Top

Published in:

01-07-2016 | Mini Review

Non-functioning pituitary adenomas: growth and aggressiveness

Authors: Kristin Astrid Øystese, Johan Arild Evang, Jens Bollerslev

Published in: Endocrine | Issue 1/2016

Abstract

Pituitary adenomas (PAs) are common, comprising approximately one third of all intracranial tumors. Non-functioning pituitary adenomas (NFPAs) are the most common PAs. Although usually benign, the NFPAs represent therapeutic challenges because of their location close to the optic chiasm and nerves, and the proximity to the pituitary gland. The therapeutic alternatives are surgery and radiation. To date there is no effective medical treatment. NFPAs are classified according to different modalities, but there are no reliable marker of aggressiveness to guide the clinician in monitoring the patient. More information on growth patterns with constituent biological markers are needed to tailor the care of this patient group. Studies characterizing the membrane receptors of NFPAs have shown promising results, which may give rise to the development of medical treatment.

E.D. Aflorei, M. Korbonits, Epidemiology and etiopathogenesis of pituitary adenomas. J. Neurooncol. 117(3), 379–394 (2014). doi:10.1007/s11060-013-1354-5 CrossRefPubMed

G. Vargas, B. Gonzalez, C. Ramirez, A. Ferreira, E. Espinosa, V. Mendoza, G. Guinto, B. Lopez-Felix, E. Zepeda, M. Mercado, Clinical characteristics and treatment outcome of 485 patients with nonfunctioning pituitary macroadenomas. Int. J. Endocrinol. 2015, 756069 (2015). doi:10.1155/2015/756069 CrossRefPubMedPubMedCentral

O. Cooper, S. Melmed, Subclinical hyperfunctioning pituitary adenomas: the silent tumors. Best practice & research. Clinical. Endocrinol. Metab 26(4), 447–460 (2012). doi:10.1016/j.beem.2012.01.002

G. Carosi, E. Malchiodi, E. Ferrante, E. Sala, E. Verrua, E. Profka, C. Giavoli, M. Filopanti, P. Beck-Peccoz, A. Spada, G. Mantovani, Hypothalamic-pituitary axis in non-functioning pituitary adenomas: focus on the prevalence of isolated central hypoadrenalism. Neuroendocrinology 102(4), 267–273 (2015). doi:10.1159/000430815 CrossRefPubMed

O. Vierimaa, M. Georgitsi, R. Lehtonen, P. Vahteristo, A. Kokko, A. Raitila, K. Tuppurainen, T.M. Ebeling, P.I. Salmela, R. Paschke, S. Gundogdu, E. De Menis, M.J. Makinen, V. Launonen, A. Karhu, L.A. Aaltonen, Pituitary adenoma predisposition caused by germline mutations in the AIP gene. Science 312(5777), 1228–1230 (2006). doi:10.1126/science.1126100 CrossRefPubMed

C. Esteves, C. Neves, L. Augusto, J. Menezes, J. Pereira, I. Bernardes, J. Fonseca, D. Carvalho, Pituitary incidentalomas: analysis of a neuroradiological cohort. Pituitary 18(6), 777–781 (2015). doi:10.1007/s11102-015-0652-7 CrossRefPubMed

T.T. Agustsson, T. Baldvinsdottir, J.G. Jonasson, E. Olafsdottir, V. Steinthorsdottir, G. Sigurdsson, A.V. Thorsson, P.V. Carroll, M. Korbonits, R. Benediktsson, The epidemiology of pituitary adenomas in Iceland, 1955–2012: a nationwide population-based study. Eur. J. Endocrinol. 173(5), 655–664 (2015). doi:10.1530/eje-15-0189 CrossRefPubMed

A. Tjornstrand, K. Gunnarsson, M. Evert, E. Holmberg, O. Ragnarsson, T. Rosen, Filipsson Nystrom, H.: the incidence rate of pituitary adenomas in western Sweden for the period 2001–2011. Eur. J. Endocrinol. 171(4), 519–526 (2014). doi:10.1530/eje-14-0144 CrossRefPubMed

A. Fernandez, N. Karavitaki, J.A. Wass, Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK). Clin. Endocrinol. (Oxf) 72(3), 377–382 (2010). doi:10.1111/j.1365-2265.2009.03667.x CrossRef

10.

A.F. Daly, M. Rixhon, C. Adam, A. Dempegioti, M.A. Tichomirowa, A. Beckers, High prevalence of pituitary adenomas: a cross-sectional study in the province of Liege, Belgium. J. Clin. Endocrinol. Metab. 91(12), 4769–4775 (2006). doi:10.1210/jc.2006-1668 CrossRefPubMed

11.

A. Di Ieva, F. Rotondo, L.V. Syro, M.D. Cusimano, K. Kovacs, Aggressive pituitary adenomas–diagnosis and emerging treatments. Nat. Rev. Endocrinol. 10(7), 423–435 (2014). doi:10.1038/nrendo.2014.64 CrossRefPubMed

12.

S.E. Mayson, P.J. Snyder, Silent pituitary adenomas. Endocrinol. Metab. Clin. North Am. 44(1), 79–87 (2015). doi:10.1016/j.ecl.2014.11.001 CrossRefPubMed

13.

H. Nishioka, N. Inoshita, O. Mete, S.L. Asa, K. Hayashi, A. Takeshita, N. Fukuhara, M. Yamaguchi-Okada, Y. Takeuchi, S. Yamada, The complementary role of transcription factors in the accurate diagnosis of clinically nonfunctioning pituitary adenomas. Endocr. Pathol. 26(4), 349–355 (2015). doi:10.1007/s12022-015-9398-z CrossRefPubMed

14.

R. DeLellis, P. Heitz, World Health Organization Classification of Tumours: Tumours of Endocrine Organs. IARC PRess, Lyon (2004)

15.

C. Ramirez, S. Cheng, G. Vargas, S.L. Asa, S. Ezzat, B. Gonzalez, L. Cabrera, G. Guinto, M. Mercado, Expression of Ki-67, PTTG1, FGFR4, and SSTR 2, 3, and 5 in nonfunctioning pituitary adenomas: a high throughput TMA, immunohistochemical study. J. Clin. Endocrinol. Metab. 97(5), 1745–1751 (2012). doi:10.1210/jc.2011-3163 CrossRefPubMed

16.

A. Righi, P. Agati, A. Sisto, G. Frank, M. Faustini-Fustini, R. Agati, D. Mazzatenta, A. Farnedi, F. Menetti, G. Marucci, M.P. Foschini, A classification tree approach for pituitary adenomas. Hum. Pathol. 43(10), 1627–1637 (2012). doi:10.1016/j.humpath.2011.12.003 CrossRefPubMed

17.

J. Trouillas, P. Roy, N. Sturm, E. Dantony, C. Cortet-Rudelli, G. Viennet, J.F. Bonneville, R. Assaker, C. Auger, T. Brue, A. Cornelius, H. Dufour, E. Jouanneau, P. Francois, F. Galland, F. Mougel, F. Chapuis, L. Villeneuve, C.A. Maurage, D. Figarella-Branger, G. Raverot, A. Barlier, M. Bernier, F. Bonnet, F. Borson-Chazot, G. Brassier, S. Caulet-Maugendre, O. Chabre, P. Chanson, J.F. Cottier, B. Delemer, E. Delgrange, L. Di Tommaso, S. Eimer, S. Gaillard, M. Jan, J.J. Girard, V. Lapras, H. Loiseau, J.G. Passagia, M. Patey, A. Penfornis, J.Y. Poirier, G. Perrin, A. Tabarin, A new prognostic clinicopathological classification of pituitary adenomas: a multicentric case-control study of 410 patients with 8 years post-operative follow-up. Acta Neuropathol. 126(1), 123–135 (2013). doi:10.1007/s00401-013-1084-y CrossRefPubMed

18.

M. Guarino, B. Rubino, G. Ballabio, The role of epithelial-mesenchymal transition in cancer pathology. Pathology 39(3), 305–318 (2007). doi:10.1080/00313020701329914 CrossRefPubMed

19.

S.L. Fougner, T. Lekva, O.C. Borota, J.K. Hald, J. Bollerslev, J.P. Berg, The expression of E-cadherin in somatotroph pituitary adenomas is related to tumor size, invasiveness, and somatostatin analog response. J. Clin. Endocrinol. Metab. 95(5), 2334–2342 (2010). doi:10.1210/jc.2009-2197 CrossRefPubMed

20.

T. Lekva, J.P. Berg, S.L. Fougner, O.K. Olstad, T. Ueland, J. Bollerslev, Gene expression profiling identifies ESRP1 as a potential regulator of epithelial mesenchymal transition in somatotroph adenomas from a large cohort of patients with acromegaly. J. Clin. Endocrinol. Metab. 97(8), E1506–E1514 (2012). doi:10.1210/jc.2012-1760 CrossRefPubMed

21.

J.A. Evang, J.P. Berg, O. Casar-Borota, T. Lekva, M.K. Kringen, J. Ramm-Pettersen, J. Bollerslev, Reduced levels of E-cadherin correlate with progression of corticotroph pituitary tumours. Clin. Endocrinol. (Oxf) 75(6), 811–818 (2011). doi:10.1111/j.1365-2265.2011.04109.x CrossRef

22.

H. Halvorsen, J. Ramm-Pettersen, R. Josefsen, P. Ronning, S. Reinlie, T. Meling, J. Berg-Johnsen, J. Bollerslev, E. Helseth, Surgical complications after transsphenoidal microscopic and endoscopic surgery for pituitary adenoma: a consecutive series of 506 procedures. Acta Neurochir. (Wien) 156(3), 441–449 (2014). doi:10.1007/s00701-013-1959-7 CrossRef

23.

J. Honegger, U. Ernemann, T. Psaras, B. Will, Objective criteria for successful transsphenoidal removal of suprasellar nonfunctioning pituitary adenomas. A prospective study. Acta Neurochir. 149(1), 21–29 (2007). doi:10.1007/s00701-006-1044-6 CrossRefPubMed

24.

R. Reddy, S. Cudlip, J.V. Byrne, N. Karavitaki, J.A. Wass, Can we ever stop imaging in surgically treated and radiotherapy-naive patients with non-functioning pituitary adenoma? Eur. J. Endocrinol. 165(5), 739–744 (2011). doi:10.1530/eje-11-0566 CrossRefPubMed

25.

A. Colao, G. Cerbone, P. Cappabianca, D. Ferone, A. Alfieri, F. Di Salle, A. Faggiano, B. Merola, E. de Divitiis, G. Lombardi, Effect of surgery and radiotherapy on visual and endocrine function in nonfunctioning pituitary adenomas. J. Endocrinol. Invest. 21(5), 284–290 (1998). doi:10.1007/bf03350330 CrossRefPubMed

26.

D. Ding, C.P. Yen, R.M. Starke, C.C. Lee, J.P. Sheehan, Unyielding progress: recent advances in the treatment of central nervous system neoplasms with radiosurgery and radiation therapy. J. Neurooncol. 119(3), 513–529 (2014). doi:10.1007/s11060-014-1501-7 CrossRefPubMed

27.

G. Ntali, N. Karavitaki, Efficacy and complications of pituitary irradiation. Endocrinol. Metab. Clin. North Am. 44(1), 117–126 (2015). doi:10.1016/j.ecl.2014.10.009 CrossRefPubMed

28.

N.C. van Varsseveld, C.C. van Bunderen, D.H. Ubachs, A.A. Franken, H.P. Koppeschaar, A.J. van der Lely, M.L. Drent, Cerebrovascular events, secondary intracranial tumors, and mortality after radiotherapy for nonfunctioning pituitary adenomas: a subanalysis from the dutch national registry of growth hormone treatment in adults. J. Clin. Endocrinol. Metab. 100(3), 1104–1112 (2015). doi:10.1210/jc.2014-3697 CrossRefPubMed

29.

D. Ding, R.M. Starke, J.P. Sheehan, Treatment paradigms for pituitary adenomas: defining the roles of radiosurgery and radiation therapy. J. Neurooncol. 117(3), 445–457 (2014). doi:10.1007/s11060-013-1262-8 CrossRefPubMed

30.

E. Chatzellis, K.I. Alexandraki, I.I. Androulakis, G. Kaltsas, Aggressive pituitary tumors. Neuroendocrinology 101(2), 87–104 (2015). doi:10.1159/000371806 CrossRefPubMed

31.

S.E. Combs, K. Kessel, D. Habermehl, T. Haberer, O. Jakel, J. Debus, Proton and carbon ion radiotherapy for primary brain tumors and tumors of the skull base. Acta Oncol. 52(7), 1504–1509 (2013). doi:10.3109/0284186x.2013.818255 CrossRefPubMed

32.

D.A. Wattson, S.K. Tanguturi, D.Y. Spiegel, A. Niemierko, B.M. Biller, L.B. Nachtigall, M.R. Bussiere, B. Swearingen, P.H. Chapman, J.S. Loeffler, H.A. Shih, Outcomes of proton therapy for patients with functional pituitary adenomas. Int. J. Radiat. Oncol. Biol. Phys. 90(3), 532–539 (2014). doi:10.1016/j.ijrobp.2014.06.068 CrossRefPubMed

33.

Vieira Neto, L. Wildemberg, L.E. Moraes, A.B. Colli, L.M. Kasuki, N.V. Marques, E.L. Gasparetto, M. Takiya, C.M. Gadelha, Dopamine receptor subtype 2 expression profile in nonfunctioning pituitary adenomas and in vivo response to cabergoline therapy. Clin. Endocrinol. (Oxf) 82(5), 739–746 (2015). doi:10.1111/cen.12684 CrossRef

34.

Y. Greenman, N. Stern, Optimal management of non-functioning pituitary adenomas. Endocrine 50(1), 51–55 (2015). doi:10.1007/s12020-015-0685-8 CrossRefPubMed

35.

St. Olavs Hospital; Norwegian University of Science Technology: Dopamine agonist treatment of non-functioning pituitary adenomas (NFPAs)—a randomized controlled trial. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US)

36.

S.L. Fougner, O.C. Borota, J.P. Berg, J.K. Hald, J. Ramm-Pettersen, J. Bollerslev, The clinical response to somatostatin analogues in acromegaly correlates to the somatostatin receptor subtype 2a protein expression of the adenoma. Clin. Endocrinol. (Oxf) 68(3), 458–465 (2008). doi:10.1111/j.1365-2265.2007.03065.x CrossRef

37.

C. Bruns, I. Lewis, U. Briner, G. Meno-Tetang, G. Weckbecker, SOM230: a novel somatostatin peptidomimetic with broad somatotropin release inhibiting factor (SRIF) receptor binding and a unique antisecretory profile. Eur. J. Endocrinol. 146(5), 707–716 (2002)CrossRefPubMed

38.

D. Iacovazzo, E. Carlsen, F. Lugli, S. Chiloiro, S. Piacentini, A. Bianchi, A. Giampietro, M. Mormando, A.J. Clear, F. Doglietto, C. Anile, G. Maira, L. Lauriola, G. Rindi, F. Roncaroli, A. Pontecorvi, M. Korbonits, L. De Marinis, Factors predicting pasireotide responsiveness in somatotroph pituitary adenomas resistant to first-generation somatostatin analogues: an immunohistochemical study. Eur. J. Endocrinol. 174(2), 241–250 (2016). doi:10.1530/eje-15-0832 CrossRefPubMed

39.

H. Nishioka, K. Tamura, H. Iida, M. Kutsukake, A. Endo, Y. Ikeda, J. Haraoka, Co-expression of somatostatin receptor subtypes and estrogen receptor-alpha mRNAs by non-functioning pituitary adenomas in young patients. Mol. Cell. Endocrinol. 331(1), 73–78 (2011). doi:10.1016/j.mce.2010.08.011 CrossRefPubMed

40.

G.F. Taboada, R.M. Luque, W. Bastos, R.F. Guimaraes, J.B. Marcondes, L.M. Chimelli, R. Fontes, P.J. Mata, P.N. Filho, D.P. Carvalho, R.D. Kineman, M.R. Gadelha, Quantitative analysis of somatostatin receptor subtype (SSTR1-5) gene expression levels in somatotropinomas and non-functioning pituitary adenomas. Eur. J. Endocrinol. 156(1), 65–74 (2007). doi:10.1530/eje.1.02313 CrossRefPubMed

41.

Vieria Neto, L., Wildemberg, L.E., Colli, L.M., Kasuki, L., Marques, N.V., Moraes, A.B., Gasparetto, E.L., Takiya, C.M., Castro, M., Gadelha, M.R.: zAC1 and SSTR2 are downregulated in non-functioning pituitary adenomas but not in somatotropinomas. PLoS ONE 8(10), e77406 (2013). doi:10.1371/journal.pone.0077406 CrossRef

42.

M. Gasperi, L. Petrini, R. Pilosu, M. Nardi, A. Marcello, F. Mastio, L. Bartalena, E. Martino, Octreotide treatment does not affect the size of most non-functioning pituitary adenomas. J. Endocrinol. Invest. 16(7), 541–543 (1993). doi:10.1007/bf03348901 CrossRefPubMed

43.

A. Fusco, A. Giampietro, A. Bianchi, V. Cimino, F. Lugli, S. Piacentini, M. Lorusso, A. Tofani, G. Perotti, L. Lauriola, C. Anile, G. Maira, A. Pontecorvi, L. De Marinis, Treatment with octreotide LAR in clinically non-functioning pituitary adenoma: results from a case-control study. Pituitary 15(4), 571–578 (2012). doi:10.1007/s11102-011-0370-8 CrossRefPubMed

44.

M. Lee, A. Lupp, N. Mendoza, N. Martin, R. Beschorner, J. Honegger, J. Schlegel, T. Shively, E. Pulz, S. Schulz, F. Roncaroli, N.S. Pellegata, SSTR3 is a putative target for the medical treatment of gonadotroph adenomas of the pituitary. Endocr. Relat. Cancer 22(1), 111–119 (2015). doi:10.1530/erc-14-0472 CrossRefPubMed

45.

Novartis, P., Novartis: Evaluate the Efficacy and Safety of Pasireotide LAR on the Treatment of Patients With Clinically Non-Functioning Pituitary Adenoma. In. Bethesda (MD): National Library of Medicine (US) (2016)

46.

D. Bengtsson, H.D. Schroder, M. Andersen, D. Maiter, K. Berinder, Feldt Rasmussen, U., Rasmussen, A.K., Johannsson, G., Hoybye, C., van der Lely, A.J., Petersson, M., Ragnarsson, O., Burman, P.: long-term outcome and MGMT as a predictive marker in 24 patients with atypical pituitary adenomas and pituitary carcinomas given treatment with temozolomide. J. Clin. Endocrinol. Metabo. 100(4), 1689–1698 (2015). doi:10.1210/jc.2014-4350 CrossRef

47.

G. Raverot, F. Castinetti, E. Jouanneau, I. Morange, D. Figarella-Branger, H. Dufour, J. Trouillas, T. Brue, Pituitary carcinomas and aggressive pituitary tumours: merits and pitfalls of temozolomide treatment. Clin. Endocrinol. (Oxf) 76(6), 769–775 (2012). doi:10.1111/j.1365-2265.2012.04381.x CrossRef

48.

G. Raverot, P. Burman, A. McCormack, S. Petersenn, V. Popovic-Brkic, J. Trouillas, ESE Survey on Aggressive Pituitary Tumors. http://www.ese-hormones.org/professional/

49.

Y. Chen, C.D. Wang, Z.P. Su, Y.X. Chen, L. Cai, Q.C. Zhuge, Z.B. Wu, Natural history of postoperative nonfunctioning pituitary adenomas: a systematic review and meta-analysis. Neuroendocrinology 96(4), 333–342 (2012). doi:10.1159/000339823 CrossRefPubMed

50.

E. Monsalves, S. Larjani, B. Loyola Godoy, K. Juraschka, F. Carvalho, W. Kucharczyk, A. Kulkarni, O. Mete, F. Gentili, S. Ezzat, G. Zadeh, Growth patterns of pituitary adenomas and histopathological correlates. J. Clin. Endocrinol. Metab. 99(4), 1330–1338 (2014). doi:10.1210/jc.2013-3054 CrossRefPubMed

51.

C. Cortet-Rudelli, J.F. Bonneville, F. Borson-Chazot, L. Clavier, B. Coche Dequeant, R. Desailloud, D. Maiter, V. Rohmer, J.L. Sadoul, E. Sonnet, P. Toussaint, P. Chanson, Post-surgical management of non-functioning pituitary adenoma. Ann Endocrinol (Paris) 76(3), 228–238 (2015). doi:10.1016/j.ando.2015.04.003 CrossRef

52.

H.M. Kistka, R.A. Kasl, A. Nayeri, A.L. Utz, K.D. Weaver, L.B. Chambless, Imaging of resected nonfunctioning pituitary adenomas: the cost of surveillance. J. Neurol. Surg. 76(5), 344–350 (2015). doi:10.1055/s-0035-1549307 CrossRef

53.

P.U. Freda, A.M. Beckers, L. Katznelson, M.E. Molitch, V.M. Montori, K.D. Post, M.L. Vance, Pituitary incidentaloma: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 96(4), 894–904 (2011). doi:10.1210/jc.2010-1048 CrossRefPubMed

54.

G. Soto-Ares, C. Cortet-Rudelli, R. Assaker, A. Boulinguez, C. Dubest, D. Dewailly, J.P. Pruvo, MRI protocol technique in the optimal therapeutic strategy of non-functioning pituitary adenomas. Eur. J. Endocrinol. 146(2), 179–186 (2002)CrossRefPubMed

55.

E.P. O’Sullivan, C. Woods, N. Glynn, L.A. Behan, R. Crowley, P. O’Kelly, D. Smith, C.J. Thompson, A. Agha, The natural history of surgically treated but radiotherapy-naive nonfunctioning pituitary adenomas. Clin. Endocrinol. (Oxf) 71(5), 709–714 (2009). doi:10.1111/j.1365-2265.2009.03583.x CrossRef

56.

N. Lenders, S. Ikeuchi, A.W. Russell, K.K. Ho, J.B. Prins, W.J. Inder, Longitudinal evaluation of the natural history of conservatively managed non-functioning pituitary adenomas. Clin. Endocrinol. (Oxf) (2015). doi:10.1111/cen.12879

57.

Y. Greenman, G. Ouaknine, I. Veshchev, G. Reider II, Y. Segev, N. Stern, Postoperative surveillance of clinically nonfunctioning pituitary macroadenomas: markers of tumour quiescence and regrowth. Clin. Endocrinol. (Oxf) 58(6), 763–769 (2003)CrossRef

58.

M. Losa, P. Mortini, R. Barzaghi, P. Ribotto, M.R. Terreni, S.B. Marzoli, S. Pieralli, M. Giovanelli, Early results of surgery in patients with nonfunctioning pituitary adenoma and analysis of the risk of tumor recurrence. J. Neurosurg. 108(3), 525–532 (2008). doi:10.3171/jns/2008/108/3/0525 CrossRefPubMed

59.

E.F. Chang, G. Zada, S. Kim, K.R. Lamborn, A. Quinones-Hinojosa, J.B. Tyrrell, C.B. Wilson, S. Kunwar, Long-term recurrence and mortality after surgery and adjuvant radiotherapy for nonfunctional pituitary adenomas. J. Neurosurg. 108(4), 736–745 (2008). doi:10.3171/jns/2008/108/4/0736 CrossRefPubMed

60.

F. Roelfsema, N.R. Biermasz, A.M. Pereira, Clinical factors involved in the recurrence of pituitary adenomas after surgical remission: a structured review and meta-analysis. Pituitary 15(1), 71–83 (2012). doi:10.1007/s11102-011-0347-7 CrossRefPubMed

61.

J. Honegger, S. Zimmermann, T. Psaras, M. Petrick, M. Mittelbronn, U. Ernemann, M. Reincke, K. Dietz, Growth modelling of non-functioning pituitary adenomas in patients referred for surgery. Eur. J. Endocrinol. 158(3), 287–294 (2008). doi:10.1530/eje-07-0502 CrossRefPubMed

62.

S. Yamada, K. Ohyama, M. Taguchi, A. Takeshita, K. Morita, K. Takano, T. Sano, A study of the correlation between morphological findings and biological activities in clinically nonfunctioning pituitary adenomas. Neurosurgery 61(3), 580–584 (2007). doi:10.1227/01.neu.0000290906.53685.79 CrossRefPubMed

63.

J.A. Balogun, E. Monsalves, K. Juraschka, K. Parvez, W. Kucharczyk, O. Mete, F. Gentili, G. Zadeh, Null cell adenomas of the pituitary gland: an institutional review of their clinical imaging and behavioral characteristics. Endocr. Pathol. 26(1), 63–70 (2015). doi:10.1007/s12022-014-9347-2 CrossRefPubMed

64.

S. Brochier, F. Galland, M. Kujas, F. Parker, S. Gaillard, C. Raftopoulos, J. Young, O. Alexopoulou, D. Maiter, P. Chanson, Factors predicting relapse of nonfunctioning pituitary macroadenomas after neurosurgery: a study of 142 patients. Eur. J. Endocrinol. 163(2), 193–200 (2010). doi:10.1530/eje-10-0255 CrossRefPubMed

Title: Non-functioning pituitary adenomas: growth and aggressiveness
Authors: Kristin Astrid Øystese
Johan Arild Evang
Jens Bollerslev
Publication date: 01-07-2016
Publisher: Springer US
Published in: Endocrine / Issue 1/2016
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-016-0940-7

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2016

Molecular profiles of cancer stem-like cell populations in aggressive thyroid cancers

Free vitamin D does not vary through the follicular phase of the menstrual cycle

Positive autoantibodies to ZnT8 indicate elevated risk for additional autoimmune conditions in patients with Addison’s disease

Spontaneous hypoglycemia: diagnostic evaluation and management

Association of depression with pre-diabetes, undiagnosed diabetes, and previously diagnosed diabetes: a meta-analysis

mTORC1 pathway mediates beta cell compensatory proliferation in 60 % partial-pancreatectomy mice

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage