Adénomes hypophysaires non fonctionnels et gonadotropes

Abstract

Clinically non-functioning pituitary adenomas and gonadotroph-cell adenomas are relatively common: microadenomas (< 1cm) are usually pituitary incidentalomas while most macroadenomas are revealed by mass effect and/or hypopituitarism. They are rarely associated with high gonadotropin (Luteinizing hormone, LH; Follicle-stimulating hormone FSH) levels while increased alpha-subunit levels are more frequent. Immunocytochemistry of pituitary tumor confirms the diagnosis of clinically non-functioning or gonadotroph-cell adenoma. Pituitary MRI follow-up seems to be indicated for microadenoma. Treatment of macroadenoma with visual field defect or hypopituitarism is transphenoidal surgery, but cure is rarely obtained and tumor recurrence is significant during follow-up. Therefore postoperative treatment (pituitary radiotherapy or medical treatment with dopamine agonists or somatostatin analogs) should be discussed against close follow-up with repeated MRI scans.