{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:34:51Z","timestamp":1772166891183,"version":"3.50.1"},"reference-count":16,"publisher":"The Endocrine Society","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,9,1]]},"abstract":"Context: GH-secreting pituitary adenomas are nearly always visible on conventional magnetic resonance (MR) imaging. However, management and outcome of acromegalic patients lacking imaging evidence of GH-secreting pituitary adenomas are undefined.<\/jats:p>\n Objective: The aim was to evaluate surgical exploration for MR-invisible GH-secreting pituitary adenomas.<\/jats:p>\n Design and Setting: We conducted a retrospective review at two tertiary care centers.<\/jats:p>\n Patients or Other Participants: Consecutive acromegalic patients without imaging evidence of a pituitary adenoma on pre- and postcontrast, spin echo T1-weighted MR imaging and who lacked evidence of an ectopic (nonpituitary) source causing GH excess were included.<\/jats:p>\n Interventions: Surgical exploration with identification and resection of a pituitary adenoma was performed.<\/jats:p>\n Main Outcome Measures: Laboratory values (GH, IGF-I), surgical findings, and clinical outcome were analyzed.<\/jats:p>\n Results: Six patients (three males, three females; 3% of all patients) with suspected GH-secreting adenomas did not demonstrate imaging evidence of pituitary adenoma on conventional MR imaging. Three patients underwent a postcontrast, volumetric interpolated breath-hold examination MR-imaging sequence (1.2-mm slice thickness), which revealed a 4-mm pituitary adenoma not seen on the spin echo T1-weighted MR imaging in one patient. A pituitary adenoma was identified and removed in all patients (mean diameter, 5.6 mm; range, 5 to 6.7 mm). Histological analysis confirmed that the lesions were GH-secreting adenomas. All patients achieved biochemical remission after surgical resection.<\/jats:p>\n Conclusion: Acromegaly can be caused by GH-secreting pituitary adenomas that are not evident on conventional MR imaging. Adenomas in some of these patients become evident using volumetric interpolated breath-hold examination MR imaging. Surgical exploration of the pituitary gland in acromegalic patients with endocrine findings consistent with a GH-secreting adenoma but negative MR imaging can lead to identification and removal of an adenoma.<\/jats:p>","DOI":"10.1210\/jc.2010-0570","type":"journal-article","created":{"date-parts":[[2010,7,7]],"date-time":"2010-07-07T22:50:06Z","timestamp":1278543006000},"page":"4192-4196","source":"Crossref","is-referenced-by-count":29,"title":["Acromegaly without Imaging Evidence of Pituitary Adenoma"],"prefix":"10.1210","volume":"95","author":[{"given":"Russell R.","family":"Lonser","sequence":"first","affiliation":[{"name":"Surgical Neurology Branch (R.R.L., B.A.K., G.U.M., E.H.O.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1414;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bogdan A.","family":"Kindzelski","sequence":"additional","affiliation":[{"name":"Surgical Neurology Branch (R.R.L., B.A.K., G.U.M., E.H.O.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1414;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gautam U.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Surgical Neurology Branch (R.R.L., B.A.K., G.U.M., E.H.O.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1414;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"John A.","family":"Jane","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery (J.A.J., E.H.O.), University of Virginia Health System, University of Virginia, Charlottesville, Virginia 22908-0816"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward H.","family":"Oldfield","sequence":"additional","affiliation":[{"name":"Surgical Neurology Branch (R.R.L., B.A.K., G.U.M., E.H.O.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1414;"},{"name":"Department of Neurosurgery (J.A.J., E.H.O.), University of Virginia Health System, University of Virginia, Charlottesville, Virginia 22908-0816"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","reference":[{"key":"2020071617385196400_R1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1023\/A:1009965803750","article-title":"Epidemiology of acromegaly.","volume":"2","author":"Holdaway","year":"1999","journal-title":"Pituitary"},{"key":"2020071617385196400_R2","doi-asserted-by":"crossref","first-page":"3099","DOI":"10.1210\/jc.2003-031138","volume":"89","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071617385196400_R3","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/1750-1172-3-17","article-title":"Acromegaly","volume":"3","author":"Chanson","year":"2008","journal-title":"Orphanet J Rare 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