Prof. Pietro MORTINI

Causes

Clinically nonfunctioning pituitary adenomas make up about half of pituitary adenomas. The vast majority of them are benign.

There are several possible reasons why nonfunctioning pituitary adenomas could occur:

Symptoms

The most common symptoms are due to the large tumor compressing nearby structures, leading to:

When severe, a patient can only see what is directly in front of them; many patients do not become aware of their visual loss until it is quite severe.

Diagnosis

Imaging scans are one method doctors use to diagnose clinically nonfunctioning pituitary adenomas. Hormone tests are also indicated to evaluate the levels of pituitary hormone, confirming that there is no evidence of hormone production by the tumor.
Necessary investigations may be:

If your symptoms suggest pituitary failure (hypopituitarism), a complete evaluation of the endocrine system may be advisable. Based on results of these blood tests, you may undergo additional hormonal studies.

If you are experiencing vision problems, an experienced ophthalmologist can evaluate you. The evaluation should include:

This will determine if you have a loss of peripheral vision.

Treatment option

Surgery for Clinically Nonfunctioning Pituitary Adenomas

For most patients with nonfunctional adenomas, surgically removing the adenoma is the most effective treatment.

The extent of surgical removal, which is related to:

Overall, surgery improves:

If the pituitary adenomas require surgery, typically the best procedure is through a nasal approach. The minimally invasive endoscopic endonasal technique. This procedure removes the tumor while minimizing complications, hospital time and discomfort. This advanced technique requires specialized training and equipment.

Very large tumors that extend into the brain cavity may require opening the skull (craniotomy) to access the tumor.

If, after your surgery, some tumor cells remained or regrew, you may be a candidate for radiation therapy or a repeat surgery

Radiation Therapy

Radiation therapy as a second-line therapy for endocrine-inactive tumors. Focused-beam radiation, named stereotactic radiosurgery, can be effective in controlling tumor growth. In some cases, radiation therapy may cause a loss of pituitary function.

 


Acromegaly     Cushing Disease     Prolactinomas     TSH-oma