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Pituitary Microadenoma
Karen L. Salzman, MD; Anne G. Osborn, MD, FACR
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11

KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Pituitary microadenoma
            • Synonyms

              • Prolactinoma, adenoma
            • Definitions

              • Microadenoma: ≤ 10 mm in diameter

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Other Modality Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Lopes MBS: Pathology of prolactinomas: any predictive value? Pituitary. 23(1):3-8, 2020
                                            2. Cossu G et al: Thyrotropin-secreting pituitary adenomas: a systematic review and meta-analysis of postoperative outcomes and management. Pituitary. 22(1):79-88, 2019
                                            3. Expert Panel on Neurologic Imaging:. et al: ACR Appropriateness Criteria® Neuroendocrine Imaging. J Am Coll Radiol. 16(5S):S161-73, 2019
                                            4. Kim JH: Erratum. Developing an optimal follow-up strategy based on the natural history of nonfunctioning pituitary adenomas. J Neurosurg. 132(2):672, 2019
                                            5. Martínez Ortega AJ et al: Surgical outcomes and comorbidities in Cushing disease: 30 years of experience in a referral center. World Neurosurg. 122:e436-e442, 2019
                                            6. Thaker VV et al: Clinical course of nonfunctional pituitary microadenoma in children: A single-center experience. J Clin Endocrinol Metab. 104(12):5906-12, 2019
                                            7. Chatain GP et al: Potential utility of FLAIR in MRI-negative Cushing's disease. J Neurosurg. 129(3):620-8, 2018
                                            8. Mastorakos P et al: Prediction of cavernous sinus invasion in patients with Cushing's disease by magnetic resonance imaging. J Neurosurg. 1-6, 2018
                                            9. Esteves C et al: Pituitary incidentalomas: analysis of a neuroradiological cohort. Pituitary. ePub, 2015
                                            10. Karppinen A et al: Transition from microscopic to endoscopic transsphenoidal surgery for nonfunctional pituitary adenomas. World Neurosurg. ePub, 2015
                                            11. Kinoshita M et al: Pituitary-targeted dynamic contrast-enhanced multisection CT for detecting MR imaging-occult functional pituitary microadenoma. AJNR Am J Neuroradiol. ePub, 2015
                                            12. Kreutz J et al: Intensity of prolactinoma on T2-weighted magnetic resonance imaging: towards another gender difference. Neuroradiology. ePub, 2015
                                            13. Melmed S: Pituitary Tumors. Endocrinol Metab Clin North Am. 44(1):1-9, 2015
                                            14. Yamada S et al: Clinicopathological characteristics and therapeutic outcomes in thyrotropin-secreting pituitary adenomas: a single-center study of 90 cases. J Neurosurg. 121(6):1462-73, 2014
                                            15. Auriemma RS et al: Effect of cabergoline on metabolism in prolactinomas. Neuroendocrinology. 98(4):299-310, 2013
                                            16. Sonksen P et al: Pituitary incidentaloma. Clin Endocrinol (Oxf). 69(2):180, 2008
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Pituitary microadenoma
                                                      • Synonyms

                                                        • Prolactinoma, adenoma
                                                      • Definitions

                                                        • Microadenoma: ≤ 10 mm in diameter

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Other Modality Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Lopes MBS: Pathology of prolactinomas: any predictive value? Pituitary. 23(1):3-8, 2020
                                                                                      2. Cossu G et al: Thyrotropin-secreting pituitary adenomas: a systematic review and meta-analysis of postoperative outcomes and management. Pituitary. 22(1):79-88, 2019
                                                                                      3. Expert Panel on Neurologic Imaging:. et al: ACR Appropriateness Criteria® Neuroendocrine Imaging. J Am Coll Radiol. 16(5S):S161-73, 2019
                                                                                      4. Kim JH: Erratum. Developing an optimal follow-up strategy based on the natural history of nonfunctioning pituitary adenomas. J Neurosurg. 132(2):672, 2019
                                                                                      5. Martínez Ortega AJ et al: Surgical outcomes and comorbidities in Cushing disease: 30 years of experience in a referral center. World Neurosurg. 122:e436-e442, 2019
                                                                                      6. Thaker VV et al: Clinical course of nonfunctional pituitary microadenoma in children: A single-center experience. J Clin Endocrinol Metab. 104(12):5906-12, 2019
                                                                                      7. Chatain GP et al: Potential utility of FLAIR in MRI-negative Cushing's disease. J Neurosurg. 129(3):620-8, 2018
                                                                                      8. Mastorakos P et al: Prediction of cavernous sinus invasion in patients with Cushing's disease by magnetic resonance imaging. J Neurosurg. 1-6, 2018
                                                                                      9. Esteves C et al: Pituitary incidentalomas: analysis of a neuroradiological cohort. Pituitary. ePub, 2015
                                                                                      10. Karppinen A et al: Transition from microscopic to endoscopic transsphenoidal surgery for nonfunctional pituitary adenomas. World Neurosurg. ePub, 2015
                                                                                      11. Kinoshita M et al: Pituitary-targeted dynamic contrast-enhanced multisection CT for detecting MR imaging-occult functional pituitary microadenoma. AJNR Am J Neuroradiol. ePub, 2015
                                                                                      12. Kreutz J et al: Intensity of prolactinoma on T2-weighted magnetic resonance imaging: towards another gender difference. Neuroradiology. ePub, 2015
                                                                                      13. Melmed S: Pituitary Tumors. Endocrinol Metab Clin North Am. 44(1):1-9, 2015
                                                                                      14. Yamada S et al: Clinicopathological characteristics and therapeutic outcomes in thyrotropin-secreting pituitary adenomas: a single-center study of 90 cases. J Neurosurg. 121(6):1462-73, 2014
                                                                                      15. Auriemma RS et al: Effect of cabergoline on metabolism in prolactinomas. Neuroendocrinology. 98(4):299-310, 2013
                                                                                      16. Sonksen P et al: Pituitary incidentaloma. Clin Endocrinol (Oxf). 69(2):180, 2008