Introduction: Available data on pituitary incidentalomas mostly derive from small-scale studies, with heterogeneous inclusion criteria and limited follow-up. No paper has focused specifically on clinically nonfunctioning pituitary in-cidentalomas (CNFPIs). Objective: To describe the charac-teristics and the natural history of patients diagnosed with CNFPIs. Methods: Retrospective multicenter cohort study evaluating hormonal, imaging, and visual field characteristics at diagnosis and during follow-up of CNFPIs investigated in 2 Pituitary Centers. Results: Three hundred and seventy-one patients were included (50.9% microadenomas, 35.6% males). Men were older and more likely to have a macroadenoma (p < 0.01). Totally, 23.7% of patients presented secondary hormonal deficits (SHDs), related to tumor size (higher in macroadenomas; p < 0.001) and age (higher in older patients; p < 0.001). Hypogonadism was the most frequent SHD (15.6%). Two hundred and ninety-six patients had follow-up data, 29.1% required surgery after first evaluation, and 97 had at least 3 years of follow-up. In total, 15.3% adenomas grew (more macroadenomas), but only in microadenomas patients with longer follow-up showed a higher growth trend. Totally, 5.2% of patients developed new SHDs (micro- vs. macroadenomas p = 1.000), and in 60% of them this was not associated with an increase in tumor size. Thirteen additional patients required surgery during follow-up (1 microadenoma at diagnosis). Conclusions: Macroadenomas and age are risk factors for SHD in CNFPIs, which occur at diagnosis in a quarter of patients. During follow-up, macroadenomas tend to grow more often, but microadenomas display higher growth trend as follow-up increases. Deterioration of pituitary function is not always related to adenoma growth.

Clinically non-functioning pituitary incidentalomas: characteristics and natural history / Tresoldi, A.; Carosi, G.; Betella, N.; Del Sindaco, G.; Indirli, R.; Ferrante, E.; Sala, E.; Giavoli, C.; Morenghi, E.; Locatelli, M.; Milani, D.; Mazziotti, G.; Spada, A.; Arosio, M.; Mantovani, G.; Lania, A. G. A.. - In: NEUROENDOCRINOLOGY. - ISSN 0028-3835. - (2020). [10.1159/000503256]

Clinically non-functioning pituitary incidentalomas: characteristics and natural history

Carosi G.;
2020

Abstract

Introduction: Available data on pituitary incidentalomas mostly derive from small-scale studies, with heterogeneous inclusion criteria and limited follow-up. No paper has focused specifically on clinically nonfunctioning pituitary in-cidentalomas (CNFPIs). Objective: To describe the charac-teristics and the natural history of patients diagnosed with CNFPIs. Methods: Retrospective multicenter cohort study evaluating hormonal, imaging, and visual field characteristics at diagnosis and during follow-up of CNFPIs investigated in 2 Pituitary Centers. Results: Three hundred and seventy-one patients were included (50.9% microadenomas, 35.6% males). Men were older and more likely to have a macroadenoma (p < 0.01). Totally, 23.7% of patients presented secondary hormonal deficits (SHDs), related to tumor size (higher in macroadenomas; p < 0.001) and age (higher in older patients; p < 0.001). Hypogonadism was the most frequent SHD (15.6%). Two hundred and ninety-six patients had follow-up data, 29.1% required surgery after first evaluation, and 97 had at least 3 years of follow-up. In total, 15.3% adenomas grew (more macroadenomas), but only in microadenomas patients with longer follow-up showed a higher growth trend. Totally, 5.2% of patients developed new SHDs (micro- vs. macroadenomas p = 1.000), and in 60% of them this was not associated with an increase in tumor size. Thirteen additional patients required surgery during follow-up (1 microadenoma at diagnosis). Conclusions: Macroadenomas and age are risk factors for SHD in CNFPIs, which occur at diagnosis in a quarter of patients. During follow-up, macroadenomas tend to grow more often, but microadenomas display higher growth trend as follow-up increases. Deterioration of pituitary function is not always related to adenoma growth.
2020
Pituitary incidentaloma; NFPA; Hypopituitarism
01 Pubblicazione su rivista::01a Articolo in rivista
Clinically non-functioning pituitary incidentalomas: characteristics and natural history / Tresoldi, A.; Carosi, G.; Betella, N.; Del Sindaco, G.; Indirli, R.; Ferrante, E.; Sala, E.; Giavoli, C.; Morenghi, E.; Locatelli, M.; Milani, D.; Mazziotti, G.; Spada, A.; Arosio, M.; Mantovani, G.; Lania, A. G. A.. - In: NEUROENDOCRINOLOGY. - ISSN 0028-3835. - (2020). [10.1159/000503256]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1493682
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