The 'incidentaloma' of the pituitary gland. Is neurosurgery required?

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.