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Clinical and Translational Oncology
Published in: Clinical and Translational Oncology 10/2018

01-10-2018 | Review Article

Recurrent non-functioning pituitary adenomas: a review on the new pathological classification, management guidelines and treatment options

Authors: P. D. Delgado-López, J. Pi-Barrio, M. T. Dueñas-Polo, M. Pascual-Llorente, M. C. Gordón-Bolaños

Published in: Clinical and Translational Oncology | Issue 10/2018

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Abstract

At least 50% of surgically resected non-functioning pituitary adenomas (NFPA) recur. Either early or late adjuvant radiotherapy is highly efficacious in controlling recurrent NFPA but associates potentially burdensome complications like hypopituitarism, vascular complications or secondary neoplasm. Reoperation is indicated in bulky tumor rests compressing the optic pathway. To date, no standardized medical therapy is available for recurrent NFPA although cabergoline and temozolomide show promising results. Guidelines on the management of recurrent NFPAs are now available. The new 2017 WHO pituitary tumor classification, based on immunohistochemistry and transcription factor assessment, identifies a group of aggressive NFPA variants that may benefit from earlier adjuvant therapy. Nevertheless, NFPA patients exhibit a reduced overall life expectancy largely due to hypopituitarism and treatment-related morbidity. The management of recurrent NFPA benefits from a multidisciplinary teamwork of surgeons, endocrinologists, radiation oncologists, ophthalmologists, pathologists and neuro-radiologists in order to provide individualized therapy and anticipate deterioration.
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Metadata
Title
Recurrent non-functioning pituitary adenomas: a review on the new pathological classification, management guidelines and treatment options
Authors
P. D. Delgado-López
J. Pi-Barrio
M. T. Dueñas-Polo
M. Pascual-Llorente
M. C. Gordón-Bolaños
Publication date
01-10-2018
Publisher
Springer International Publishing
Published in
Clinical and Translational Oncology / Issue 10/2018
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-018-1868-6

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