Spontaneous regression of hormonally inactive pituitary adenoma: a clinical case and literature review

Nikita I. Mikhailov; Михайлов Никита Игоревич; Anton M. Zaytsev; Зайцев А. М.; Olga N. Kirsanova; Кирсанова О. Н.; Sergei A. Kisaryev; Кисарьев С. А.

doi:10.18565/pharmateca.2023.6-7.117-120

Spontaneous regression of hormonally inactive pituitary adenoma: a clinical case and literature review

Authors: Mikhailov N.I.¹, Zaytsev A.M.¹, Kirsanova O.N.¹, Kisaryev S.A.¹
Affiliations:
1. P. Herzen Moscow Oncology Research Institute, Branch of the National Medical Research Radiology Center of the Ministry of Health of the Russian Federation
Issue: Vol 30, No 6/7 (2023)
Pages: 117-120
Section: Clinical case
URL: https://journals.eco-vector.com/2073-4034/article/view/562821
DOI: https://doi.org/10.18565/pharmateca.2023.6-7.117-120
ID: 562821

Cite item

Full Text

Open Access
Restricted Access

Access granted
Restricted Access

Subscription or Fee Access

Abstract
Full Text
About the authors
References
Supplementary files
Statistics

Abstract

Background. Pituitary adenomas are benign neoplasms, which account for up to 15% of intracranial tumors. Most pituitary macroadenomas today are subject to surgical treatment, and therefore information on the natural course of these tumors is scarce.

Description of the clinical case. In patient B., born in 1990, an endosuprasellar tumor was detected on MRI of the brain performed for headache. Given the absence of neurological symptoms, the patient was kept under follow-up. MRI control 2 months after showed a decrease in the size of the tumor, 4 months after - almost complete regression.

Conclusion. Spontaneous regression of pituitary adenomas is considered a rare but potentially possible outcome. In this regard, when planning the surgical treatment of pituitary adenomas, it is necessary to carefully study all preoperative imaging to confirm that the tumor has not regressed spontaneously.

Keywords

pituitary adenoma, spontaneous tumor regression, pituitary hemorrhage, clinical case

Full Text

About the authors

Nikita I. Mikhailov

P. Herzen Moscow Oncology Research Institute, Branch of the National Medical Research Radiology Center of the Ministry of Health of the Russian Federation

Author for correspondence.
Email: Michailov_md@mail.ru
ORCID iD: 0000-0001-9212-6564

Cand. Sci. (Med.), Neurosurgeon

Russian Federation, Moscow

References

Anderson E., Heller R.S., Lechan R.M., Heilman C.B. Regression of a nonfunctioning pituitary macroadenoma on the CDK4/6 inhibitor palbociclib: case report Neurosurg Focus. 2018;44(6):E9. doi: 10.3171/2018.2.FOCUS17660.
Кутин М.А., Калинин П.Л., Кадашев Б.А. Питуитарная апоплексия. Результаты консервативного и хирургического лечения. Вестник неврологии, психиатрии и нейрохирургии. 2019;2:52–61. [Kutin M.A., Kalinin P.L., Kadashev B.A. Pituitary apoplexy. Results of conservative and surgical treatment. Vestnik nevrologii, psikhiatrii i neirokhirurgii. 2019;2:52–61. (In Russ.)].
Михайлов Н.И. Осложнения после эндоскопического эндоназального транссфеноидального удаления аденом гипофиза. Дисc. канд. мед. наук. Москва, 2021. [Mikhailov N.I. Complications after endoscopic endonasal transsphenoidal removal of pituitary adenomas. Diss. Cand. Sci. Moscow, 2021. (In Russ.)].
Fernandez A., Karavitaki N., Wass J.A. Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK). Clin Endocrinol (Oxf). 2010;72:377–82. doi: 10.1111/j.1365-2265.2009.03667.x.
Nammour G.M., Ybarra J., Naheedy M.H., Romeo J.H. Aron DC Incidental pituitary macroadenoma: a population-based study. Am J Med Sci. 1997;314:287–91. doi: 10.1097/00000441-199711000-00003.
Daly A.F., Rixhon M., Adam C., et al. High prevalence of pituitary adenomas: a cross-sectional study in the province of Liege, Belgium. J Clin Endocrinol Metab. 2006;91:4769–75. doi: 10.1210/jc.2006-1668.
Gruppetta M., Mercieca C., Vassallo J. Prevalence and incidence of pituitary adenomas: a population based study in Malta. Pituitary. 2013;16:545–53. doi: 10.1007/s11102-012-0454-0.
Raappana A., Koivukangas J., Ebeling T., Pirila T. Incidence of pituitary adenomas in Northern Finland in 1992–2007. J Clin Endocrinol Metab. 2010;95:4268–75. Doi: 10.1210/ jc.2010-0537.
Marques P., Korbonits M. Genetic aspects of pituitary adenomas. Endocrinol Metab Clin North Am. 2017;46:335–74. doi: 10.1016/j.ecl.2017.01.004.
Freda P.U., Beckers A.M., Katznelson L., et al. Pituitary incidentaloma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2011;96:894–904. Doi: 10.1210/ jc.2010-1048.
Lake M.G., Krook L.S., Cruz S.V. Pituitary adenomas: an overview. Am Fam Physician. 2013;88:319–27.
Dekkers O.M., Pereira A.M., Romijn J.A. Treatment and Follow-Up of Clinically Nonfunctioning Pituitary Macroadenomas J Clin Endocrinol Metab. 2008;93(10):3717–26. Doi: 10.1210/ jc.2008-0643.
Feldkamp J., Santen R., Harms E., et al. Incidentally discovered pituitary lesions: high frequency of macroadenomas and hormone-secreting adenomas – results of a prospective study. Clin Endocrinol (Oxf). 1999;51:109–13. doi: 10.1046/j.1365-2265.1999.00748.x.
Sanno N., Oyamav K., Tahara S., et al. Asurvey of pituitary incidentaloma in Japan. Eur J Endocrinol. 2003;149:123–27. doi: 10.1530/eje.0.1490123.
Molitch M.E. Nonfunctioning pituitary tumors and pituitary incidentalomas. Endocrinol Metab Clin North Am. 2008;37:151–71. doi: 10.1016/j.ecl.2007.10.011.
Burrow G.N., Wortzman G., Rewcastle N.B., et al. Microadenomas of the pituitary and abnormal sellar tomograms in an unselected autopsy series. N Engl J Med. 1981;304:156–58. doi: 10.1056/NEJM198101153040306.
Teramoto A., Hirakawa K., Sanno N., Osamura Y. Incidental pituitary lesions in 1,000 unselected autopsy specimens. Radiology 1994;193:161–64. doi: 10.1148/radiology.193.1.8090885.
Ghalaenovi H., Azar M., Fattahi A. Spontaneous regression of nonfunctioning pituitary adenoma, Br J Neurosurg. 2019;Jun 17:1–2. doi: 10.1080/02688697.2019.1630552.
Anderson E., Heller R.S., Lechan R.M., Heilman C.B. Regression of a nonfunctioning pituitary macroadenoma on the CDK4/6 inhibitor palbociclib: case report. Neurosurgical Focus. 2018;44:E9. doi: 10.1080/02688697.2019.1630552.
Bahar A., Kashi Z., Nowzari A. Spontaneous regression of one nonfunctioning pituitary macroadenoma associated with abnormal liver enzyme tests. Caspian J Intern Med. 2011;2:201.
Eichberg D.G., Di L., Shah A.H., et al. Spontaneous preoperative pituitary adenoma resolution following apoplexy: a case presentation and literature review. Br J Neurosurg. 2020; 34(5):502-7. doi: 10.1080/02688697.2018. 1529737.
Arita K., Tominaga A., Sugiyama K., et al. Natural course of incidentally found nonfunctioning pituitary adenoma, with special reference to pituitary apoplexy during follow-up examination. J Neurosurg. 2006;104:884–91. doi: 10.3171/jns.2006.104.6.884.
Caturegli P., Newschaffer C., Olivi A., et al. Autoimmune Hypophysitis. Endocr Rev. 2005;26:599–614. Doi: 10.1210/ er.2004-0011.
Wakai S., Fukushima T., Teramoto A., Sano K. Pituitary apoplexy: its incidence and clinical significance. J Neurosurg. 1981;55:187–93. doi: 10.3171/jns.1981.55.2.0187.
Chanson P., Lepeintre J-F., Ducreux D. Management of pituitary apoplexy. Expert Opin Pharmacother. 2004;5:1287–98. doi: 10.1517/14656566.5.6.1287.
Epstein S., Pimstone B.L., De Villiers J.C., Jackson W.P. Pituitary apoplexy in five patients with pituitary tumours. Br Med J. 1971;2:267–70. doi: 10.1136/bmj.2.5756.267.
Yoshino A. Vanishing pituitary mass revealed by timely magnetic resonance imaging: examples of spontaneous resolution of nonfunctioning pituitary adenoma. Acta Neurochir (Wien). 2005;147:253–57. discussion 257. doi: 10.1007/s00701-004-0443-9.
Rovit R..L, Fein J.M. Pituitary apoplexy: a review and reappraisal. J Neurosurg. 1972;37:280–88. doi: 10.3171/jns.1972.37.3.0280.
Mohr G., Hardy J. Hemorrhage, necrosis, and apoplexy in pituitary adenomas. Surg Neurol. 1982;18:181–89. doi: 10.1016/0090-3019(82)90388-3.
Randeva H.S., Schoebel J., Byrne J., et al. Classical pituitary apoplexy: clinical features, management and outcome. Clin Endocrinol. 1999;51:181–88. doi: 10.1046/j.1365-2265.1999.00754.x.