{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T03:06:29Z","timestamp":1780628789944,"version":"3.54.1"},"reference-count":28,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Exp Clin Endocrinol Diabetes"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Although non-functioning pituitary tumors are frequent, diagnostic and therapeutic concepts are not well standardized. We here present the first German multidisciplinary guideline on this topic. The single most important message is to manage the patients by a multidisciplinary team (consisting at least of an endocrinologist, a neurosurgeon, and a (neuro-) radiologist). The initial diagnostic work-up comprises a detailed characterization of both biochemical (focusing on hormonal excess or deficiency states) and morphological aspects (with magnetic resonance imaging of the sellar region). An ophthalmological examination is only needed in presence of symptoms or large tumors affecting the visual system. Asymptomatic, hormonally inactive tumors allow for a 'wait and scan' strategy. In contrast, surgical treatment by an experienced pituitary surgeon is standard of care in case of (impending) visual impairment. Therapeutic options for incompletely resected or recurrent tumors include re-operation, radiotherapy, and observation; the individual treatment plan should be developed multidisciplinary. Irrespective of the therapeutic approach applied, patients require long-term follow-up. Patient with larger pituitary tumors or former surgery\/radiotherapy should be regularly counseled regarding potential symptoms of hormonal deficiency states.<\/jats:p>","DOI":"10.1055\/a-1373-4087","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T23:33:58Z","timestamp":1615332838000},"page":"250-264","source":"Crossref","is-referenced-by-count":19,"title":["First German Guideline on Diagnostics and Therapy of Clinically Non-Functioning Pituitary Tumors"],"prefix":"10.1055","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0586-0168","authenticated-orcid":false,"given":"Timo","family":"Deutschbein","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital W\u00fcrzburg, University of W\u00fcrzburg, W\u00fcrzburg, Germany"},{"name":"Medicover Oldenburg MVZ, Oldenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Jaursch-Hancke","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, German Clinic of Diagnostics, Wiesbaden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich J.","family":"Knappe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johannes Wesling Hospital, University Hospital of the Ruhr-University Bochum, Minden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Saeger","sequence":"additional","affiliation":[{"name":"Institute for Neuropathology, University Hospital Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Flitsch","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Bojunga","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology, Goethe-University Hospital, Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Buchfelder","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital Erlangen, Friedrich-Alexander University of Erlangen-N\u00fcrnberg, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beate","family":"Ditzen","sequence":"additional","affiliation":[{"name":"Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Ruprecht-Karls University Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00fcdiger","family":"Gerlach","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Helios Klinikum Erfurt, Erfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elfriede","family":"Gertzen","sequence":"additional","affiliation":[{"name":"Niels Stensen Bildungszentrum, Osnabr\u00fcck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Honegger","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital T\u00fcbingen, Eberhard-Karls-University T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard A.","family":"Horstmann","sequence":"additional","affiliation":[{"name":"Gamma Knife Center Krefeld, Krefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arend","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Neuropathology, Berlin Institute of Health, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t Zu Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6389-0261","authenticated-orcid":false,"given":"Ilonka","family":"Kreitschmann-Andermahr","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Spine Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Kunz","sequence":"additional","affiliation":[{"name":"Schwerpunktpraxis f\u00fcr Diabetologie und Endokrinologie, Ludwigshafen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolf A.","family":"Lagr\u00e8ze","sequence":"additional","affiliation":[{"name":"Eye Center, Medical Center, Medical Faculty, University of Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils H.","family":"Nicolay","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Freiburg \u2013 Medical Center, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Paulus","sequence":"additional","affiliation":[{"name":"Institute of Neuropathology, University Hospital M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Reincke","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik IV, Klinikum der Universit\u00e4t, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel A.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, University Hospital Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias M.","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, I Medical Clinic, University Hospital, Johannes Gutenberg University of Mainz, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut","family":"Wilhelm","sequence":"additional","affiliation":[{"name":"Centre for Ophthalmology, University Hospital T\u00fcbingen, Eberhard-Karls-University T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Fassnacht","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital W\u00fcrzburg, University of W\u00fcrzburg, W\u00fcrzburg, 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