How Should a Nonfunctioning Pituitary Macroadenoma be Monitored After Debulking Surgery?

Yona Greenman; Naftali Stern

Disclosures

Clin Endocrinol. 2009;70(6):829-832. 

In This Article

The Problem of Lack of Secretory Markers

In clinically functioning pituitary adenomas, circulating hormone levels are accurate tumour markers. Hence, the presence of elevated serum hormone concentration may indicate incomplete surgical resection or tumour recurrence even in face of an apparently normal imaging study. This important tool is lacking for the follow-up of most NFPA, as elevated gonadotropins are detected only in a minority of patients on basal conditions, and the TRH-induced increase in β-subunits is not a sufficiently reliable marker for the presence of residual tumour.[1] Consequently, detection of recurrence or residual tumour growth relies directly on imaging studies, or is indirectly based on appearance of new defects or deterioration of previously impaired visual and pituitary function.

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