Natural history of non-functioning pituitary microadenomas: results from the UK non-functioning pituitary adenoma consortium

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dc.contributor.authorHamblin, R
dc.contributor.authorFountas, A
dc.contributor.authorLithgow, K
dc.contributor.authorLoughrey, PB
dc.contributor.authorBonanos, E
dc.contributor.authorShinwari, SK
dc.contributor.authorMitchell, K
dc.contributor.authorShah, S
dc.contributor.authorGrixti, L
dc.contributor.authorMatheou, M
dc.contributor.authorIsand, K
dc.contributor.authorMcLaren, DS
dc.contributor.authorSurya, A
dc.contributor.authorUllah, HZ
dc.contributor.authorKlaucane, K
dc.contributor.authorJayasuriya, A
dc.contributor.authorBhatti, S
dc.contributor.authorMavilakandy, A
dc.contributor.authorAshan, M
dc.contributor.authorMathew, S
dc.contributor.authorHussein, Z
dc.contributor.authorJansz, T
dc.contributor.authorWunna, W
dc.contributor.authorMacFarlane, J
dc.contributor.authorAyuk, J
dc.contributor.authorAbraham, P
dc.contributor.authorDrake, WM
dc.contributor.authorGurnell, M
dc.contributor.authorBrooke, A
dc.contributor.authorBaldeweg, SE
dc.contributor.authorSam, AH
dc.contributor.authorMartin, N
dc.contributor.authorHigham, C
dc.contributor.authorReddy, N
dc.contributor.authorLevy, MJ
dc.contributor.authorAhluwalia, R
dc.contributor.authorNewell-Price, J
dc.contributor.authorVamvakopoulos, J
dc.contributor.authorKrishnan, A
dc.contributor.authorLansdown, A
dc.contributor.authorMurray, RD
dc.contributor.authorPal, A
dc.contributor.authorBradley, K
dc.contributor.authorMamoojee, Y
dc.contributor.authorPurewal, T
dc.contributor.authorPanicker, J
dc.contributor.authorFreel, EM
dc.contributor.authorHasan, F
dc.contributor.authorKumar, M
dc.contributor.authorJose, B
dc.contributor.authorHunter, SJ
dc.contributor.authorKaravitaki, N
dc.date.accessioned2024-04-09T13:42:39Z
dc.date.available2024-04-09T13:42:39Z
dc.date.issued2023-07
dc.description.abstractObjective: The optimal approach to the surveillance of non-functioning pituitary microadenomas (micro-NFPAs) is not clearly established. Our aim was to generate evidence on the natural history of micro-NFPAs to support patient care. Design: Multi-centre, retrospective, cohort study involving 23 endocrine departments (UK NFPA consortium). Methods: Clinical, imaging, and hormonal data of micro-NFPA cases between January, 1, 2008 and December, 21, 2021 were analysed. Results: Data for 459 patients were retrieved [median age at detection 44 years (IQR 31-57)-152 males/307 females]. Four hundred and nineteen patients had more than two magnetic resonance imagings (MRIs) [median imaging monitoring 3.5 years (IQR 1.71-6.1)]. One case developed apoplexy. Cumulative probability of micro-NFPA growth was 7.8% (95% CI, 4.9%-8.1%) and 14.5% (95% CI, 10.2%-18.8%) at 3 and 5 years, respectively, and of reduction 14.1% (95% CI, 10.4%-17.8%) and 21.3% (95% CI, 16.4%-26.2%) at 3 and 5 years, respectively. Median tumour enlargement was 2 mm (IQR 1-3) and 49% of micro-NFPAs that grew became macroadenomas (nearly all >5 mm at detection). Eight (1.9%) patients received surgery (only one had visual compromise with surgery required >3 years after micro-NFPA detection). Sex, age, and size at baseline were not predictors of enlargement/reduction. At the time of detection, 7.2%, 1.7%, and 1.5% patients had secondary hypogonadism, hypothyroidism, and hypoadrenalism, respectively. Two (0.6%) developed hypopituitarism during follow-up (after progression to macroadenoma). Conclusions: Probability of micro-NFPA growth is low, and the development of new hypopituitarism is rare. Delaying the first follow-up MRI to 3 years and avoiding hormonal re-evaluation in the absence of tumour growth or clinical manifestations is a safe approach for micro-NFPA surveillance.
dc.identifier.citationEur J Endocrinol . 2023 Jul 20;189(1):87-95
dc.identifier.doi10.1093/ejendo/lvad070.
dc.identifier.pmid37345849
dc.identifier.scopusKumar, Mohit - Author details - Scopus Preview
dc.identifier.urihttps://wwl.dspace-express.com/handle/20.500.13063/104
dc.language.isoen
dc.publisherOxford Academic
dc.titleNatural history of non-functioning pituitary microadenomas: results from the UK non-functioning pituitary adenoma consortium
dc.typeArticle
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