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Nonfunctioning pituitary adenoma
Background
Overview
Definition
A NFPA is a benign neoplasm of neuroendocrine origin that lacks clinical evidence of hormonal hypersecretion.
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Pathophysiology
The factors that induce neoplastic transformation of pituitary cells include various abnormalities in cell cycle regulation and genetic mutations (p16, PTTG1, PRKRA1, and AIP.
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Epidemiology
The prevalence and incidence of non-functioning pituitary adenoma are 7.0-41.3 per 100,000 population and 0.65-2.34 per 100,000 person-years, respectively.
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Disease course
The clinical manifestations of NFPAs are related to local mass effect (headache, visual field abnormalities, pituitary apoplexy, hypopituitarism, and hyperprolactinemia).
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Prognosis and risk of recurrence
A complete surgical resection of symptomatic NFPAs is achieved in 40-50% of patients undergoing surgery.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of nonfunctioning pituitary adenoma are prepared by our editorial team based on guidelines from the European Society of Endocrinology (ESE 2021), the American College of Radiology (ACR 2019), the Congress of Neurological Surgeons (CNS 2016), the French Endocrine Society (FES 2015), and the Endocrine Society (ES 2011).
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