A clinico-pathological study on pituitary incidentalomas

计算机断层扫描（CT）和磁共振成像（MRI）的发展导致了意外的内分泌学无症状垂体肿块（垂体偶发瘤）的发现。本研究的目的是进行全国性垂体偶发瘤的调查。2000年至2001年进行了一项调查研究。506例垂体偶发瘤患者中，258例接受手术治疗（手术组），248例接受保守随访，平均随访时间为26.9个月（范围，6至173个月）（非手术组）。在平均45.5个月的随访期内，33例垂体偶发瘤（13.3%）发生了肿瘤增大。在29例患者（12.0%）中，肿块的大小明显减小。体重增加和体重减少的患者的平均年龄分别为54.7岁和42.1岁。肿块增大的常见诊断为无功能垂体腺瘤（23例，69.7%）和巨大肿瘤（17例，51.5%）。非手术组115个估计无功能腺瘤中有23个（20.2%）增加。直径大于10 mm的大腺瘤，实性肿块，在老年受试者中倾向于增大。通过免疫组化，46%的偶然发现的腺瘤阳性的一个或多个促性腺激素亚单位。

The development of computed tomography (CT) and magnetic resonance imaging (MRI) has resulted in the discovery of unsuspected endocrinologically silent pituitary masses (pituitary incidentalomas). The aim of this study was to perfom a national survey on pituitary incidentalomas. A survey study was performed from 2000 to 2001. Five hundred and six patients with pituitary incidentalomas obtained Two hundred fifty-eight patients underwent surgery (surgical group), while 248 patients were followed up conservatively for a mean period of 26.9 months (range, 6 to 173 months) (non-surgical group). In thirty-three patients with pituitary incidentalomas (13.3%) developed tumor enlargement during the mean follow-up period of 45.5 months. In twenty-nine patients (12.0%), masses rather decreased in size. The mean age of patients who had increased mass and decreased mass were 54.7 years and 42.1 years, respectively. The common diagnosis of increased mass was non-functioning pituitary adenomas (23 patients, 69.7%) and macro tumors (17 patients, 51.5%). In non-surgical group, 23(20.2%) of 115 estimated non-functioning adenomas increased. Macroadenoma over 10 mm in diameter, solid mass, in older subjects tended to have enlargement. By immunohistochemistry, 46% of incidentally discovered adenomas were positive for one or more gonadotropin subunits.