Abstract
Silent corticotroph adenomas (SCAs) are a subtype of non-functioning pituitary adenomas (NFPA) demonstrating positive immunoreactivity for ACTH, but without clinical or biochemical features of hypercortisolism. A number of mechanisms have been proposed to explain the “silence” of these tumors. SCAs typically present as macroadenomas, with symptoms related to local mass effect as a result of extension outside the pituitary fossa. Recognition of SCAs is important because there may be a degree of dysregulation of the pituitary adrenal axis in some patients, necessitating a more prolonged course of peri-operative steroids, as is the case for patients with Cushing’s disease. Furthermore, when these tumors recur, they demonstrate a more aggressive phenotype, often with multiple recurrences refractory to standard therapies. It is, therefore, imperative that closer surveillance is instigated following recurrence. Adjuvant radiotherapy following pituitary surgery appears to be as effective at reducing recurrence of SCAs as it is for other NFPAs. The benefit of pharmacological therapies for SCAs has yet to be elucidated.
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Kaushal, K., Shalet, S.M. (2011). Silent Corticotroph Adenomas. In: Swearingen, B., Biller, B. (eds) Cushing's Disease. Endocrine Updates, vol 31. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-0011-0_15
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DOI: https://doi.org/10.1007/978-1-4614-0011-0_15
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