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Incidental pituitary adenomas

机译：附带性垂体腺瘤

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Object: Pituitary incidentalomas are a common finding with a poorly understood natural history. Over the last few decades, numerous studies have sought to decipher the optimal evaluation and treatment of these lesions. This paper aims to elucidate the current evidence regarding their prevalence, natural history, evaluation, and management. Methods: A search of articles on PubMed (National Library of Medicine) and reference lists of all relevant articles was conducted to identify all studies pertaining to the incidence, natural history, workup, treatment, and followup of incidental pituitary and sellar lesions, nonfunctioning pituitary adenomas, and incidentalomas. Results: The reported prevalence of pituitary incidentalomas has increased significantly in recent years. A complete history, physical, and endocrinological workup with formal visual field testing in the event of optic apparatus involvement constitutes the basics of the initial evaluation. Although data regarding the natural history of pituitary incidentalomas remain sparse, they seem to suggest that progression to pituitary apoplexy (0.6/100 patient-years), visual field deficits (0.6/100 patient-years), and endocrine dysfunction (0.8/100 patient-years) remains low. In larger lesions, apoplexy risk may be higher. Conclusions: While the majority of pituitary incidentalomas can be managed conservatively, involvement of the optic apparatus, endocrine dysfunction, ophthalmological symptoms, and progressive increase in size represent the main indications for surgery.
机译：目的：垂体偶发瘤是一个自然病史知之甚少的常见发现。在过去的几十年中，许多研究试图破译这些病变的最佳评估和治疗方法。本文旨在阐明有关其流行，自然史，评估和管理的最新证据。方法：对PubMed（国家医学图书馆）上的文章和所有相关文章的参考文献列表进行搜索，以确定与垂体偶发性和垂体病变，无功能性垂体病变的发生率，自然史，检查，治疗和随访有关的所有研究腺瘤和偶发瘤。结果：近年来报道的垂体偶发瘤患病率显着增加。在涉及光学仪器的情况下，进行完整的病史，物理和内分泌检查，并进行正式的视野测试，构成了初始评估的基础。尽管有关垂体偶发性瘤自然史的数据仍然很少，但它们似乎表明进展为垂体中风（0.6 / 100病人-年），视野缺损（0.6 / 100病人-年）和内分泌功能障碍（0.8 / 100病人） -年）保持较低水平。在较大的病灶中，中风风险可能更高。结论：尽管大多数垂体偶发瘤可以保守治疗，但视神经器官受累，内分泌功能障碍，眼科症状和大小逐渐增加是手术的主要指征。

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