clinical, endocrine and imaging follow-up.

Results: 118 patients aged of 56 (range 24.7-81) yr., of which 62% were female and 72% macroadenomas, were followed for a median of 3.9 yr. (range 0.42-16 yr.). On follow-up, 49.1% increased (56% of macro- and 31% of microadenomas (P=0.023)), 14.4% decreased and 36.5% were unchanged in size. The median time to increase in size was 2.1 (0.12-12.8) yr. for macro- and 3.44 (0.41-7.4) yr. for microadenomas (P =0.10). Twenty-nine (24.6%) of patients (26 that were macro- and 3 that were microadenomas at diagnosis) underwent pituitary surgery after 2.58 (0.4-7.6) yr. of follow-up. Male sex, tumor size and age contributed to increase the risk of tumor increase in size and/or surgery. Most surgically removed CNFPAs were typical, hormone immuno-negative or gonadotrophin staining tumors.

Conclusions: In this prospective study of 6-9 mm micro- and macro- CNFPAs followed conservatively, growth and surgery can occur within the first year or after many years of observation risks of enlargement and growth are increased for some groups. These factors should be considered in designing the follow-up plan.