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Endocrine inactive and gonadotroph adenomas: diagnosis and management

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Abstract

Endocrine inactive pituitary adenomas represent about one quarter of all pituitary tumors. By immunocytochemistry, most of these tumors are positive for intact gonadotropins and/or their subunits. Clinical presentation is usually secondary to mass effect symptoms, such as visual disturbances, headache, and hypopituitarism. Differential diagnosis is usually accomplished by neuroradiologic studies, even though in selected cases positron emission tomography and/or single photon emission tomography may aid to distinguish pituitary adenomas from other endocrine inactive lesions, such as meningiomas and craniopharyngiomas. Surgical management is usually considered the first choice treatment for patients with endocrine inactive pituitary adenomas because it is very effective in ameliorating symptoms of chiasmal compression and headache. Radical removal of the tumor, however, is difficult to obtain because of the frequent invasiveness into the cavernous sinus. Radiation therapy diminishes the likelihood of tumor recurrence, especially in patients with demonstrable tumor remnants after surgery. Medical therapy with dopaminergic drugs, somatostatin analogs, or gonadotropin-releasing hormone agonists or antagonists causes mild reduction of tumor size in few patients and, therefore, seems to be of limited value in the therapeutic management of patients with endocrine inactive pituitary adenomas.

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References

  1. Snyder PJ: Gonadotroph cell adenomas of the pituitary. Endocrinol Rev 6: 552–563, 1993

    Google Scholar 

  2. Black PM, Hsu DW, Klibanski A, Kliman B, Jameson JL, Ridgway EC, Hedley-White ET, Zervas NT: Hormone production in clinically nonfunctioning pituitary adenomas. J Neurosurg 66: 244–250, 1987

    Google Scholar 

  3. White MC, Daniels M, Newland P, Thompson CJ, Cook D, Dewar J, Perry R, Jewitt R, Mathias D, Murdoch AP, Kendall-Taylor P: LH and FSH secretion and responses to GnRH and TRH in patients with clinically functionless pituitary adenomas. Clin Endocrinol (Oxf) 32: 681–688, 1990

    Google Scholar 

  4. Ambrosi B, Faglia G, and the Multicenter Pituitary Tumor Study Group, Lombardia Region: Epidemiology of pituitary tumors. In: Faglia G, Beck-Peccoz P, Ambrosi B, Travaglini P, Spada A (eds) Pituitary Adenomas: New Trends in Basic and Clinical Research. Excerpta Medica, Amsterdam, 1991, pp 159–168

    Google Scholar 

  5. Arafah BM: Reversible hypopituitarism in patients with large nonfunctioning pituitary adenomas. J Clin Endocrinol Metab 62: 1173–1179, 1986

    Google Scholar 

  6. Comtois R, Beauregard H, Somma M, Serri O, Aris-Jilwan N, Hardy J: The clinical and endocrine outcome to trans-sphenoidal microsurgery of nonsecreting pituitary adenomas. Cancer 68: 860–866, 1991

    Google Scholar 

  7. Klibanski A: Nonsecreting pituitary tumors. Endocrinol Metab Clin North Am 16: 793–804, 1987

    Google Scholar 

  8. Berezin M, Olchovsky D, Pines A, Tadmor R, Lunenfeld B: Reduction of follicle-stimulating hormone (FSH) secretion in FSH-producing pituitary adenoma by bromocriptine. J Clin Endocrinol Metab 59: 1220–1223, 1984

    Google Scholar 

  9. Djerassi A, Coutifaris C, West VA, Asa SL, Kapoor SC, Pavlou SN, Snyder PJ: Gonadotroph adenoma in a premenopausal woman secreting follicle-stimulating hormone and causing ovarian hyperstimulation. J Clin Endocrinol Metab 80: 591–594, 1995

    Google Scholar 

  10. Christin-Maitre S, Rongieres-Bertrand C, Kottler M, Lahlou N, Frydman R, Touraine P, Bouchard P: A spontaneous and severe hyperstimulation of the ovaries revealing a gonadotroph adenoma. J Clin Endocrinol Metab 83: 3450–3453, 1998

    Google Scholar 

  11. Valimaki MJ, Tiitinen A, Alfthan H, Paetau A, Poranen A, Sane T, Stenman UH: Ovarian hyperstimulation caused by a gonadotroph adenoma secreting follicle-stimulating hormone in 28-year-old woman. J Clin Endocrinol Metab 84: 4204–4208, 1999

    Google Scholar 

  12. Snyder PJ, Sterling FH: Hypersecretion of LH and FSH by a pituitary adenoma. J Clin Endocrinol Metab 42: 544–550, 1976

    Google Scholar 

  13. Heseltine D, White MC, Kendall-Taylor P, De Kretser DM, Kelly W: Testicular enlargement and elevated serum inhibin concentrations occur in patients with pituitary macroadenomas secreting FSH. Clin Endocrinol (Oxf) 31: 411–423, 1998

    Google Scholar 

  14. Faggiano M, Criscuolo T, Perrone I, Quarto C, Sinisi AA: Sexual precocity in a boy due to hypersecretion of LH and 175 prolactin by a pituitary adenoma. Acta Endocrinol (Copenh) 102: 167–172, 1983

    Google Scholar 

  15. Ambrosi B, Bassetti M, Ferrario R, Medri G, Giannattasio G, Faglia G: Precocious puberty in a boy with a PRL-LH and FSH secreting pituitary tumor: hormonal and immunocytochemical studies. Acta Endocrinol (Copenh) 122: 569–576, 1990

    Google Scholar 

  16. Saccomanno K, Spada A, Bassetti M, Gil-del-Alamo P, Faglia G: Immunodetection of chorionic gonadotropin and its subunits in human nonfunctioning pituitary adenomas. J Clin Endocrinol Metab 78: 1103–1107, 1994

    Google Scholar 

  17. Oppenheim DS, Kana AR, Sangha JS, Klibanski A: Prevalence of alpha-subunit hypersecretion in patients with pituitary tumors: clinically non-functioning and somatotroph adenomas. J Clin Endocrinol Metab 70: 859–864, 1990

    Google Scholar 

  18. Gil-del-Alamo P, Saccomanno K, Lania A, Pettersson KSI, Beck-Peccoz P, Spada A: Serum levels of β-subunit of chorionic gonadotropin in patients with pituitary tumors. Eur J Endocrinol 133: 33–37, 1995

    Google Scholar 

  19. Kwekkeboom DJ, de Jong FH, Lamberts SWJ: Gonadotropin release by clinically nonfunctioning and gonadotroph pituitary adenomas in vivo and in vitro: relation to sex and effects of thyrotropin-releasing hormone, gonadotropin-releasing hormone and bromocriptine. J Clin Endocrinol Metab 68: 1128–1135, 1989

    Google Scholar 

  20. Daneshdoost L, Gennarelli TA, Bashey HM, Savino PJ, Sergott RC, Bosley TM, Snyder PJ: Recognition of gonadotroph adenomas in women. N Engl J Med 324: 589–594, 1991

    Google Scholar 

  21. Katznelson L, Alexander JM, Bikkal HA, Jameson JL, Hsu DW, Klibanski A: Imbalanced follicle-stimulating hormone beta-subunit hormone biosynthesis in human pituitary adenomas. J Clin Endocrinol Metab 74: 1343–1351, 1992

    Google Scholar 

  22. Daneshdoost L, Gennarelli TA, Bashey HM, Savino PJ, Sergott RC, Bosley TM, Snyder PJ: Identification of gonadotroph adenomas in men with clinically nonfunctioning adenomas by the luteinizing hormone β subunit response to thyrotropin-releasing hormone. J Clin Endocrinol Metab 77: 1352–1355, 1993

    Google Scholar 

  23. Losa M, Terreni MR, Mortini P, Acerno S, Giovanelli M: Responsiveness of gonadotropins to TRH in patients with nonfunctioning pituitary adenomas: correlation with immunohistochemical results. Highlights in Molecular and Clinical Endocrinology, Ares-Serono Symposia Series - Frontiers in Endocrinology, Vol. 9, 1994, pp 155–158

  24. Lamberts SWJ, Verleun T, Oosterom R, Hofland L, van Ginkel LA, Loeber JG, van Vroonhoven CC, Stefanko SZ, de Jong FH: The effects of bromocriptine, thyrotropin-releasing hormone, and gonadotropin-releasing hormone on hormone secretion by gonadotropin-secreting pituitary adenomas in vivo and in vitro. J Clin Endocrinol Metab 64: 524–530, 1987

    Google Scholar 

  25. Samuels MH, Henry P, Kleinschmidts-Demasters BK, Lillehei K, Ridgway EC: Pulsatile glycoprotein hormone secretion in glycoprotein-producing pituitary tumors. J Clin Endocrinol Metab 73: 1281–1288, 1991

    Google Scholar 

  26. McGrath GA, Goncalves RJ, Udupa JK, Grossman RI, Pavlou SN, Molitch ME, Rivier J, Vale WW, Snyder PJ: New technique for quantitation of pituitary adenoma size: use in evaluating treatment of gonadotroph adenomas with a gonadotropin-releasing hormone antagonist. J Clin Endocrinol Metab 76: 1363–1368, 1993

    Google Scholar 

  27. Klibanski A, Jameson JL, Biller BM, Crowley WF Jr, Zervas NT, Rivier J, Vale WW, Bikkal H: Gonadotropin and alpha-subunit responses to chronic gonadotropin-releasing hormone analog administration in patients with glycoprotein hormone-secreting pituitary tumors. J Clin Endocrinol Metab 68: 81–86, 1989

    Google Scholar 

  28. Lamberts SWJ, de Herder WW, Kwekkeboom DJ, van der Lely AJ, Nobels FRE, Krenning EP: Current tools in the diagnosis of pituitary tumors. Acta Endocrinol (Copenh) 129(Suppl 1): 6–12, 1993

    Google Scholar 

  29. De Herder WW, Lamberts SWJ: 1995 Imaging of pituitary tumours. Bailliere's Clin Endocrinol Metab 9: 367–389, 1995

    Google Scholar 

  30. Krenning EP, Kwekkeboom DJ, Bakker WH, Breeman WAP, Kooij PPM, Oei HJ, van Hagen M, Postema PTE, de Jong M, Reubi JC, Visser TJ, Reijs AEM, Hofland LJ, Koper JW, Lamberts SWJ: Somatostatin receptor scintigraphy with [111In-DTPA-d-Phe1]-and [123I-Tyr3]-octreotide: the Rotterdam experience in more than 1000 patients. Eur J Nucl Med 20: 716–731, 1993

    Google Scholar 

  31. Faglia G, Bazzoni N, Spada A, Arosio M, Ambrosi B, Spinelli F, Sara R, Bonino C, Lunghi F: In vivo detection of somatostatin receptors in patients with functionless pituitary adenomas by means of a radioiodinated analog of somatostatin ([123I]SDZ 204-090). J Clin Endocrinol Metab 73: 850–856, 1991

    Google Scholar 

  32. Lamberts SW, Krenning EP, Reubi JC: The role of somatostatin and its analogs in the diagnosis and treatment of tumors. Endocrinol Rev 12: 450–482, 1991

    Google Scholar 

  33. Bergström M, Muhr C, Jossan S, Lilja A, Nyberg G, Långström B: Differentiation of pituitary adenoma and meningioma: visualization with positron emission tomography and [11C]-L-deprenyl. Neurosurgery 30: 855–861, 1992

    Google Scholar 

  34. Koga M, Nakao H, Arao M, Sato B, Noma K, Morimoto Y, Kishimoto S, Mori S, Uozumi T: Demonstration of specific dopamine receptors on human pituitary adenomas. Acta Endocrinol (Copenh) 114: 595–602, 1987

    Google Scholar 

  35. Lucignani G, Losa M, Moresco RM, Del Sole A, Matarrese M, Bettinardi V, Mortini P, Giovanelli M, Fazio F: Differentiation of clinically non-functioning pituitary adenomas from meningiomas and craniopharyngiomas by positron emission tomography with [18F]fluoro-ethylspiperone. Eur J Nucl Med 24: 1149–1155, 1997

    Google Scholar 

  36. Salmi J, Grahne B, Valtonen S, Pelkonen R: Recurrence of chromophobe pituitary adenomas after operation and postoperative radiotherapy. Acta Neurol Scand 66: 681–689, 1982

    Google Scholar 

  37. Ebersold MJ, Quast LM, Laws ER Jr, Scheithauer B, Randall RV: Long-term results in transsphenoidal removal of nonfunctioning pituitary adenomas. J Neurosurg 64: 713–719, 1986

    Google Scholar 

  38. Bevan JS Adams CB, Burke CW, Morton KE, Molyneux AJ, Moore RA, Esiri MM: Factors in the outcome of transsphenoidal surgery for prolactinoma and nonfunctioning pituitary tumour, including pre-operative bromocriptine therapy. Clin Endocrinol (Oxf) 26: 541–556, 1987

    Google Scholar 

  39. Harris PE, Afshar F, Coates P, Doniach I, Wass JAH, Besser GM, Grossman A: The effects of transsphenoidal surgery on endocrine function and visual fields in patients with functionless pituitary tumours. Q J Med 265: 417–427, 1989

    Google Scholar 

  40. Giovanelli M, Losa M, Baiguini M, Motti E, Ducati A: Transcranial vs. transsphenoidal approach in the surgical treatment of pituitary adenomas. In: Faglia G, Beck-Peccoz P, Ambrosi B, Travaglini P, Spada A (eds) Pituitary adenomas: New Trends in Basic and Clinical Research. Excerpta Medica, Amsterdam, 1991, pp 313–320

    Google Scholar 

  41. Shone GR, Richards SH, Hourihan MD, Hall R, Thomas JP, Scanlon MF: Non-secretory adenomas of the pituitary treated by trans-ethmoidal sellotomy. J R Soc Med 84: 140–143, 1991

    Google Scholar 

  42. Sassolas G, Trouillas J, Treluyer C, Perrin G: Management of nonfunctioning pituitary adenomas. Acta Endocrinol (Copenh) 129 (Suppl 1): 21–26, 1993

    Google Scholar 

  43. Marazuela M, Astigarraga B, Vicente A, Estrada J, Cuerda C, Garcia-Uria J, Lucas T: Recovery of visual and endocrine function following transsphenoidal surgery of large nonfunctioning pituitary adenomas. J Endocrinol Invest 17: 703–707, 1994

    Google Scholar 

  44. Petruson B, Jakobsson KE, Elfverson J, Bengtsson BA: Five-year follow-up of nonsecreting pituitary adenomas. Arch Otolaryngol Head Neck Surg 121: 317–322, 1995

    Google Scholar 

  45. Colao A, Cerbone G, Cappabianca P, Ferone D, Alfieri A, Di Salle F, Faggiano A, Merola B, de Divitiis E, Lombardi G: Effect of surgery and radiotherapy on visual and endocrine function in nonfunctioning pituitary adenomas. J Endocrinol Invest 21: 284–290, 1998

    Google Scholar 

  46. Webb SM, Rigla M, Wägner A, Oliver B, Bartumeus F: Recovery of hypopituitarism after neurosurgical treatment of pituitary adenomas. J Clin Endocrinol Metab 84: 3696–3700, 1999

    Google Scholar 

  47. Woollons AC, Hunn MK, Rajapakse YR, Toomath R, Hamilton DA, Conaglen JV, Balakrishnan V: Nonfunctioning pituitary adenomas: indications for postoperative radiotherapy. Clin Endocrinol (Oxf) 53: 713–717, 2000

    Google Scholar 

  48. Losa M, Franzin A, Mangili F, Terreni MR, Barzaghi R, Veglia F, Mortini P, Giovanelli M: Proliferation index of nonfunctioning pituitary adenomas: correlations with clinical characteristics and long term follow up results. Neurosurgery 47: 1313–1319, 2000

    Google Scholar 

  49. Lillehei KO, Kirschman DL, Kleinschmidt-DeMasters BK, Ridgway EC: Reassessment of the role of radiation therapy in the treatment of endocrine-inactive pituitary macroadenomas. Neurosurgery 43: 432–439, 1998

    Google Scholar 

  50. Rajaraman V, Schulder M: Postoperative MRI appearance after transsphenoidal pituitary tumor resection. Surg Neurol 52: 592–599, 1999

    Google Scholar 

  51. Hayes TP, Davis RA, Raventos A: The treatment of pituitary chromophobe adenomas. Radiology 98:149–153, 1971

    Google Scholar 

  52. Sheline GE, Tyrrell B: Pituitary adenomas. In: Phillips TL, Pinstenma DA (eds) Radiation Oncology Annual. Raven Press, New York, 1983, pp 1–35

    Google Scholar 

  53. Gittoes NJL, Bates AS, Tse W, Bullivan B, Sheppard MC, Clayton RN, Stewart PM: Radiotherapy for non-functioning pituitary tumours. Clin Endocrinol (Oxf) 48: 331–337, 1998

    Google Scholar 

  54. Turner HE, Stratton IM, Byrne JV, Adams CBT, Wass JAH: Audit of selected patients with nonfunctioning pituitary adenomas treated without irradiation - a follow-up study. Clin Endocrinol (Oxf) 51: 281–284, 1999

    Google Scholar 

  55. Shibuya M, Saito F, Miwa T, Davis RL, Wilson CB, Hoshino T: Histochemical study of pituitary adenomas with Ki-67 and anti-DNA polymerase β monoclonal antibodies, bromodeoxyuridine labeling, and nucleolar organizer region counts. Acta Neuropathol 84: 178–183, 1992

    Google Scholar 

  56. Hsu DW, Hakim F, Biller BMK, de la Monte S, Zervas NT, Klibanski A, Hedley-White ET: Significance of proliferating cell nuclear antigen index in predicting pituitary adenoma recurrence. J Neurosurg 78: 753–761, 1993

    Google Scholar 

  57. Ekramullah SM, Saitoh Y, Arita N, Ohnishi T, Hayakawa T: The correlation of Ki-67 staining indices with tumour doubling times in regrowing non-functioning pituitary adenomas. Acta Neurochir (Wien) 138: 1449–1455, 1996

    Google Scholar 

  58. Yonezawa K, Tamaki N, Kokunai T: Clinical features and growth fractions of pituitary adenomas. Surg Neurol 48: 494–500, 1997

    Google Scholar 

  59. Rush SC, Kupersmith MJ, Leuch I, Cooper P, Ransohoff J, Newall J: Neuro-ophthalmological assessment of vision before and after radiation therapy alone for pituitary macroadenomas. J Neurosurg 72: 594–599, 1990

    Google Scholar 

  60. Grigsby PW, Simpson JR, Stokes S, Marks JE, Fineberg B: Results of surgery and irradiation or irradiation alone for pituitary adenomas. J Neuro-Oncol 6: 129–134, 1988

    Google Scholar 

  61. Rush SC, Newall J: Pituitary adenoma: the efficacy of radiotherapy as the sole treatment. Int J Radiat Oncol Biol Phys 17: 165–169, 1989

    Google Scholar 

  62. McCollough WM, Marcus RB Jr, Rhoton AL Jr, Ballinger WE, Million RR: Long-term follow-up of radiotherapy for pituitary adenoma: the absence of late recurrence after greater than or equal to 4500cGy. Int J Radiat Oncol Biol Phys 21: 607–614, 1991

    Google Scholar 

  63. Brada M, Rajan B, Traish D, Ashley S, Holmes-Sellors PJ, Nussey S, Uttley D: The long-term efficacy of conservative surgery and radiotherapy in the control of pituitary adenomas. Clin Endocrinol (Oxf) 38: 571–578, 1993

    Google Scholar 

  64. Breen P, Flickinger JC, Kondziolka D, Martinez AJ: Radiotherapy for nonfunctional pituitary adenoma: analysis of long-term tumor control. J Neurosurg 89: 933–938, 1998

    Google Scholar 

  65. Flickinger JC, Nelson PB, Martinez AJ, Deutsch M, Taylor F: Radiotherapy of nonfunctional adenomas of the pituitary gland. Results with long-term follow-up. Cancer 63: 2409–2414, 1989

    Google Scholar 

  66. Plowman PN: Pituitary adenoma radiotherapy - when, who and how? Clin Endocrinol (Oxf) 51: 265–271, 1999

    Google Scholar 

  67. Tsang RW, Brierley JD, Panzarella T, Gospodarowicz MK, Sutcliffe SB, Simpson WJ: Radiation therapy for pituitary adenoma: treatment outcome and prognostic factors. Int J Radiat Oncol Biol Phys 30: 557–565, 1994

    Google Scholar 

  68. Bevan JS, Burke CW: Non-functioning pituitary adenomas do not regress during bromocriptine therapy but possess membrane-bound dopamine receptors which bind bromocriptine. Clin Endocrinol (Oxf) 25: 561–572, 1986

    Google Scholar 

  69. Wollesen F, Andersen T, Karle A: Size reduction of extrasellar pituitary tumours during bromocriptine treatment. Quantitation of effect on different types of tumours. Ann Intern Med 96: 281–286, 1982

    Google Scholar 

  70. Liuzzi A, Dallabonzana D, Oppizzi G, Arrigoni L, Cozzi R, Strada S, Benini Z, Chiodini J, Chiodini PG: Is there a real medical treatment for ‘non secreting’ pituitary adenomas? In: Faglia G, Beck-Peccoz P, Ambrosi B, Travaglini P, Spada A (eds) Pituitary adenomas: New Trends in Basic and Clinical Research. Excerpta Medica, Amsterdam, 1991, pp 383–390

    Google Scholar 

  71. Bevan JS, Webster J, Burke CW, Scanlon MF: Dopamine agonists and pituitary tumour shrinkage. Endocrinol Rev 13: 220–240, 1992

    Google Scholar 

  72. D'Emden MC, Harrison LC: Rapid improvement in visual field defects following bromocriptine treatment of patients with non-functioning pituitary adenomas. Clin Endocrinol (Oxf) 25: 697–702, 1986

    Google Scholar 

  73. Garcia-Luna PP, Leal-Cerro A, Pereira JL, Montero C, Acosta D, Trujillo F, Mazuelos C, Astorga R: Rapid improvement in visual defects with parenteral depot bromocriptine in a patient with a nonfunctioning pituitary adenoma. Horm Res 32: 183–187, 1989

    Google Scholar 

  74. Kwekkeboom DJ, Lamberts SWJ: Long-term treatment with dopamine agonist CV 205-502 of patients with a clinically non-functioning, gonadotroph, or β-subunit secreting pituitary adenoma: Clin Endocrinol (Oxf) 36: 171–176, 1992

    Google Scholar 

  75. Ferone D, Lastoria S, Colao A, Varrella P, Cerbone G, Acampa W, Merola B, Salvatore M, Lombardi G: Correlation of scintigraphic results using 123I-methoxybenzamide with hormone levels and tumour size response to quinagolide in patients with pituitary adenomas. J Clin Endocrinol Metab 83: 248–252, 1998

    Google Scholar 

  76. Colao A, Ferone D, Lastoria S, Cerbone G, Di Sarno A, Di Somma C, Lucci R, Lombardi G: Hormone levels and tumour size response to quinagolide and cabergoline in patients with prolactin-secreting and clinically nonfunctioning pituitary adenomas: predictive value of pituitary scintigraphy with 123I-methoxybenzamide. Clin Endocrinol (Oxf) 52: 437–445, 2000

    Google Scholar 

  77. Reubi JC, Heitz PU, Landolt AM: Visualization of somatostatin receptors and correlation with immunoreactive growth hormone and prolactin in human pituitary adenomas: evidence for different tumors subclasses. J Clin Endocrinol Metab 65: 65–73, 1987

    Google Scholar 

  78. de Bruin TW, Kwekkeboom DJ, Van'tVerlaat JW, Reubi JC, Krenning EP, Lamberts SW, Croughs RJM: Clinically nonfunctioning pituitary adenoma and octreotide response to long term high dose treatment, and studies in vitro. J Clin Endocrinol Metab 75: 1310–1317, 1992

    Google Scholar 

  79. Warnet A, Harris AG, Renard E, Martin D, James-Deidier A, Chaumet-Riffaud P: A prospective multicenter trial of octreotide in 24 patients with visual defects caused by nonfunctioning and gonadotropin-secreting pituitary adenomas. French Multicenter Octreotide Study Group. Neurosurgery 41: 786–797, 1997

    Google Scholar 

  80. Plöckinger U, Reichel M, Fett U, Saeger W, Quabbe HJ: Preoperative octreotide treatment of growth hormonesecreting and clinically nonfunctioning pituitary macroadenomas: effect on tumor volume and lack of correlation with immunohistochemistry and somatostatin receptor scintigraphy. J Clin Endocrinol Metab 79: 1416–1423, 1994

    Google Scholar 

  81. Andersen M, Bjerre P, Schrøder HD, Edal A, Høllund-Carlsen PF, Pedersen PH, Hagen C: In vivo secretory potential and the effect of combination therapy with octreotide and cabergoline in patients with clinically nonfunctioning pituitary adenomas. Clin Endocrinol (Oxf) 54: 23–30, 2001

    Google Scholar 

  82. Warnet A, Timsit J, Chanson P, Guillausseau P, Zamfirescu F, Harris AG, Derome P, Cophignon J, Lubetzki J: The effect of somatostatin analogue on chiasmal dysfunction from pituitary macroadenomas. J Neurosurg 71: 687–690, 1989

    Google Scholar 

  83. Sassolas G, Lejeune H, Trouillas J, Forest MG, Claustrat B, Lahlou N, Loras B: Gonadotropin releasing hormone agonists are unsuccessful in reducing tumoral gonadotropin secretion in two patients with gonadotropin secreting pituitary adenomas. J Clin Endocrinol Metab 67: 180–185, 1988

    Google Scholar 

  84. Colombo P, Ambrosi A, Saccomanno K, Bassetti M, Cortelazzi D, Faglia G: Effects of long term treatment with the gonadotropin releasing hormone analog nafarelin in patients with non-functioning pituitary adenomas. Eur J Endocrinol 130: 339–345, 1994

    Google Scholar 

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  1. Pituitary Unit, Department of Neurosurgery, IRCCS San Raffaele, University of Milano, Milano, Italy

    Marco Losa, Pietro Mortini, Raffaella Barzaghi, Alberto Franzin & Massimo Giovanelli

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Losa, M., Mortini, P., Barzaghi, R. et al. Endocrine inactive and gonadotroph adenomas: diagnosis and management. J Neurooncol 54, 167–177 (2001). https://doi.org/10.1023/A:1012965617685

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