Clinically Nonfunctioning Pituitary Adenomas

Clinically nonfunctioning pituitary adenomas are tumors of the pituitary gland that do not cause hypersecretion syndromes. The term "nonfunctioning" refers to lack of clinical and hormonal evidence of hypersecretion syndromes, although these tumors may actually produce pituitary hormones. Clinically nonfunctioning adenomas may present with mass effect symptoms or pituitary hormone deficiencies. These tumors are generally benign, but a subset may display aggressive behavior, be resistant to treatment, or metastasize. The mainstay of treatment for nonfunctioning pituitary adenomas is transsphenoidal surgical resection, with adjuvant radiation therapy used sometimes for residual or recurrent tumor. The optimal management of patients with nonfunctioning adenomas is based on combined management by neurosurgeons and endocrinologists.