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The Pituitary Gland

The Pituitary Gland

The pituitary is a small endocrine organ in the sphenoid bone under the hypothalamus. Primarily, the pituitary in adults has two distinct anatomical and functional regions— the anterior and posterior lobes. During human fetal development, a third pituitary gland region called the pars intermedia atrophies and disappears. However, some of its cells migrate and exist adjacent to the anterior pituitary in adults.

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Updated: Jan 8, 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

Prospective Observational Study of 118 Clinically Nonfunctioning Pituitary Adenomas.

Pamela U Freda¹, Jeffrey N Bruce², Kalmon D Post³

¹Department of Medicine, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

|December 19, 2025

Summary

This summary is machine-generated.

Observation of clinically nonfunctioning pituitary adenomas (CNFPAs) shows significant growth and surgery rates, even years after diagnosis. Male sex and macroadenomas predict increased risks, informing personalized follow-up strategies for these pituitary tumors.

Keywords:

MRI nonfunctioning adenoma observation outcome pituitary surgery pituitary tumor

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Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery

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Published on: July 5, 2021

Area of Science:

Endocrinology
Neurosurgery
Oncology

Background:

Clinically nonfunctioning pituitary adenomas (CNFPAs) are diagnosed based on imaging and lack of hormonal dysfunction.
Understanding the natural history of CNFPAs managed conservatively is crucial for patient care.

Purpose of the Study:

To evaluate the outcomes of observation alone for CNFPAs not requiring immediate surgery.
To identify predictors of tumor growth and need for surgery in CNFPA patients.

Main Methods:

Prospective observational study of 118 patients with apparent CNFPAs (≥ 6mm).
Follow-up included clinical, endocrine, and imaging assessments according to European Society guidelines.
Multivariable analysis was used to identify predictors of tumor growth and surgery.

Main Results:

49% of CNFPAs increased in size, with higher rates in macroadenomas (56%) versus microadenomas (31%).
24.6% of patients underwent surgery, with macroadenomas at diagnosis being a significant predictor.
Male sex was a predictor of tumor growth.

Conclusions:

CNFPA growth and the need for surgery can occur unpredictably, sometimes years after initial observation.
Specific patient groups, including males and those with macroadenomas, face increased risks.
These findings necessitate individualized follow-up plans for CNFPA management.