Non functioning pituitary adenomas non functioning pituitary neuroendocrine tumores NF PitNETS

Non functioning pituitary adenomas,
non-functioning pituitary neuroendocrine tumores (NF-PitNETS)

 Clinical cases

Akbar Soltani. MD.MSc.Endocrinologist

Evidence Based Medicine Research Center

Critical Thinking Group

Tehran University of Medical Sciences

1st case: Mrs B., 55 yo

•Previous history

–Mammary benign cyst

–Bilateral ovariectomy when 48yo, HRT for menopause

–Hysterectomy when 49yo (endometriosis)

•Recent history:

–Consults an endocrinologist for weight gain,

–He measures PRL level which is increased to 120 ng/ml (N<20)

•Normal clinical examination

MRI macroadenoma measuring 28X25X20 mm with suprasellar expansion suprasellaire compressing the optic chiasm

The qualitative importance of T2 for NFPA vs. FUNCTIONAL?

Hardy’s classification of pituitary tumors: classification of sphenoid bone invasion

grade 0: intact with normal contour;

Grade I: intact with bulging floor

grade II: intact, with enlarged fossa

grade III: localized sellar destruction

grade IV: diffuse destruction

Hardy’s classification of pituitary tumors: classification of the suprasellar extension

grade A: suprasellar cistern only

grade B: recess of the third ventricle

grade C: whole anterior third ventricle

grade D: intracranial extradural

grade E extracranial extradural (cavernous sinus)