Management of clinically non-functioning pituitary adenoma

Philippe Chanson (1, 2) , Gérald Raverot (3, 4) , Frederic Castinetti (5) , Christine Cortet-Rudelli (6) , Françoise Galland (7) , Sylvie Salenave (1)

1 Service d'endocrinologie
2 Récepteurs stéroïdiens : physiopathologie endocrinienne et métabolique
3 GHE - Groupement Hospitalier Lyon-Est
4 CRNL - Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
5 CRN2M - Centre de recherche en neurobiologie - neurophysiologie de Marseille
6 LILLE - Endocrino - Service Endocrinologie, diabétologie, maladies métaboliques et nutrition
7 Service d'endocrinologie diabétologie et nutrition [Rennes]

Clinically NFPA is currently the preferred term for designing all the pituitary adenomas which are not hormonally active (in other words, not associated with clinical syndromes such as amenorrhea-galactorrhea in the context of prolactinomas, acromegaly, Cushing's disease or hyperthyroidism secondary to TSH-secreting adenomas). They account for 15-30% of pituitary adenomas. Diagnosis is usually made either in the context of mass effect due to a macroadenoma or, increasingly, fortuitously during imaging performed for some unrelated purpose; the latter case is known as pituitary incidentaloma. Surgery is indisputably indicated in case of tumoral syndrome, but other aspects of NFPA (hormonal work-up, follow-up, and especially postoperative follow-up, management of remnant or recurrence, the special case of incidentaloma, or apoplexy) remain controversial. The French Endocrinology Society (SFE) therefore set up an expert working group of endocrinologists, neurosurgeons, ophthalmologists, neuroradiologists, pathologists and biologists to draw up guidelines, at the 2012 SFE Congress in Toulouse, France. The present article presents the guidelines suggested by this group of French-speaking experts

Mots clés: Adenoma; Adénomes gonadotropes; Adénomes hypophysaires non fonctionnels; Adénomes hypophysaires non sécrétants; Adénomes hypophysaires silencieux; Apoplexie hypophysaire; Chirurgie hypophysaire; Consensus; Gonadotroph adenoma; Humans; Incidentalomes hypophysaires; Non-functioning pituitary adenoma; Non-secreting pituitary adenoma; Pituitary Apoplexy; Pituitary incidentaloma; Pituitary Neoplasms; Pituitary surgery; Radiation therapy; Radiothérapie; Silent pituitary adenoma

Domaines: Sciences du Vivant [q-bio]

Philippe Chanson, Gérald Raverot, Frederic Castinetti, Christine Cortet-Rudelli, Françoise Galland, et al.. Management of clinically non-functioning pituitary adenoma. Annales d'Endocrinologie, 2015, 76 (3), pp.239--247. ⟨10.1016/j.ando.2015.04.002⟩. ⟨hal-01321415⟩