Clinical and morphological features of “inactive” pituitary adenomas: a retrospective analysis of 95 cases

Abstract

Ninety-five case histories of patients with “inactive ” pituitary adenoma are analyzed. These patients were operated on from 1977 to 1983, and the diagnosis was verified in them by histological, electron-microscopic, and immunohistochemical studies of the operation material. Clinical manifestations of the disease included a) neuroophthalmological symptoms; b) sexual disorders in men and women; c) pituitary insufficiency (hypogonadism, hypothyrosis, or hypocorticoidism); d) neurological and psychopathological symptoms. By the moment of the first manifestation of the symptoms the majority of patients were middle-aged. In older patients the disease starts with ocular and/or neurological disorders, in women under 50 and men under 55 years of age as a rule with sex disorders. Moderate hyperprolactinemia was detected in half of the patients, which in 30% of cases was associated with oligo-amenorrhea-galactorrhea often leading to hyperdiagnosis of prolactotrophic adenoma. In general, all types of inactive pituitary adenoma are chromophobic by their tinctorial properties, except oncocytoma, which is poorly eosinophilic in half the cases; electron microscopy showed zero-cell adenoma to be the most incident (40%) in the examined patient population.