Document Detail

Silent corticotroph adenomas have unique recurrence characteristics compared with other nonfunctioning pituitary adenomas.
MedLine Citation:
PMID:  19650787     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The prevalence of silent corticotroph adenomas (SCAs) is not rare among nonfunctioning pituitary adenomas (NFPAs); however, it is unknown whether the clinical significance of SCAs differs from that of NFPAs without ACTH immunoreactivity (non-SCAs). Our goal was to compare the clinical characteristics and natural history between patients with SCAs and non-SCAs. DESIGN/PATIENTS: We reviewed the medical records of all patients who underwent transsphenoidal surgery for NFPAs from January 1990 to October 2007 at the Seoul National University Hospital. MEASUREMENTS: We analysed whether clinical manifestations at diagnosis, postoperative recurrence rate and recurrence characteristics differed between SCA and non-SCA patients. RESULTS: In total, 28 patients with SCAs and 134 patients with non-SCAs were analysed. The mean age at the time of diagnosis was 44 years (range, 13-67 years) in the SCA group and 50 years (18-79 years) in the non-SCA group (P = 0.026), with respective follow-up periods of 5.2 (range, 1.0-16.0 years) and 4.2 years (0.5-16.1 years) (P = 0.255). Overall recurrence rates of SCAs and non-SCAs were 25.0% and 26.9% respectively (P = 0.839). More than two recurrences (P = 0.001) and recurrence after more than 5 years (P = 0.040) were associated with SCAs. Multiple recurrences of SCAs were confined to younger patients. CONCLUSION: The overall recurrence rate was similar between SCAs and non-SCAs. However, young patients with SCAs had a higher frequency of multiple and late recurrences, which showed more aggressive tumour behaviour. Therefore, we suggest that patients with SCAs, especially patients diagnosed at a young age, require careful long-term monitoring.
Hwa Young Cho; Sun Wook Cho; Sang Wan Kim; Chan Soo Shin; Kyong Soo Park; Seong Yeon Kim
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-07-24
Journal Detail:
Title:  Clinical endocrinology     Volume:  72     ISSN:  1365-2265     ISO Abbreviation:  Clin. Endocrinol. (Oxf)     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-07     Completed Date:  2010-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  England    
Other Details:
Languages:  eng     Pagination:  648-53     Citation Subset:  IM    
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
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MeSH Terms
Adenoma / metabolism,  pathology*,  surgery
Adrenocorticotropic Hormone / analysis*
Age Factors
Middle Aged
Neoplasm Recurrence, Local*
Pituitary Neoplasms / metabolism,  pathology*,  surgery
Retrospective Studies
Time Factors
Young Adult
Reg. No./Substance:
9002-60-2/Adrenocorticotropic Hormone

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