Endocrine Abstracts

Objective and importance: Clinically nonfunctioning pituitary adenomas (NFPA) are the most common pituitary tumors after prolactinomas. The absence of clinical symptoms of hormonal hypersecretion can contribute to the late diagnosis of the disease.

Clinical presentation: A 52-year-old man presented with muscle weakness, weight loss, fatigue and a long term history of depression. He had no headaches and no vision problems. Physical exam was unremarkable. Neck and thorax CT was performed because of lung malignancy suspicious. Neck CT detected a cranial mass. Cranial MRI was performed. Magnetic resonance imaging (MRI) revealed a pituitary macroadenoma (3.5 cm high, 2.5 cm wide and 2.3 cm deep). It extended up and out of the sella turcica, stretching the optic chiasm and optic nerves. The levels of prolactin and the other pituitary hormones (except for testosterone) were normal and the lesion was given a diagnosis of a non-secreting pituitary adenoma. Endoscopic trans-nasal trans-sphenoidal pituitary adenoma resection was performed. The tumour was completely removed, identified as a pituitary adenoma with intracapsular hematoma.

Conclusion: Nonsecretory pituitary tumors are called null-cell tumors measuring a few millimeters are common and found in up to 25% of autopsies. These may grow slowly, destroying normal pituitary function, or they may compress nearby structures and cause neurologic problems. In our case report we discuss asymptomatic pituitary macroadenoma.