{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:35:50Z","timestamp":1791387350400,"version":"4.3.3"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T00:00:00Z","timestamp":1687392000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The optimal approach to the surveillance of non-functioning pituitary microadenomas (micro-NFPAs) is not clearly established. Our aim was to generate evidence on the natural history of micro-NFPAs to support patient care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Multi-centre, retrospective, cohort study involving 23 endocrine departments (UK NFPA consortium).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Clinical, imaging, and hormonal data of micro-NFPA cases between January, 1, 2008 and December, 21, 2021 were analysed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Data for 459 patients were retrieved [median age at detection 44 years (IQR 31-57)\u2014152 males\/307 females]. Four hundred and nineteen patients had more than two magnetic resonance imagings (MRIs) [median imaging monitoring 3.5 years (IQR 1.71-6.1)]. One case developed apoplexy. Cumulative probability of micro-NFPA growth was 7.8% (95% CI, 4.9%-8.1%) and 14.5% (95% CI, 10.2%-18.8%) at 3 and 5 years, respectively, and of reduction 14.1% (95% CI, 10.4%-17.8%) and 21.3% (95% CI, 16.4%-26.2%) at 3 and 5 years, respectively. Median tumour enlargement was 2\u2005mm (IQR 1-3) and 49% of micro-NFPAs that grew became macroadenomas (nearly all &amp;gt;5\u2005mm at detection). Eight (1.9%) patients received surgery (only one had visual compromise with surgery required &amp;gt;3 years after micro-NFPA detection). Sex, age, and size at baseline were not predictors of enlargement\/reduction. At the time of detection, 7.2%, 1.7%, and 1.5% patients had secondary hypogonadism, hypothyroidism, and hypoadrenalism, respectively. Two (0.6%) developed hypopituitarism during follow-up (after progression to macroadenoma).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Probability of micro-NFPA growth is low, and the development of new hypopituitarism is rare. Delaying the first follow-up MRI to 3 years and avoiding hormonal re-evaluation in the absence of tumour growth or clinical manifestations is a safe approach for micro-NFPA surveillance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejendo\/lvad070","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T18:27:13Z","timestamp":1687631233000},"page":"87-95","source":"Crossref","is-referenced-by-count":40,"title":["Natural history of non-functioning pituitary microadenomas: results from the UK non-functioning pituitary adenoma consortium"],"prefix":"10.1093","volume":"189","author":[{"given":"Ross","family":"Hamblin","sequence":"first","affiliation":[{"name":"Institute of Metabolism and Systems Research, University of Birmingham , Birmingham, B15 2TT , United Kingdom"},{"name":"Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners , Birmingham, B15 2TT , United Kingdom"},{"name":"Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust , Birmingham, B15 2GW , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Fountas","sequence":"additional","affiliation":[{"name":"Institute of Metabolism and Systems Research, University of Birmingham , Birmingham, B15 2TT , United Kingdom"},{"name":"Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners , Birmingham, B15 2TT , United Kingdom"},{"name":"Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust , Birmingham, B15 2GW , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirstie","family":"Lithgow","sequence":"additional","affiliation":[{"name":"Institute of Metabolism and Systems Research, University of Birmingham , Birmingham, B15 2TT , United Kingdom"},{"name":"Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners , Birmingham, B15 2TT , United Kingdom"},{"name":"Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust , Birmingham, B15 2GW , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul Benjamin","family":"Loughrey","sequence":"additional","affiliation":[{"name":"Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital , Belfast, BT12 6BA , United Kingdom"},{"name":"Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast , Belfast, BT9 7AE , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efstathios","family":"Bonanos","sequence":"additional","affiliation":[{"name":"Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital , Belfast, BT12 6BA , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shah Khalid","family":"Shinwari","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolic Medicine, Royal Stoke University Hospital, University Hospitals of North Midlands , Stoke-on-Trent, ST4 6QE , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Queen Elizabeth University Hospital , Glasgow, G51 4TF , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Liverpool University Hospitals NHS Foundation Trust , Liverpool, L7 8YE , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Grixti","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolic Medicine, The Newcastle-Upon-Tyne NHS Foundation Trust , Newcastle , NE7 7DN, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Matheou","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals NHS Foundation Trust , Oxford, OX3 7LE , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Isand","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals NHS Foundation Trust , Oxford, OX3 7LE , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S","family":"McLaren","sequence":"additional","affiliation":[{"name":"Leeds Centre for Diabetes & Endocrinology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust , Leeds , LS9 7TF, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashutosh","family":"Surya","sequence":"additional","affiliation":[{"name":"Centre for Diabetes and Endocrinology, University Hospital of Wales , Cardiff, CF14 4XW , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafiz Zubair","family":"Ullah","sequence":"additional","affiliation":[{"name":"Centre for Diabetes and Endocrinology, University Hospital of Wales , Cardiff, CF14 4XW , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Klaucane","sequence":"additional","affiliation":[{"name":"Manx Centre for Endocrinology, Diabetes & Metabolism, Manx Care , Douglas, IM4 4RJ , Isle of Man"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuradha","family":"Jayasuriya","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust , Sheffield, S10 2JF , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumbal","family":"Bhatti","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Norfolk and Norwich University Hospitals Foundation Trust , Norwich, NR4 7UY , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash","family":"Mavilakandy","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust , Leicester, LE1 5WW , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Ahsan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust , Leicester, LE1 5WW , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Mathew","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, The Christie NHS Foundation Trust , Manchester, M20 4BX , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziad","family":"Hussein","sequence":"additional","affiliation":[{"name":"Department of Diabetes & Endocrinology, University College London Hospital NHS Foundation Trust , London, NW1 2PG , United 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E","family":"Baldeweg","sequence":"additional","affiliation":[{"name":"Department of Diabetes & Endocrinology, University College London Hospital NHS Foundation Trust , London, NW1 2PG , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir H","family":"Sam","sequence":"additional","affiliation":[{"name":"Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust , London, W6 8RF , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niamh","family":"Martin","sequence":"additional","affiliation":[{"name":"Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust , London, W6 8RF , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Higham","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, The Christie NHS Foundation Trust , Manchester, M20 4BX , United Kingdom"},{"name":"Manchester Academic Health Science Centre, University of 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