Abstract
Background
 There are ongoing studies to predetermine non-functional invasive pituitary adenomas which may show aggressive behavior. Our aim is to discuss whether there is a relationship between the immunohistochemical presence of GH, FSH, LH, PRL, ACTH, TSH and their aggressive clinical course in non-functional pituitary adenomas.
 Materials and Methods 
 In this study, we evaluated retrospectively the files of the patients who were diagnosed with thesellar or parasellar tumor in our endocrinology clinic between the years of 2004-2014.The patients were divided into two groups as non-invasive pituitary adenomas and non-functional invasive pituitary adenomas. The immunohistochemical staining characteristics were compared between the two groups.
 Results 
 In this study, we scanned the data of 70 patients who were followed for non-functional sellar or parasellar mass. 47.1% of the patients were female and 52.9% of the patients were male.39 patients had a non-functional pituitary adenoma.The rate of non-functional invasive adenoma was found to be 20.5%. There was a significant relationship between the immunohistochemical positivity of GH, FSH, LH andaggressive behavior of non-functional invasive adenomas. There was no a significant relationship between the immunohistochemicalpositivityof PRL, ACTH, TSH and aggressive behavior of non-functional invasive adenomas.
 Conclusion 
 We found silent GH and gonadotropin adenomas as non-functional aggressive pituitary adenoma. More aggressive treatment and close clinical monitoring should be performed because atypical pituitary adenomas are characterized by invasive growth and aggressive clinical course.
Highlights
Hypophysis adenoma, contrary to common belief, is quite widespread
> 90% of the patients operated on with the diagnosis of hypophysis tumor were diagnosed with hypophysis adenoma [4]
55.8% of the non-functional sellar and parasellar regional tumoral lesions were regarded as hypophysis adenoma in the wake of the operation, whereas 30% of them were considered as cystic lesions, craniopharyngioma, meningioma, and neurofibroma
Summary
Hypophysis adenoma, contrary to common belief, is quite widespread. It is found in the normal population at a rate of 20%. Invasive hypophysis adenomas are very large, treatment-resistant adenomas that exhibit common and extensive invasion of peripheral anatomic structures while growing rapidly and recurring quickly in the wake of treatment. There are ongoing studies to predetermine non-functional invasive pituitary adenomas that may show aggressive behavior. Our aim is to discuss whether there is a relationship between the immunohistochemical presence of GH, FSH, LH, PRL, ACTH, TSH and their aggressive clinical course in non-functional pituitary adenomas. While there was a significant relationship between the immunohistochemical positivity of GH, FSH, LH and the aggressive behavior of non-functional invasive adenomas. No significant relationship was found between the immunohistochemical positivity of PRL, ACTH, TSH and the aggressive behavior of non-functional invasive adenomas. More aggressive treatment and close clinical monitoring should be performed because atypical pituitary adenomas are characterized by invasive growth and aggressive clinical course
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