November 14, 1990

The Pituitary Incidentaloma Beyond the First Year of Follow-up-Reply

Author Affiliations

University of Cologne West Germany

University of Cologne West Germany

JAMA. 1990;264(18):2387. doi:10.1001/jama.1990.03450180043024

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


In Reply.—  Drs Frohman, Kupersmith, and Warren provide important additional information on the conservative approach to patients with incidentally discovered small pituitary tumors. They describe several patients with lesions less than 1 cm in diameter and no increase in tumor size during the first year of follow-up who experienced later tumor enlargement and compression of the optic nerve.Although we did not observe a similar case in a total of 30 patients with incidentalomas treated conservatively (14 patients in our initial series, 16 additional patients studied since 1988), unexpected late tumor growth certainly may occur in a small percentage of these patients. However, our preliminary results demonstrate that the great majority of incidentalomas remain asymptomatic and stable during follow-up. Nevertheless, close surveillance seems to be necessary for more than a year. Since yearly magnetic resonance imaging or computed tomographic scans should be avoided, we recommend clinical follow-up studies (for