Best Practice & Research Clinical Endocrinology & Metabolism
Volume 23, Issue 5 , Pages 667-675 , October 2009

Pituitary incidentalomas

  • Mark E. Molitch, MD (Professor of Medicine)

      Affiliations

    • Corresponding Author InformationTel.: +1 312 503 4130; Fax: +1 312 926 8693.

References 

  1. Young WF, Scheithauer BW, Kovacs KT, et al. Gonadotroph adenoma of the pituitary gland: a clinicopathologic analysis of 100 cases. Mayo Clinic Proceedings. 1996;71:649–656
  2. Yamada S, Kovacs K, Horvath E, et al. Morphological study of clinically nonsecreting pituitary adenomas in patients under 40 years of age. Journal of Neurosurgery. 1991;75:902–905
  3. Chambers EF, Turski PA, LaMasters D, et al. Regions of low density in the contrast-enhanced pituitary gland: normal and pathologic processes. Radiology. 1982;144:109–113
  4. Elster AD. Modern imaging of the pituitary. Radiology. 1993;187:1–14
  5. Freda PU, Wardlaw SL, Post KD. Unusual causes of sellar/parasellar masses in a large transsphenoidal surgical series. The Journal of Clinical Endocrinology and Metabolism. 1996;81:3455–3459
  6. Naidich MJ, Russell EJ. Current approaches to imaging of the sellar region and pituitary. Endocrinology and Metabolism Clinics of North America. 1999;28:45–79
  7. Molitch ME, Gilliam MP. Lymphocytic hypophysitis. Hormone Research. 2007;68(S5):145–150
  8. Doraiswamy PM, Potts JM, Axelson DA, et al. MR assessment of pituitary gland morphology in healthy volunteers: age-and gender-related differences. American Journal of Neuroradiology. 1992;13:1295–1299
  9. Elster AD, Chen MY, Williams DWD, et al. Pituitary gland: MR imaging of physiologic hypertrophy in adolescence. Radiology. 1999;174:681–685
  10. Tsunoda A, Okuda O, Sato K. MR height of the pituitary gland as a function of age and sex: especially physiological hypertrophy in adolescence and in climacterium. American Journal of Neuroradiology. 1997;18:551–554
  11. Chanson P, Daujat F, Young J, et al. Normal pituitary hypertrophy as a frequent cause of pituitary incidentalomas: a follow-up study. The Journal of Clinical Endocrinology and Metabolism. 2001;86:3009–3015
  12. Susman W. Pituitary adenoma. British Medical Journal. 1933;2:1215
  13. Close HG. The incidence of adenoma of the pituitary body in some types of new growth. Lancet. 1934;1:732–734
  14. Costello RT. Subclinical adenoma of the pituitary gland. The American Journal of Pathology. 1936;12:205–215
  15. Sommers SC. Pituitary cell relations to body states. Laboratory Investigation. 1959;8:588–621
  16. McCormick WF, Halmi NS. Absence of chromophobe adenomas from a large series of pituitary tumors. Archives of Pathology. 1971;92:231–238
  17. Haugen OA. Pituitary adenomas and the histology of the prostate in elderly men. Section A Acta Pathologica et Microbiologica Scandinavica. 1973;81:425–434
  18. Kovacs K, Ryan N, Horvath E. Pituitary adenomas in old age. Journal of Gerontology. 1980;35:16–22
  19. Landolt AM. Biology of pituitary microadenomas. In:  Faglia G,  Giovanelli MA,  MacLeod RM editor. Pituitary microadenomas. New York: Academic Press; 1980;p. 107–122
  20. Mosca L, Solcia E, Capella C, et al. Pituitary adenomas: surgical versus post-mortem findings today. In:  Faglia G,  Giovanelli MA,  MacLeod RM editor. Pituitary microadenomas. New York: Academic Press; 1980;p. 137–142
  21. Burrows GN, Wortzman G, Rewcastle NB, et al. Microadenomas of the pituitary and abnormal sellar tomograms in an unselected autopsy series. The New England Journal of Medicine. 1981;304:156–158
  22. Parent AD, Bebin J, Smith RR. Incidental pituitary adenomas. Journal of Neurosurgery. 1981;54:228–231
  23. Muhr C, Bergstrom K, Grimelius L, et al. A parallel study of the roentgen anatomy of the sella turcica and the histopathology of the pituitary gland in 205 autopsy specimens. Neuroradiology. 1981;21:55–65
  24. Max MB, Deck MDF, Rottenberg DA. Pituitary metastasis: incidence in cancer patients and clinical differentiation from pituitary adenoma. Neurology. 1981;31:998–1002
  25. Schwezinger G, Warzok R. Hyperplasien und adenome der hypophyse im unselektierten sektionsgut. Ergebnisse der Allgemeinen Pathologie. 1982;126:495–498
  26. Coulon G, Fellmann D, Arbez-Gindre F, et al. Les adenome hypophysaires latents. La Semaine des Hôpitaux de Paris. 1983;59:2747–2750
  27. Siqueira MG, Guembarovski AL. Subclinical pituitary microadenomas. Surgical Neurology. 1984;22:134–140
  28. Char G, Persaud V. Asymptomatic microadenomas of the pituitary gland in an unselected autopsy series. The West Indian Medical Journal. 1986;35:275–279
  29. Gorczyca W, Hardy J. Microadenomas of the human pituitary and their vacularization. Neurosurgery. 1988;22:1–6
  30. El-Hamid MWA, Joplin GF, Lewis PD. Incidentally found small pituitary adenomas may have no effect on fertility. Acta Endocrinologica. 1988;117:361–364
  31. Scheithauer BW, Kovacs KT, Randall RV, et al. Effects of estrogen on the human pituitary: a clinicopathologic study. Mayo Clinic Proceedings. 1989;64:1077–1084
  32. Kontogeorgos G, Kovacs K, Horvath E, et al. Multiple adenomas of the human pituitary. A retrospective autopsy study with clinical implications. Journal of Neurosurgery. 1991;74:243–247
  33. Marin F, Kovacs KT, Scheithauer BW, et al. The pituitary gland in patients with breast carcinoma: a histologic and immunocytochemical study of 125 cases. Mayo Clinic Proceedings. 1992;67:949–956
  34. Sano T, Kovacs KT, Scheithauer BW, et al. Aging and the human pituitary gland. Mayo Clinic Proceedings. 1993;68:971–977
  35. Teramoto A, Hirakawa K, Sanno N, et al. Incidental pituitary lesions in 1,000 unselected autopsy specimens. Radiology. 1994;193:161–164
  36. Camaris C, Balleine R, Little D. Microadenomas of the human pituitary. Pathology. 1995;27:8–11
  37. Tomita T, Gates E. Pituitary adenomas and granular cell tumors. Incidence, cell type, and location of tumor in 100 pituitary glands at autopsy. American Journal of Clinical Pathology. 1999;111:817–825
  38. Kurosaki M, Saeger W, Lüdecke DK. Pituitary tumors in the elderly. Pathology, Research and Practice. 2001;197:493–497
  39. Buurman H, Saeger W. Subclinical adenomas in postmortem pituitaries: classification and correlations to clinical data. European Journal of Endocrinology. 2006;154:753–758
  40. Rittierodt M, Hori A. Pre-morbid morphological conditions of the human pituitary. Neuropathology. 2007;27:43–48
  41. Furgal-Borzych A, Lis GJ, Litwin JA, et al. Increased incidence of pituitary microadenomas in suicide victims. Neuropsychology. 2007;55:163–166
  42. Kim J-H, Seo J-S, Lee B-W, et al. The characteristics of incidental pituitary microadenomas in 120 Korean forensic autopsy cases. Journal of Korean Medical Science. 2007;22(Suppl.):S61–S65
  43. Auer RN, Alakija P, Sutherland GR. Asymptomatic large pituitary adenomas discovered at autopsy. Surgical Neurology. 1996;46:28–31
  44. Wolpert SM, Molitch ME, Goldman JA, et al. Size, shape and appearance of the normal female pituitary gland. American Journal of Neuroradiology. 1984;5:263–267
  45. Peyster RG, Adler LP, Viscarello RR, et al. CT of the normal pituitary gland. Neuroradiology. 1986;28:161–165
  46. Chong BW, Kucharczyk AW, Singer W, et al. Pituitary gland MR: a comparative study of healthy volunteers and patients with microadenomas. American Journal of Neuroradiology. 1994;15:675–679
  47. Hall WA, Luciano MG, Doppman JL, et al. Pituitary magnetic resonance imaging in normal human volunteers: occult adenomas in the general population. Annals of Internal Medicine. 1994;120:817–820
  48. Nammour GM, Ybarra J, Naheedy MH, et al. Incidental pituitary macroadenoma: a population-based study. The American Journal of the Medical Sciences. 1997;314:287–291
  49. Yue NC, Longsteth WT, Elster AD, et al. Clinically serious abnormalities found incidentally at MR imaging of the brain: data from the Cardiovascular Health Study. Radiology. 1997;202:41–46
  50. Vernooij MW, Ikram A, Tanghe HL, et al. Incidental findings on brain MRI in the general population. The New England Journal of Medicine. 2007;357:1821–1828
  51. Chacko AG, Chandy MJ. Incidental pituitary macroadenomas. British Journal of Neurosurgery. 1992;6:233–236
  52. Donovan LE, Corenblum B. The natural history of the pituitary incidentaloma. Archives of Internal Medicine. 1995;153:181–183
  53. Reincke M, Allolio B, Saeger W, et al. The ‘incidentaloma’ of the pituitary gland. Is neurosurgery required?. The Journal of the American Medical Association. 1990;263:2772–2776
  54. Nishizawa S, Ohta S, Yokoyama T, et al. Therapeutic strategy for incidentally found pituitary tumors (‘pituitary incidentalomas’). Neurosurgery. 1998;43:1344–1348
  55. Feldkamp J, Santen R, Harms E, et al. Incidentally discovered pituitary lesions: high frequency of macroadenomas and hormone-secreting adenomas - results of a prospective study. Clinical Endocrinology. 1999;51:109–113
  56. Igarashi T, Saeki N, Yamaura A. Long-term magnetic resonance imaging follow-up of asymptomatic sellar tumors. Their natural history and surgical indications. Neurologia Medico-Chirurgica. 1999;39:592–599
  57. Sanno N, Oyama K, Tahara S, et al. A survey of pituitary incidentaloma in Japan. European Journal of Endocrinology. 2003;149:123–127
  58. Fainstein Day P, Guitelman M, Artese R, et al. Retrospective multicentric study of pituitary incidentalomas. Pituitary. 2004;7:145–148
  59. Arita K, Tominaga A, Sugiyama K, et al. Natural course of incidentally found nonfunctioning pituitary adenoma, with special reference to pituitary apoplexy during follow-up examination. Journal of Neurosurgery. 2006;104:884–891
  60. Karavitaki N, Collison K, Halliday J, et al. What is the natural history of nonoperated, nonfunctioning pituitary adenomas?. Clinical Endocrinology. 2007;67:938–943
  61. Dekkers OM, Hammer S, de Keizer RJW, et al. The natural course of non-functioning pituitary macroadenomas. European Journal of Endocrinology. 2007;156:217–224
  62. Angeli A, Terzolo M. Adrenal incidentaloma–a modern disease with old complications. The Journal of Clinical Endocrinology and Metabolism. 2002;87:4869–4871
  63. Bradley KJ, Wass JAH, Turner HE. Non-functioning pituitary adenomas with positive immunoreactivity for ACTH behave more aggressively than ACTH immunonegative tumours but do not recur more frequently. Clinical Endocrinology. 2003;58:59–64
  64. Baldeweg SE, Pollock JR, Powell M, et al. A spectrum of behaviour in silent corticotroph pituitary adenomas. British Journal of Neurosurgery. 2005;19:38–42
  65. Lopez JA, Kleinschmidt-DeMasters BK, Sze C-I, et al. Silent corticotroph adenomas: further clinical and pathological observations. Human Pathology. 2004;35:1137–1147
  66. King JT, Justice AC, Aron DC. Management of incidental pituitary microadenomas: a cost-effectiveness analysis. The Journal of Clinical Endocrinology and Metabolism. 1997;82:3625–3632
  67. Krikorian A, Aron D. Evaluation and management of pituitary incidentalomas – revisiting an acquaintance. Nature Clinical Practice. Endocrinology & Metabolism. 2006;2:138–145
  68. Chanson P, Young J. Pituitary incidentalomas. The Endocrinologist. 2003;13:124–135
  69. Casanueva FF, Molitch ME, Schlechte JA, et al. Guidelines of the Pituitary Society for the diagnosis and management of prolactinomas. Clinical Endocrinology. 2006;65:265–273
  70. Molitch ME, Reichlin S. Hypothalamic hyperprolactinemia: neuroendocrine regulation of prolactin secretion in patients with lesions of the hypothalamus and pituitary stalk. In:  MacLeod RM,  Thorner MO,  Scapagnini U editor. Prolactin. Basic and clinical correlates. Padova: Liviana Press; 1985;p. 709–719
  71. Arafah MB, Neki KE, Gold RS, et al. Dynamics of prolactin secretion in patients with hypopituitarism and pituitary macroadenomas. The Journal of Clinical Endocrinology and Metabolism. 1995;80:3507–3512
  72. Karavitaki N, Thanabalasingham G, Shore HC, et al. Do the limits of serum prolactin in disconnection hyperprolactinaemia need re-definition? A study of 226 patients with histologically verified non-functioning pituitary macroadenoma. Clinical Endocrinology. 2006;65:524–529
  73. St-Jean E, Blain F, Comtois R. High prolactin levels may be missed by immunoradiometric assay in patients with macroprolactinomas. Clinical Endocrinology. 1996;44:305–309
  74. Barkan AL, Chandler WF. Giant pituitary prolactinoma with falsely low serum prolactin: the pitfall of the ‘high-dose hook effect’: case report. Neurosurgery. 1998;42:913–915
  75. The Growth Hormone Research Society , The Pituitary Society Consensus Conference . Biochemical assessment and long-term monitoring in patients with acromegaly. The Journal of Clinical Endocrinology and Metabolism. 2004;89:3099–3012
  76. Arnaldi G, Angeli A, Atkinson AB, et al. Diagnosis and complications of Cushing's syndrome: a consensus statement. The Journal of Clinical Endocrinology and Metabolism. 2003;88:5593–5602
  77. Findling JW, Raff H. Cushing's syndrome: important issues in diagnosis and management. The Journal of Clinical Endocrinology and Metabolism. 2006;91:3746–3753
  78. Carroll T, Raff H, Findling JW. Late-night salivary cortisol measurement in the diagnosis of Cushing's syndrome. Nature Clinical Practice. Endocrinology & Metabolism. 2008;4:344–350
  79. Yuen KCJ, Cook DM, Sahasranam P, et al. Prevalence of GH and other anterior pituitary hormone deficiencies in adults with nonsecreting pituitary microadenomas and normal serum IGF-1 levels. Clinical Endocrinology. 2008;69:292–298
  80. Dekkers OM, Pereira AM, Romijn JA. Treatment and follow-up of clinically nonfunctioning pituitary macroadenomas. The Journal of Clinical Endocrinology and Metabolism. 2008;93:3717–3726
  81. Molitch ME. Nonfunctioning pituitary tumors and pituitary incidentalomas. Endocrinology and Metabolism Clinics of North America. 2008;37:151–171
  82. Arafah AM. Reversible hypopituitarism in patients with large nonfunctioning pituitary adenomas. The Journal of Clinical Endocrinology and Metabolism. 1986;62:1173–1179
  83. Daly AF, Burlacu MC, Livadariu E, et al. The epidemiology and management of pituitary incidentalomas. Hormone Research. 2007;68(suppl. 5):195–198
  84. Honegger J, Zimmermann S, Psaras T, et al. Growth modeling of non-functioning pituitary adenomas in patients referred for surgery. European Journal of Endocrinology. 2008;158:287–294

PII: S1521-690X(09)00048-7

doi: 10.1016/j.beem.2009.05.001

Best Practice & Research Clinical Endocrinology & Metabolism
Volume 23, Issue 5 , Pages 667-675 , October 2009

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