Prospective Observational Study of 118 Clinically Nonfunctioning Pituitary Adenomas
Authors' conclusion
In this prospective study of 6 to 9 mm micro-CNFPAs and macro-CNFPAs followed conservatively, growth and surgery can occur within the first year or after many years of observation. Risks of enlargement and surgery are increased for certain patient groups. These factors should be considered in designing a plan for follow-up.
Study context
- Population
- Patients with apparent clinically nonfunctioning pituitary adenomas ≥6 mm followed by observation per Endocrine Society guidelines; age 56 years (range 24.7–81), 62% female, 72% macroadenomas
- Participants
- 118 patients
- Outcome
- Tumor size change on follow-up
- Follow-up
- Median 3.9 years (range: 0.42-16)
Main finding
As reported in the abstract
- Tumors increased in size
- 49%
- Macroadenomas increased in size
- 56%
- Microadenomas increased in size
- 31%
- Tumors decreased in size
- 12%
- Tumors unchanged
- 39%
Observational data: associations, not effects.
Further findings
Median, years
| Outcome | Macroadenomas | Microadenomas | P value |
|---|---|---|---|
| Time to increase in size | 2.2 (range 0.43–12.8) | 3.44 (range 0.41–7.4) | P = 0.16 |
Pituitary surgery · after 2.58 years of follow-up (range: 0.4-7.6)
- Underwent pituitary surgery
- 29 (24.6%)
- Surgery in macroadenomas / microadenomas at diagnosis
- 26 / 3
Predictors (multivariable analysis)
- Male sex a significant predictor of tumor growth
- Macroadenoma a significant predictor of surgery
Pathology of surgically removed tumors
- Most were typical, hormone-immunonegative, or gonadotropin-staining tumors
Original publication
Prospective Observational Study of 118 Clinically Nonfunctioning Pituitary Adenomas. Endocr Pract. Published 17 December 2025. doi:10.
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