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Updated: Apr 19, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Silent corticotroph adenomas.

Odelia Cooper¹

¹Pituitary Center, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., Suite A6600, Los Angeles, CA, 90048, USA, coopero@cshs.org.

|December 24, 2014

Summary

Silent corticotroph adenomas (SCAs) are often diagnosed late and may recur frequently. Rigorous monitoring for recurrence and hypopituitarism is essential for patients with SCAs.

Area of Science:

Endocrinology
Neurosurgery
Oncology

Background:

Silent corticotroph adenomas (SCAs) are a subtype of pituitary adenomas.
SCAs are often diagnosed incidentally after surgery for presumed nonfunctioning adenomas (NFAs).
SCAs do not present with clinical or biochemical hypercortisolism.

Purpose of the Study:

To review the incidence, pathogenesis, and clinical behavior of SCAs.
To highlight the diagnostic challenges and management of SCAs.
To emphasize the importance of postoperative monitoring for SCAs.

Main Methods:

Systematic literature review using PubMed.
Analysis of epidemiological data.
Review of clinical presentation and management strategies.

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Main Results:

SCAs represent 20% of corticotroph adenomas and 3-19% of NFAs.
SCAs share preoperative features with NFAs but may show increased cavernous sinus invasion.
Patients with SCAs experience more frequent and earlier recurrences than those with NFAs.

Conclusions:

SCAs require vigilant postoperative surveillance for recurrence.
Monitoring for hypopituitarism is crucial in patients with SCAs.
SCAs may necessitate multidisciplinary treatment approaches.