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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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A Real-World Longitudinal Study in Non-Functioning Pituitary Incidentalomas: A PRECES Micro-Adenomas Sub-Analysis.
Mihai Costachescu1,2,3, Claudiu Nistor3,4, Ana Valea5,6
1Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania.
Diseases (Basel, Switzerland)
|October 25, 2024
Summary
Many pituitary incidentalomas (PIs) grow over time, even small ones, necessitating longer surveillance. Age at diagnosis does not predict tumor growth in these non-functioning micro-adenomas.
Area of Science:
- Endocrinology
- Radiology
- Oncology
Background:
- Increasing incidence of incidentalomas globally due to advanced imaging.
- Pituitary incidentalomas (PIs) are a subset of endocrine incidentalomas.
- Non-functioning micro-adenomas (<1 cm) are common PIs.
Purpose of the Study:
- To analyze dynamic changes in pituitary incidentalomas (PIs) via serial computed tomography (CT) scans.
- To evaluate growth patterns in adult patients with initially diagnosed non-functioning micro-adenomas.
- To identify factors influencing PI size changes over time.
Main Methods:
- Multi-centric, longitudinal, retrospective study of adult patients (20-70 years).
- Inclusion criteria: non-functioning micro-adenoma (<1 cm), no hormonal excess/deficiency.
- Exclusion criteria: tumors >1 cm, baseline hormonal dysfunction.
- Data collected on tumor diameter, follow-up duration, and patient demographics.
Main Results:
- 117 adult patients included (94% female), mean age 43.86 years.
- Median follow-up of 40 months; no PIs became functioning or exceeded 1 cm.
- 39.32% of patients showed increased PI diameter during follow-up.
- Increased diameter group had smaller initial sizes and longer surveillance periods.
- Initial tumor size, not age, influenced growth potential.
Conclusions:
- A significant percentage of pituitary incidentalomas may increase in diameter over extended follow-up periods.
- Smaller initial tumor size is associated with a higher likelihood of growth.
- Age at diagnosis is not a predictor of tumor growth in PIs.
- Findings may inform long-term surveillance protocols for pituitary incidentalomas.
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