The clinical characteristics of three subgroups of non-functioning pituitary adenomas

Adam Hull, Stephen D. Milhollin, John E. Vena, David V. LaBorde

College of Public Health, University of Georgia, Athens, USA.
School of Medicine, Emory University, Atlanta, USA.

DOI: 10.4236/wjns.2014.41009                

Abstract

Introduction: Despite the fact that non-functioning pituitary adenomas do not overproduce hormones, many will stain positive for a particular pituitary hormone, which can be used to differentiate these adenomas into subgroups. If these different sub-groups behave differently in terms of post surgical progression of disease (PSPD) rates or other clinical variables, then better treatment and prognosis could be predicted. Methods: This was a retrospective cohort study. Patients who have undergone surgery for removal of a non-functioning pituitary adenoma at Emory University Hospital served as the source for all data used in this study (n = 184). Data were collected from a database of electronic medical records (EMRs) for these patients in 2010 documenting clinical and demographic variables including treatment and PSPD. Results: Risk for PSPD did not differ by adenoma subtypes: follicle-stimulating hormone (FSH+), luteinizing hormone (LH+), or those that do not stain positive for any hormone (non-functioning, or NF?) (p = 0.971). There were two clinical characteristics statistically related to adenoma subtype: altered mental status and the anterior-posterior (AP) dimension of pre-operative adenomas. PSPD was related to several clinical characteristics, including gender, previous adenoma, post-operative residual, and follow-up time.

Keywords

Non-Functioning Pituitary Adenomas; Clinical Characteristics; Recurrence

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Alexander, J.M., et al. (1990) Clinically nonfunctioning pituitary tumors are monoclonal in origin. The Journal of Clinical Investigation, 86, 336-340. http://dx.doi.org/10.1172/JCI114705
[2]	Moreno, C.S., et al. (2005) Novel molecular signaling and classification of human clinically nonfunctional pituitary adenomas identified by gene expression profiling and proteomic analyses. Cancer Research, 65, 10214-10222. http://dx.doi.org/10.1158/0008-5472.CAN-05-0884
[3]	Ebersold, M.J., et al., (1986) Long-term results in transsphenoidal removal of nonfunctioning pituitary adenomas. Journal of Neurosurgery, 64, 713-719. http://dx.doi.org/10.3171/jns.1986.64.5.0713
[4]	Chun, M., G.B. Masko, and S. Hetelekidis (1988) Radiotherapy in the treatment of pituitary adenomas. International Journal of Radiation Oncology *Biology* Physics, 15, 305-309. http://dx.doi.org/10.1016/S0360-3016(98)90009-8
[5]	Grigsby, P.W., et al. (1988) Prognostic factors and results of radiotherapy alone in the management of pituitary adenomas. International Journal of Radiation Oncology *Biology* Physics, 15, 1103-1110. http://dx.doi.org/10.1016/0360-3016(88)90191-5
[6]	Comtois, R., et al. (1991) The clinical and endocrine outcome to trans-sphenoidal microsurgery of nonsecreting pituitary adenomas. Cancer, 68, 860-866. http://dx.doi.org/10.1002/1097-0142(19910815)68:4<860::AID-CNCR2820680431>3.0.CO;2-4
[7]	Chandler, W.F. and A.L. Barkan (2008) Treatment of pituitary tumors: A surgical perspective. Endocrinology and Metabolism Clinics of North America, 37, 51-66, viii. http://dx.doi.org/10.1016/j.ecl.2007.10.006
[8]	Boelaert, K. and N.J. Gittoes (2001) Radiotherapy for non-functioning pituitary adenomas. European Journal of Endocrinology, 144, 569-575. http://dx.doi.org/10.1530/eje.0.1440569
[9]	Park, P., et al. (2004) The role of radiation therapy after surgical resection of nonfunctional pituitary macroadenomas. Neurosurgery, 55, 100-106; discussion 106-107. http://dx.doi.org/10.1227/01.NEU.0000126885.71242.D7
[10]	Colao, A., et al. (2008) Medical therapy for clinically non-functioning pituitary adenomas. Endocrine-Related Cancer, 15, 905-915. http://dx.doi.org/10.1677/ERC-08-0181
[11]	Johnson, M.D., Woodburn, C.J. and Vance, M.L. (2003) Quality of life in patients with a pituitary adenoma. Pituitary, 6, 81-87. http://dx.doi.org/10.1023/B:PITU.0000004798.27230.ed
[12]	Dekkers, O.M., et al. (2006) Quality of life is decreased after treatment for nonfunctioning pituitary macroadenoma. The Journal of Clinical Endocrinology and Metabolism, 91, 3364-3369. http://dx.doi.org/10.1210/jc.2006-0003
[13]	Dekkers, O.M., et al. (2007) The natural course of nonfunctioning pituitary macroadenomas. European Journal of Endocrinology, 156, 217-224. http://dx.doi.org/10.1530/eje.1.02334
[14]	Dekkers, O.M., et al. (2006) Observation alone after transsphenoidal surgery for nonfunctioning pituitary macroadenoma. The Journal of Clinical Endocrinology and Metabolism, 91, 1796-1801. http://dx.doi.org/10.1210/jc.2005-2552