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Related Experiment Video

Updated: Oct 16, 2025

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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Nonfunctioning Pituitary Microadenomas: Should Imaging Interval be Extended? A Large Single-center Cohort Study.

Ashley J Han1,2, Elena V Varlamov2,3,4, Maria Fleseriu2,3,4

  • 1School of Medicine, Oregon Health & Science University, Portland, OR, USA.

The Journal of Clinical Endocrinology and Metabolism
|October 14, 2021
PubMed
Summary

The natural history of nonfunctioning pituitary microadenomas (NFPmAs) is benign. Imaging follow-up for NFPmAs can be extended to three years, avoiding unnecessary monitoring.

Keywords:
growthmicroadenomanatural historynonfunctioningpituitary adenomapituitary tumor

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Area of Science:

  • Endocrinology
  • Neurosurgery
  • Radiology

Background:

  • Clinical characterization of nonfunctioning pituitary microadenomas (NFPmAs) is limited by small, heterogeneous studies.
  • Understanding the natural history of NFPmAs is crucial for optimizing patient management and follow-up protocols.

Purpose of the Study:

  • To characterize the clinical presentation and natural history of NFPmAs.
  • To evaluate the feasibility of extending imaging follow-up intervals for NFPmAs.

Main Methods:

  • Retrospective single-center cohort study of 347 patients with NFPmAs managed conservatively (2006-2021).
  • Assessment of initial symptoms, pituitary function, and tumor size via magnetic resonance imaging (MRI).
  • Significant tumor growth defined as ≥2 mm size change on MRI.

Main Results:

  • Headache and fatigue were common symptoms despite no significant mass effect or pituitary hypofunction.
  • Only 8.1% of NFPmAs demonstrated growth during a median follow-up of 29 months.
  • Tumor growth was mild and did not lead to new pituitary or visual deficits.

Conclusions:

  • The natural history of NFPmAs is generally benign.
  • Initial MRI follow-up for NFPmAs can be extended to three years.
  • Exceptions to extended follow-up include proximity to the optic chiasm, mass effect symptoms, or new pituitary deficiencies.