Endocrinology Clinic, Hippokration Hospital, Thessaloniki, Greece.
Int J Clin Pract. 2011 Feb;65(2):172-7. doi: 10.1111/j.1742-1241.2010.02537.x.
Pituitary incidentalomas (PIs) are diagnosed in about 10% of the patients undergoing radiological investigation for non-pituitary disorders. The aim of this study was to describe the morphological and hormonal characteristics of PIs in a cohort of patients, followed up in a single centre from 1982-2009.
Retrospective analysis of electronic medical records of patients with PIs was carried out. All patients underwent basal and dynamic evaluation of the hypothalamus-pituitary axis. Mass size was assessed at yearly intervals.
Sixty-one patients (38 men/23 women, aged 53±2 years) were studied. The mean follow-up time was 48±8 months, and mean size of PIs was 20±2 mm. Twelve PIs (20%) were microadenomas, 48 (78%) were macroadenomas and one (2%) was a Rathke's cyst. The most common reasons that led to their discovery were headaches, dizziness, syncope, stroke and head injury. Forty-seven of the 61 PIs (77%) were non-functioning, 11 (18%) prolactinomas, and two (3%) GH-secreting adenomas. Hypopituitarism was present in 12% at diagnosis. Forty-eight per cent of the patients were submitted to surgery with conventional radiotherapy in 8%. Relapse in size was observed in 48% of the surgically treated patients. Of the PIs followed conservatively, 78% remained stable, 11% showed decrease and 11% increase in size during follow up. Hypopituitarism rose to 57% postoperatively.
Majority of PIs are non-functioning adenomas that remain stable in size. Relapse in size and hypopituitarism postoperatively are common. PIs, for which conservative management was initially considered appropriate, did not progress in size.
在因非垂体疾病而行影像学检查的患者中，约有 10%被诊断为垂体偶发瘤（PIs）。本研究的目的是描述 1982 年至 2009 年在单一中心随访的一组患者的 PIs 的形态和激素特征。
对 PIs 患者的电子病历进行回顾性分析。所有患者均接受了下丘脑-垂体轴的基础和动态评估。每年评估一次肿块大小。
共纳入 61 例患者（38 例男性/23 例女性，年龄 53±2 岁）。平均随访时间为 48±8 个月，PIs 的平均大小为 20±2mm。12 个 PIs（20%）为微腺瘤，48 个（78%）为大腺瘤，1 个（2%）为 Rathke 囊肿。发现它们的最常见原因是头痛、头晕、晕厥、中风和头部外伤。61 个 PIs 中有 47 个（77%）无功能，11 个（18%）为泌乳素瘤，2 个（3%）为 GH 分泌腺瘤。诊断时存在垂体功能减退症的占 12%。48%的患者接受了手术治疗，其中 8%接受了常规放疗。手术治疗的患者中有 48%出现肿瘤复发。在保守治疗的患者中，78%的肿瘤大小稳定，11%的肿瘤缩小，11%的肿瘤增大。术后垂体功能减退症增加到 57%。
大多数 PIs 是无功能的腺瘤，其大小保持稳定。术后肿瘤复发和垂体功能减退症较为常见。最初认为适合保守治疗的 PIs 其大小没有进展。
