ASYMPTOMATIC LARGE PITUITARY-ADENOMAS DISCOVERED AT AUTOPSY

BACKGROUND Pituitary adenomas over 1 inch (2.5 cm) in diameter might s eem to warrant surgical Intervention by virtue of their inevitable com pression and distortion of surrounding neural tissues. METHODS We repo rt three pituitary adenomas over 1 inch in diameter, causing gross dis tortion of the optic nerves, chiasm, and tracts, as well as surroundin g brain structures. All three tumors were asymptomatic and were discov ered incidentally at autopsy in patients 65, 79, and 101 years of age. RESULTS Tumor diameters were 2.5, 4.0, and 2.5 cm, respectively. Hist ologically, all were chromophobe adenomas, free of either hemorrhage o r necrosis, In the absence of hormonal secretion or pituitary apoplexy , symptom-free giant adenomas of the pituitary are compatible with a l ong life. CONCLUSIONS We conclude that the need for surgical intervent ion in pituitary adenomata should be determined by considerations othe r than mere tumor presence and size.