Pituitary Center, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., Suite A6600, Los Angeles, CA, 90048, USA,
Pituitary. 2015 Apr;18(2):225-31. doi: 10.1007/s11102-014-0624-3.
Silent corticotroph adenomas (SCAs) comprise 20% of all corticotroph adenomas and 3-19% of nonfunctioning adenomas (NFAs). As they do not manifest clinical or biochemical hypercortisolism, they are diagnosed after pathologic examination of resected tumor tissue demonstrates positive ACTH expression. While preoperative features are similar to those of NFAs, SCAs may have more cavernous sinus invasion. Further, patients with SCAs tend to have more frequent and earlier recurrences than those with NFAs, often necessitating multiple surgeries and other modalities of treatment. This article reviews the incidence, pathogenesis, and clinical behavior of SCAs.
A systematic literature review was performed using PubMed for information regarding SCAs.
Up to date findings regarding epidemiology, pathogenesis, pathology, clinical presentation, postoperative course, and management of patients with SCAs are presented.
This review highlights the necessity of rigorous monitoring for recurrences and hypopituitarism in patients with SCAs.
沉默型促肾上腺皮质激素腺瘤（SCAs）占促肾上腺皮质激素腺瘤的 20%，占无功能腺瘤的 3-19%。由于它们没有表现出临床或生化皮质醇增多症，因此在切除的肿瘤组织的病理检查显示 ACTH 表达阳性后才被诊断出来。虽然术前特征与无功能腺瘤相似，但 SCA 可能有更多的海绵窦侵犯。此外，SCA 患者比无功能腺瘤患者更频繁、更早地复发，往往需要多次手术和其他治疗方式。本文综述了 SCA 的发病率、发病机制和临床行为。
使用 PubMed 进行系统的文献复习，以获取有关 SCA 的信息。
目前的研究结果涉及 SCA 的流行病学、发病机制、病理学、临床表现、术后过程以及患者的管理。
本文强调了对 SCA 患者进行复发和垂体功能减退监测的必要性。
