Related Experiment Video
Updated: Jun 21, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Silent corticotroph adenomas have unique recurrence characteristics compared with other nonfunctioning pituitary
Hwa Young Cho1, Sun Wook Cho, Sang Wan Kim
1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Objective:
The prevalence of silent corticotroph adenomas (SCAs) is not rare among nonfunctioning pituitary adenomas (NFPAs); however, it is unknown whether the clinical significance of SCAs differs from that of NFPAs without ACTH immunoreactivity (non-SCAs). Our goal was to compare the clinical characteristics and natural history between patients with SCAs and non-SCAs.
Design/Patients:
We reviewed the medical records of all patients who underwent transsphenoidal surgery for NFPAs from January 1990 to October 2007 at the Seoul National University Hospital.
Measurements:
We analysed whether clinical manifestations at diagnosis, postoperative recurrence rate and recurrence characteristics differed between SCA and non-SCA patients.
Results:
In total, 28 patients with SCAs and 134 patients with non-SCAs were analysed. The mean age at the time of diagnosis was 44 years (range, 13-67 years) in the SCA group and 50 years (18-79 years) in the non-SCA group (P = 0.026), with respective follow-up periods of 5.2 (range, 1.0-16.0 years) and 4.2 years (0.5-16.1 years) (P = 0.255). Overall recurrence rates of SCAs and non-SCAs were 25.0% and 26.9% respectively (P = 0.839). More than two recurrences (P = 0.001) and recurrence after more than 5 years (P = 0.040) were associated with SCAs. Multiple recurrences of SCAs were confined to younger patients.
Conclusion:
The overall recurrence rate was similar between SCAs and non-SCAs. However, young patients with SCAs had a higher frequency of multiple and late recurrences, which showed more aggressive tumour behaviour. Therefore, we suggest that patients with SCAs, especially patients diagnosed at a young age, require careful long-term monitoring.
Related Concept Videos
Cushing Syndrome I: Introduction
Cushing Syndrome II: Pathophysiology
Adrenal Gland Disorders
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Sympathetic Pathways: Collateral Ganglia and Adrenal Medulla
Collateral Ganglia
Sympathetic preganglionic axons reach the collateral ganglia along the route of splanchnic nerves. These nerves bypass the sympathetic trunk and communicate with sympathetic postganglionic neurons housed in the prevertebral ganglia. These ganglia supply the organs of the abdominopelvic cavity.
The greater splanchnic nerve, formed by the...
Hormones of the Pituitary Gland
The most abundantly secreted hormone from the anterior lobe is the growth hormone, which controls overall growth by...
The Pituitary Gland

