Background. Nonfunctioning pituitary adenomas (NFPAs) are the most common benign lesions of the pituitary gland. Objective. To describe our experience with the management of NFPA. Study Design and Methods. Retrospective evaluation of NFPA patients managed between 2008 and 2013. We analyzed data regarding clinical presentation, imaging diagnosis, hormonal status, surgical, radiotherapeutic, and pharmacological treatment, and outcome. Results. 485 patients (54% men, mean age 53 ± 14 years) were followed for a median of 6.5 years. Visual field abnormalities and headaches were the presenting complaints in 87% and 66%, respectively. The diagnosis of NFPA was made incidentally in 6.2%, and 8% presented with clinical evidence of apoplexy. All patients harbored macroadenomas, with a median volume of 10306 mm3; 57.9% had supra- or parasellar invasion and 19.6% had tumors larger than 4 cm. Central hypothyroidism, hypogonadism, and hypocortisolism were present in 47.2%, 35.9%, and 27.4%, respectively. Surgical resection was performed at least once in 85.7%. Tumor persistence was documented in 27% and was related to the size and invasiveness of the lesion. In selected cases, radiotherapy proved to be effective in controlling or preventing tumor growth. Conclusions. The diagnosis and treatment of NFPA are complex and require a multidisciplinary approach.
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机译：背景。无功能的垂体腺瘤（NFPAs）是垂体最常见的良性病变。目的。描述我们在NFPA管理方面的经验。研究设计和方法。对2008年至2013年间管理的NFPA患者进行回顾性评估。我们分析了有关临床表现，影像学诊断，荷尔蒙状况，手术，放射治疗和药物治疗以及结局的数据。结果。随访485例患者（54％的男性，平均年龄53±14岁），中位数为6.5年。视野异常和头痛分别为87％和66％。偶然发现NFPA的诊断率为6.2％，其中有8％的临床表现为中风。所有患者均具有大腺瘤，中位体积为10306 mm 3 ； 57.9％的肿瘤侵犯了鞘上或旁，而19.6％的肿瘤大于4cm。中枢甲状腺功能减退症，性腺机能减退和皮质醇减少症分别占47.2％，35.9％和27.4％。手术切除率至少为85.7％。记录的肿瘤持久性占27％，与病变的大小和侵袭性有关。在某些情况下，放疗被证明可有效控制或预防肿瘤的生长。结论。 NFPA的诊断和治疗很复杂，需要多学科的方法。
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