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Is Neurosurgery Required?

Martin Reincke, MD; Bruno Allolio, MD; Wolfgang Saeger, MD; Jürgen Menzel, MD; Werner Winkelmann, MD

JAMA. 1990;263(20):2772-2776.

Abstract
We describe a series of 18 patients with an intrasellar mass incidentally discovered by computed tomography or magnetic resonance imaging. The average size of the mass was 13 mm, with a range from 5 to 25 mm. Initial ophthalmologic examination revealed bitemporal hemianopia in 2 patients. Results of routine endocrine testing showed partial hypopituitarism in 5 patients and growth hormone hypersecretion without signs and symptoms of acromegaly in 1 patient. Four patients underwent neurosurgery. Histologically, one chondroid chordoma and three pituitary adenomas were found. In the remaining 14 patients treated conservatively, repeated computed tomography and magnetic resonance imaging revealed no significant change in tumor size at the time of follow-up (median, 22 months). Our results suggest that the "incidentaloma" of the pituitary gland is a benign condition that does not necessarily require neurosurgical intervention.

(JAMA. 1990;263:2772-2776)

Author Affiliations
From the Department of Medicine II, University of Cologne, Krankenhaus Merheim, West Germany (Drs Reincke and Allolio and Prof Dr Winkelmann); Department of Pathology, Marienkrankenhaus Hamburg, West Germany (Prof Dr Saeger); Department of Neurosurgery, Krankenhaus Merheim, Cologne, West Germany (Prof Dr Menzel).

Footnotes
Reprint requests to Department of Medicine II, Krankenhaus Merheim, Ostmerheimer Str 200, 5000 Köln 91, West Germany (Dr Reincke).

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