Non-functioning pituitary adenoma: when and how to operate? What pathologic criteria for typing?

Abstract

After diagnosis of non-functioning pituitary adenoma and impact assessment (pituitary deficiency, visual field disorder), the question of management arises between surgery and surveillance. This part of the Consensus document aims to clarify the principal situations encountered in clinical practice (visual disorder, pituitary deficiency, asymptomatic adenoma, etc.), so as to determine which ones indicate surgery and which ones simple surveillance. Particular contexts are also dealt with (elderly patients, young women hoping for pregnancy, etc). The principal surgical techniques (microscopy, endoscopy, etc.) are also considered. Finally, in case of surgery, the principal pathologic criteria are specified (immunolabeling, proliferation markers, etc.).

Keywords: Adénome hypophysaire; Adénome hypophysaire silencieux; Anomalie du champ visuel; Déficit hypophysaire; Elderly subject; Grossesse; Ki67; Pituitary adenoma; Pituitary deficiency; Pregnancy; Silent pituitary adenoma; Sujet âgé; Visual field defect; p53.