Description
Non-functioning pituitary adenomas (NFPAs) comprise ~30% of pituitary adenomas. Although clinically non-functioning, they frequently produce glycoprotein hormone subunits, as evidenced by mRNA, immunostaining and secretion in vitro. Up to 30% of tumours are associated with elevated serum glycoprotein hormone a-subunit levels. Due to the absence of biologically active hormone secretion, these tumours frequently present as large macroadenomas, often with visual field defects. Patients usually have varying degrees of hypopituitarism. Associated hyperprolactinaemia from stalk compression sometimes complicates the diagnosis. Treatment of choice is surgery. Invasive tumours or large amounts of residual tumour following surgery should be treated by radiotherapy. Otherwise, radiotherapy can be withheld unless there is evidence of recurrence on MRI.
