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Non-Functioning Pituitary Tumours

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Pituitary Disease

Part of the book series: Endocrine Updates ((ENDO,volume 18))

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Abstract

Sporadic pituitary tumours account for about 10% of all intracranial tumours (1). These are generally benign tumours although about 50% show histological evidence of invasion of the capsule or into surrounding structures (2). Between 0.1-0.2% of adenomas develop into frank carcinomas defined by metastatic spread, usually within the central nervous system but occasionally more distally (3,4). The peak incidence is between ages 30-60 years, being somewhat earlier in women (20-45 years) than in men (35-60 years) due to the greater frequency of prolactinomas in young women (5,6). Pituitary tumours are rare below the age of 20 years when the vast majority (86%) are prolactinomas, or corticotrophinomas (10%) (5).

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References

  1. Gold E.B. 1981 Epidemiology ofpituitary adenomas. Epidemiology Reviews 3: 163–183.

    CAS  Google Scholar 

  2. Sautner D., Saeger W. 1991 Invasiveness of pituitary adenomas. Pathology Research Practice 187:632–63

    Article  CAS  Google Scholar 

  3. Doniach I. 1997 Pituitary carcinoma. In: Sheaves R., Jenkins P.J., Wass J.A.H., eds. Clinical Endocrine Oncology. Oxford: Blackwell 225–227

    Google Scholar 

  4. Pernicone P.J., Scheithauer B.W., Sebo T.J., Kovacs K.T., Horvath E., Young W.F., Lloyd R.V., Davis D.H., Guthrie B.H., Schoene W.C. 1997 Pituitary carcinoma: a clinicopathological study of 15 cases. Cancer 79:804–812

    Article  PubMed  CAS  Google Scholar 

  5. Falgia G. 1993 Epidemiology and pathogenesis of pituitary adenomas. Acta Endocrinologica 129 (suppl) 1–5

    Google Scholar 

  6. Mindermann T., Wilson C.B. 1994 Age-related and gender-related occurrence of pituitary adenomas. Clinical Endocrinology 41:359–364

    Article  PubMed  CAS  Google Scholar 

  7. Thakker R.V. 1998 Multiple Endocrine Neoplasia - Syndromes of the Twentieth Century. Journal Clinical Endocrinology Metabolism 83:2617–2620

    Article  CAS  Google Scholar 

  8. Agarwal S.K., Guru S.C., Heppner C., Erdos M.R., Collins R.M., Park S.Y., Saggar S., Chandrasekharappa S.C., Collins F.C., Speigel A.M., Marx S.J., Burns A.L. 1999 Menin interacts with the AP1 transcription factor Jun D and represses Jun D - activated transcription. Cell 96:143–152

    Article  PubMed  CAS  Google Scholar 

  9. Corbetta S., Pizzocaro A., Peracchi M., Beck-Peccoz P., Faglia G., Spada A. 1997. Multiple endocrine neoplasia type 1 in patients with recognised pituitary tumours of different types. Clinical Endocrinology 47:507–512

    Article  PubMed  CAS  Google Scholar 

  10. Farell W.E., Clayton R.N. 1999 Tumour suppressor genes in pituitary tumour formation. in Ballieres Clinical Endocrinology Metabolism 13 (3) Ed JRE Davis

    Google Scholar 

  11. Benlian P., Giraud S., Lahlou N., Roger M., Blin C., Holler C., Lenoir G., Sallandre J., Calender A., Turpin G. 1995 Familial acromegaly: a specific clinical entity - further evidence from the genetic study of a three generation family. European Journal of Endocrinology 133:45–456

    Article  Google Scholar 

  12. Teh B.T., Kytola S., Farnebo F., Bergman L., Wong F.K., Weber G. et al 1998 Mutation analysis of the MEN-1 gene in multiple endocrine neoplasia typel, familial acromegaly, and familial isolated hyperparathyroidism. Journal Clinical Endocrinology Metabolism 83:2621–2626

    Article  CAS  Google Scholar 

  13. Asa S.L., Horvath E., Kovacs K. 1993 Pituitary neoplasms: an overview of the clinical presentation, diagnosis, treatment, and pathology. In Endocrine Tumours, Blackwells Oxford Ed. Mazzaferri E.L., and Sarmann N.A. pp77–112

    Google Scholar 

  14. Leavens ME, Khouri K, Samaan NA, Schultz PN 1993. Non-adenomatons intrasellar and parasellar neoplasms in Endocrine Tumours Ed Mazzaferri EL & Samaan NA, Blackwells Oxford pp 179–196

    Google Scholar 

  15. Snyder P J. 1993. Gonadotroph adenomas. In Endocrine Tumours. Ed Mazzaferri EL & Samaan NA, Blackwells Oxford pp 152–166.

    Google Scholar 

  16. Snyder P J 1993 Clinically nonfunctioning pituitary adenomas. Endocrinology Metabolism Clinics North America. 22: 163–175.

    CAS  Google Scholar 

  17. Katznelson L, Alexander J M, Klibanski A, 1993. Clinically non-functioning pituitary adenomas. J.Clin.Endo.Metab. 76:1089–1094.

    Article  CAS  Google Scholar 

  18. Jameson J L, Klibanski A, Black PM other authors 1987. Glycoprotein hormone genes are expressed in clinically non-functioning pituitary adenomas. J.Clin.Invest. 80: 1472–1478

    Article  PubMed  CAS  Google Scholar 

  19. Asa SL, Ezzat S. 1998. The cytogenesis and pathogenesis of pituitary adenomas. Endocrine Reviewers 19: 798–827.

    Article  CAS  Google Scholar 

  20. Faglia G, Ambrosi B 1997. Non-functioning pituitary adenomas. In clinical Endocrine Oncology Ed.Sheaves, Jenkins & Wass. Blackwells, Oxford pp 213–217.

    Google Scholar 

  21. Ambrosi B, Colombo P, Bochicchio D, Bassetti M, Masini B, Faglia G 1992. The Silent corticotrophinoma: is clinical diagnosis possible? J. Endocrinol Invest. 15:443–452.

    PubMed  CAS  Google Scholar 

  22. Ikeda H, Yoshimoto T, Kovacs K, Horvath E 1995 Cushing ’s disease due to fmale gonadotroph adenoma of the pituitary. Clin. Endocrinol. 43:383–386

    CAS  Google Scholar 

  23. Clayton R.N, Pfeifer M, Atkinson AB, Belchetz P, Wass JAH, Kyrodinou E, Vanderpump M, Simpson D, Bicknell J, Farrell WE 2000. Different patterns of allelic loss (LOH) in recurrent human pituitary tumours provide evidence for multiclonal origins Clin. Cancer Research (in press).

    Google Scholar 

  24. Alexander JM, Biller BMK, Bikkal H, Zervas NT, Arnold A, Klibanski A. 1990. Clinically non-functional pituitary tumours are monoclonal in origin. J.Clin.Invest. 86:336–340.

    Article  PubMed  CAS  Google Scholar 

  25. Bates AS, Farrell WE, Bicknell EJ, McNicol AM Talbot AJ, Broome JC, Perrett CW, Thakker RV, Clayton RN. 1997. Allelic delection in pituitary adenomas relects aggressive biological activity and has potential value as a prognostic marker. J.Clin.Endocrinol.Metab. 82:818–824.

    Article  PubMed  CAS  Google Scholar 

  26. Molitch M.E. 1997 Pituitary incidentalomas. Endocrinology and Metabolism Clinics of North America 26: 725–740

    Article  PubMed  CAS  Google Scholar 

  27. Burrow G.N., Wortzman G., Rewcastle N.B., Holgate R.C., Kovacs K. 1981 Microadenomas of the pituitary and abnormal sellar tomograms in an unselected autopsy series. New England Journal of Medicine 304: 156–158

    Article  PubMed  CAS  Google Scholar 

  28. Chong B.W., Kucharczyk A.W., Singer W., George S. 1994 Pituitary MR: a comparative study of healthy volunteers and patients with microadenomas. American Journal of Neuroradiology 15:675–679

    PubMed  CAS  Google Scholar 

  29. Hall W.A., Luciano M.G., Doppman J.L., Patronas N.J., Oldfield E.H. 1994 Pituitary magnetic resonance imaging in normal human volunteers: occult adenomas in the general population. Annals of Internal Medicine 120: 817–820

    PubMed  CAS  Google Scholar 

  30. Arafah BM, Prunty D, Ybarra J, Hlavia ML, Selman WA 2000. The dominant role of increased intrasellar pressure in the pathogenesis of hypopituitarism, hyperprolactimaemia, and headaches in patients with pituitary adenomas. J.Clin.Endo Metab. 85:1789–1793.

    Article  CAS  Google Scholar 

  31. Stewart, PM, Maheshwaran S, Griffith J, Li J, Sheppard MC, Olliff J, Franklyn JA, 1993 Pituitary imaging is essential for women with moderate hyperprolactimaemia. Brit. Med. J. 306:507–508.

    Article  PubMed  CAS  Google Scholar 

  32. Toogood AA, Beardwell CG, Shalet SM 1994. The severity of growth hormone deficiency in adults with pituitary disease is related to the degree of hypopituitarism. Clin. Endo. 41:511–516.

    Article  CAS  Google Scholar 

  33. Ahmed S; Elsheikh M, Page RCL, Adams CBT, Wass JAH 1999. Outcome of trans-spheniodal surgery for acromegaly and its relationship to surgical experience. Clin. Endo, 50: 561–567.

    Article  CAS  Google Scholar 

  34. Turner HE, Adams BT, Wass JAH 1999 Trans-sphenoidal surgery for microprolactinoma an acceptable alternative to dopamine agonists. Eur. J Endocrinology. 140:43–47.

    Article  CAS  Google Scholar 

  35. Clayton, R.N. 1999. How many surgeons to operate on acromegalics patients? Clin. Endo, 50: 557–559.

    Article  CAS  Google Scholar 

  36. Arafah BM 1986. Reversible hypopituitarism in patients with large nonfunctioning pituitary adenomas. J.Clin.Endocrinol.Metab. 62:1173–1179.

    Article  PubMed  CAS  Google Scholar 

  37. Arafah BM, Kailani SH, Nekl KE, Gold RS, Selman WR 1994. Immediate recovery of pituitary function after trans-spheniodal resection of pituitary macroadenomas. J.Clin.Endocrinol.Metab 79:348–354.

    Article  PubMed  CAS  Google Scholar 

  38. Ciric I, Mikheal M, Stafford T, Lawson L, Garces R, 1983. Trans-sphenoidal microsurgery of pituitary macroadenomas with long-term follow-up results. J.Neurosurg. 59: 395–340

    Article  PubMed  CAS  Google Scholar 

  39. Ebersold MJ, Quast LM, Laws ER, Scheithauer B, Randall RV, 1986. Longterm results in transspheniodal removal of non-functioning pituitary adenomas. J.Neurosurg 64:713–719.

    Article  PubMed  CAS  Google Scholar 

  40. Comtois R, Beauregard H, Somma M, Serri O, Jilwan-Aris N, Hardy J. 1991. The clinical and endocrine outcome to trans-sphenoidal microsurgery of non-secreting pituitary adenomas. Cancer 68: 860–866.

    Article  PubMed  CAS  Google Scholar 

  41. Sassolas G, Trouillas J, Treluyer C, Perrin G 1993. Management of nonfunctioning pituitary adenomas Acta. Endocrinologica 129:21–26

    Google Scholar 

  42. Gittoes NJL, Bates AS, Tse W, Bullivant B, Sheppard MC, Clayton RN, Stewart PM, 1998. Radiotherapy for nonfunctioning pituitary tumours. Clin. Endocrinol 48: 331–337.

    Article  CAS  Google Scholar 

  43. Brada M, Rajan B, Traish D, Ashley S, Holmes-Sellors PJ, Nussey S, Littley D 1993. The long-term efficacy of conservative surgery and radiotherapy in control of pituitary adenomas. Clin. Endocrinol 38:571–578.

    CAS  Google Scholar 

  44. Bradley KM, Adams CBT, Potter CPS,Wheeler DW,Anslow PJ, Burke CW 1994. An audit of selected patients with non-functioning pituitary adenomas treated by transspheniodal surgery without irradiation. Clin.Endocrinol. 41: 655–659.

    Article  CAS  Google Scholar 

  45. Turner HE, Stratton IM, Byrne JV, Adams CBT, Wass JAH 1999. Audit of selected patients with non-functioning pituitary adenomas treated without irradiation - a follow-up study. Clin.Endocrinol. 51: 281–284.

    Article  CAS  Google Scholar 

  46. Turner HE & Wass JAH 1999. Are markers of proliferation valuable in the histological assessment of pituitary tumours? Pituitary 1: 147–151.

    Article  PubMed  CAS  Google Scholar 

  47. Brada H, Ford D, Ashley S, Bliss JM, Crowley S, Mason M, Rajan B, Traish D 1992. Risk of second brain tumour after conservative surgery and radiotherapy for pituitary adenomas. Brit.Med.J. 304:1343–1346.

    Article  PubMed  CAS  Google Scholar 

  48. Tsang RW, Brierley JD, Panzarella T, Gospodarowicz MK, Sutcliffe SB, Simpson WJ. 1994 Radiation therapy for pituitary adenoma: treatment outcome and prognostic factors. Int. J. Rad. Oncol.Biol.Physics 30:557–565

    Article  CAS  Google Scholar 

  49. Miller JL, Spry NA, Lamb DS, Delahunt J. 1991 Blindness in patients after external beam irradiation for pituitary adenomas: two cases occurring after small daily fractionated doses. Clinical Oncology 3: 291–294

    Article  Google Scholar 

  50. Gratton-Smith P, Morris J 1992. Delayed radiation necrosis of the central nervous system in patients irradiated for pituitary tumours. J Neurol.Neurosurg. & Psychiatry 55: 949–955.

    Article  Google Scholar 

  51. Bulow B, Hagmar L, Orbaek P, Osterberg K, Erfurth EM, 2000.High incidence of psychiatric illness and increased prevalence of cognitive and psychosocial dysfunction in hypopituitary women without GH substitution. Proceedings of the American Endocrine Society. Toronto June 21–24 2000.Abs.1 21–72.

    Google Scholar 

  52. Jones A 1991. Radiation oncogenesis in relation to treatment of pituitary tumours. Clin.Endocrinol 35: 379–397.

    Article  CAS  Google Scholar 

  53. Bliss P, Kerr GR, Gregor A 1994. Incidence of second brain tumour after pituitary irradiation in Edinburgh 1962–1990. Clinical Oncology 6: 361–363.

    Article  PubMed  CAS  Google Scholar 

  54. Peace KA, Orme SM, Padayatty SJ, Godfrey HPD, Belchetz PE 1998. Cognitive dysfunction in patients with pituitary tumour who have been treated with transfrontal or transsphenoided surgery or medication. Clin.Endocrinol. 49: 391–396.

    Article  CAS  Google Scholar 

  55. Sheline G 1987. Pituitary tumours: radiation therapy in Clinical Endocrinology (eds Beardwell C & Robertson G) pp 106–139. Butterworths London.

    Google Scholar 

  56. Snyder P, Fowble B, Schatz N, Sarino P, Gennarelli T 1986. Hypopituitarism following radiation therapy of pituitary adenomas. Am. Journal of Medicine 81:457–462.

    Article  CAS  Google Scholar 

  57. Littley MD, Shalet SM, Beardwell CG, Ahmed SR, Applegate G, Sutton ML. 1989. Hypopituitarism following external radiotherapy for pituitary tumours in adults. Quart. Journal of Medicine 70: 145–160.

    CAS  Google Scholar 

  58. Rosen T, Bengtsson B-A. 1990 Premature mortality due to cardiovascular disease in hypopituitarism. Lancet 336:285–288

    Article  PubMed  CAS  Google Scholar 

  59. Bates AS, van’t Hoff W, Jones PJ, Clayton RN. 1996 The effect of hypopituitarism on life expectancy. J. Clin.Endocrinol.Metab. 81:1169–1172

    Article  PubMed  CAS  Google Scholar 

  60. Bates AS, Bullivant B, Sheppard MC, Stewart PM. 1999 Life expectancy following surgery for pituitary tumours. Clin. Endocrinol. 50:315–319

    CAS  Google Scholar 

  61. Tomlinson JW, Holden N, Hills R, Wheatley K, Clayton RN, Bates AS, Sheppard MC, Stewart PM. 2000 Premature mortality in 1014 patients with hypopituitarism. Journal of Endocrinology (suppl) 164:OC 41

    Google Scholar 

  62. Bulow B, Hagmar L, Mikoczy Z, Nordstrom C-H, Erfurth EM. 1997 Increased cerebrovascular mortality in patients with hypopituitarism. Clin. Endocrinol. 46:75–81

    CAS  Google Scholar 

  63. Bulow B, Hagmar L, Eskilsson J, Erfurth EM. 2000 Hypopituitary females have a high incidence of cardiovascular morbidity and an increased prevalence of cardiovascular risk factors. J. Clin.Endocrinol.Metab. 85:574–584

    Article  PubMed  CAS  Google Scholar 

  64. Beshyah SA, Johnston DG. 1999 Cardiovascular disease and risk factors in adults with hypopituitarism. Clin. Endocrinol. 50:1–15

    CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, School of Postgraduate Medicine, Keele University, Stoke on Trent, Staffordshire, ST4 7QB

    R. N. Clayton

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  1. University of Birmingham, Birmingham, USA

    Michael C. Sheppard  & Paul M. Stewart  & 

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Clayton, R.N. (2002). Non-Functioning Pituitary Tumours. In: Sheppard, M.C., Stewart, P.M. (eds) Pituitary Disease. Endocrine Updates, vol 18. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1115-1_4

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  • DOI: https://doi.org/10.1007/978-1-4615-1115-1_4

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