Pituitary Microadenomas Follow-up

  • Author: David M Klachko, MBBCh; Chief Editor: George T Griffing, MD   more...
 
Updated: May 18, 2011
 

Further Outpatient Care

Follow-up MRI scans can be performed at 6 and/or 12 months to assess progression. If the tumor enlarges, full endocrine testing and therapy are justified.

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Inpatient & Outpatient Medications

If the tumor is secreting excess hormone, initiate appropriate medical therapy as described in the articles Hyperprolactinemia, Acromegaly, and Cushing disease.

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Complications

  • Complications are caused by enlargement of the tumor to a macroadenoma or by excessive hormone secretion.
  • Inactive microadenomas rarely cause complications unless they are pressing on the pituitary stalk.
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Prognosis

Prognosis depends on the hormonal activity of the adenoma. Most incidentalomas are inactive and do not cause morbidity, except morbidity related to excessive investigation. A meta-analysis showed that microadenomas rarely enlarge (3.3 per 100 patient-years [95% CI 2.1-4.5]).[7]

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Patient Education

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Contributor Information and Disclosures
Author

David M Klachko, MBBCh  Professor Emeritus, Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Missouri

David M Klachko, MBBCh is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, American Diabetes Association, American Federation for Medical Research, Endocrine Society, Missouri State Medical Association, and Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

Harris C Taylor, MD  Clinical Professor of Medicine, Division of Clinical and Molecular Endocrinology, Case Western Reserve University School of Medicine

Harris C Taylor, MD is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Physicians, American Thyroid Association, and Endocrine Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: eMedicine Salary Employment

Yoram Shenker, MD  Chief of Endocrinology Section, Veterans Affairs Medical Center of Madison; Interim Chief, Associate Professor, Department of Internal Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Wisconsin at Madison

Yoram Shenker, MD is a member of the following medical societies: American Heart Association, Central Society for Clinical Research, and Endocrine Society

Disclosure: Nothing to disclose.

Mark Cooper, MBBS, PhD, FRACP  Head, Diabetes & Metabolism Division, Baker Heart Research Institute, Professor of Medicine, Monash University

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD  Professor of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

References

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  2. Bush ZM, Lopes MB, Hussaini IM, et al. Immunohistochemistry of COUP-TFI: an adjuvant diagnostic tool for the identification of corticotroph microadenomas. Pituitary. Jun 13 2009;[Medline].

  3. Suda T, Kageyama K, Nigawara T, et al. Evaluation of diagnostic tests for ACTH-dependent Cushing's syndrome. Endocr J. Jun 2009;56(3):469-76. [Medline]. [Full Text].

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MRI showing a nonenhancing area in the pituitary consistent with a microadenoma in a patient with hyperprolactinemia.
 
 
 
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