[Incidentally discovered pituitary macroadenoma. Neurosurgical treatment indications illustrated by two cases]

Pituitary macroadenomas (more than 10 mm in diameter) are infrequent as casual findings and optimal management strategy for these tumours has not been established. Neurosurgical approach must be always considered in patients with visual field defects or with hormone-secreting adenomas (but prolactinoma), and in those with evidence of lesion's growth or if clinical pituitary apoplexy occurs. We present two cases in which surgical indication was based on patient's young age (case number one), and on hypogonadal status, in a male patient not suitable of androgen substitution (case number two). We also discuss the benefits of including such unusual indications for neurosurgical treatment into the incidentally discovered pituitary macroadenomas evaluation strategy.