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Updated: Jul 17, 2026
07:43
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
The natural course of non-functioning pituitary macroadenomas
O M Dekkers1, S Hammer, R J W de Keizer
1Department of Endocrinology, Leiden University Medical Center, The Netherlands. o.m.dekkers@lumc.nl
European Journal of Endocrinology
|February 9, 2007
Summary
Observation of non-functioning pituitary macroadenomas (NFMA) is safe for selected patients. Monitoring tumor size and pituitary function can prevent irreversible visual loss, making observation a viable alternative to surgery.
Area of Science:
- Endocrinology
- Neurosurgery
- Ophthalmology
Background:
- Non-functioning pituitary macroadenomas (NFMA) natural history requires further elucidation.
- Long-term outcomes for non-operated NFMA patients are not well-defined.
Purpose of the Study:
- To evaluate pituitary function, visual fields, and tumor size in non-operated NFMA patients.
- To assess the safety and efficacy of observation versus surgery for NFMA.
Main Methods:
- A follow-up study including 28 non-operated patients with NFMA.
- Assessment of pituitary function, visual fields, and tumor size over extended follow-up periods.
Main Results:
- 50% of patients showed tumor growth after 118 months; 21% required surgery due to visual field defects.
- Spontaneous tumor volume reduction occurred in 29% of patients.
- No predictors for tumor volume change were identified.
Conclusions:
- Observation is a safe alternative to surgery for selected NFMA patients.
- Monitoring can prevent irreversible visual compromise, supporting conservative management.
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