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Gilbert Schaison - One of the best experts on this subject based on the ideXlab platform.
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normal Pituitary hypertrophy as a frequent cause of Pituitary Incidentaloma a follow up study
The Journal of Clinical Endocrinology and Metabolism, 2001Co-Authors: Philippe Chanson, Angela Bellucci, Dominique Doyon, Michele Kujas, Jacques Young, Gilbert SchaisonAbstract:Enlargement of the Pituitary gland is a frequent cause of Incidentaloma and of referrals to endocrinologists for hormonal evaluation and therapeutic advice. In neuroradiological series, 25–50% of healthy women who are 18–35 yr old have a convex superior Pituitary contour, but Pituitary height exceeds 9 mm in less than 0.5% of cases. This study was performed to provide thorough clinical and hormonal data and long-term endocrinological and imaging follow-up data on subjects with incidentally discovered Pituitary hypertrophy (height > 9 mm). Seven eugonadal nulliparous women, 15–27 yr old, referred between 1989 and 1998 with incidentally diagnosed Pituitary gland enlargement (height > 9 mm) and a suspected Pituitary tumor, were studied. At presentation and at yearly intervals, PRL plasma levels and corticotropic, somatotropic, and thyrotropic Pituitary function were measured; and Pituitary dimensions and signal on magnetic resonance imaging (MRI), before and after iv gadolinium-diethylene-triamine-pentaaceti...
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Normal Pituitary hypertrophy as a frequent cause of Pituitary Incidentaloma: a follow-up study.
The Journal of clinical endocrinology and metabolism, 2001Co-Authors: Philippe Chanson, Angela Bellucci, Dominique Doyon, Michele Kujas, Jacques Young, Gilbert SchaisonAbstract:Enlargement of the Pituitary gland is a frequent cause of Incidentaloma and of referrals to endocrinologists for hormonal evaluation and therapeutic advice. In neuroradiological series, 25-50% of healthy women who are 18-35 yr old have a convex superior Pituitary contour, but Pituitary height exceeds 9 mm in less than 0.5% of cases. This study was performed to provide thorough clinical and hormonal data and long-term endocrinological and imaging follow-up data on subjects with incidentally discovered Pituitary hypertrophy (height > 9 mm). Seven eugonadal nulliparous women, 15-27 yr old, referred between 1989 and 1998 with incidentally diagnosed Pituitary gland enlargement (height > 9 mm) and a suspected Pituitary tumor, were studied. At presentation and at yearly intervals, PRL plasma levels and corticotropic, somatotropic, and thyrotropic Pituitary function were measured; and Pituitary dimensions and signal on magnetic resonance imaging (MRI), before and after iv gadolinium-diethylene-triamine-pentaacetic acid injection, were assessed. PRL plasma levels were normal; and corticotropic, somatotropic, and thyrotropic Pituitary function was considered normal in all cases. In all the women, the upper boundary of the Pituitary was convex, on MRI, and touched the optic chiasm in four cases. The width and anteroposterior diameter of the gland were normal. The Pituitary itself seemed normal, with a homogeneous signal, on plain and dynamic studies with iv contrast injection. Despite normal initial hormone values, two women underwent surgery, by the transsphenoidal approach, in another center. During surgery, the Pituitary seemed normal in both cases, with no evidence of tumoral or inflammatory processes. Biopsy specimens showed the morphologic characteristics of a normal, nonhyperplastic Pituitary gland. All seven women were seen at yearly intervals for 2-8 yr (median, 4 yr). Clinical and hormonal status remained stable, as did the structure and size of Pituitary, on serial MRI. No tumor formation occurred, supporting the diagnosis of physiologic hypertrophy of the Pituitary gland. In conclusion, these observations suggest that careful examination of MRI results may help to distinguish physiologic Pituitary hypertrophy from Pituitary tumors and infiltrating lesions. The former diagnosis is confirmed by normal baseline Pituitary function in extensive hormonal tests. Correct identification of such patients is important to avoid unnecessary Pituitary surgery and costly MRI surveillance.
Mark E. Molitch - One of the best experts on this subject based on the ideXlab platform.
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Management of nonfunctioning Pituitary adenomas (NFAs): observation
Pituitary, 2018Co-Authors: Wenyu Huang, Mark E. MolitchAbstract:Clinically nonfunctioning Pituitary adenomas (NFAs) range from those causing significant hypothalamic/Pituitary dysfunction and visual field compromise due to their large size to those being completely asymptomatic. In the absence of hypersecretion, hypopituitarism or visual field defects, patients with NFAs may be followed by periodic surveillance using MRI to detect tumor enlargement. In some cases, endocrine tests are also needed during observation to discover new Pituitary dysfunction. Enlargement of NFAs without treatment occurs in about 10% of microadenomas and 23% of macroadenomas. Growth of a Pituitary Incidentaloma, the development of visual field defects or the development of hypopituitarism are potential indications for surgery during follow up.
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Management of incidentally found nonfunctional Pituitary tumors.
Neurosurgery clinics of North America, 2012Co-Authors: Mark E. MolitchAbstract:Clinically nonfunctioning Pituitary adenomas range from those causing significant hypothalamic/Pituitary dysfunction and visual field compromise to those being completely asymptomatic, detected either at autopsy or as incidental findings on imaging scans performed for other reasons (often referred to as Pituitary Incidentalomas). Growth of nonfunctioning Pituitary adenomas without treatment occurs in about 10% of microadenomas and 24% of macroadenomas. In the absence of hypersecretion, hypopituitarism, or visual-field defects, periodic screening by magnetic resonance imaging may detect enlargement. Potential indications for surgery are growth of a Pituitary Incidentaloma, the development of visual-field defects, or the development of hypopituitarism.
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Pituitary Incidentaloma an endocrine society clinical practice guideline
The Journal of Clinical Endocrinology and Metabolism, 2011Co-Authors: Pamela U. Freda, Albert Beckers, Laurence Katznelson, Mark E. Molitch, Victor M Montori, Kalmon D Post, Mary Lee VanceAbstract:Practice guidelines for the endocrine evaluation and treatment of Pituitary Incidentalomas are presented, including indications for surgery.
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Patient Guide to Pituitary Incidentaloma Assessment and Treatment
The Journal of clinical endocrinology and metabolism, 2011Co-Authors: Pamela U. Freda, Laurence Katznelson, Mark E. MolitchAbstract:The aim was to formulate practice guidelines for endocrine evaluation and treatment of Pituitary Incidentalomas. Consensus was guided by systematic reviews of evidence and discussions through a series of conference calls and e-mails and one in-person meeting. We recommend that patients with a Pituitary Incidentaloma undergo a complete history and physical examination, laboratory evaluations screening for hormone hypersecretion and for hypopituitarism, and a visual field examination if the lesion abuts the optic nerves or chiasm. We recommend that patients with Incidentalomas not meeting criteria for surgical removal be followed with clinical assessments, neuroimaging (magnetic resonance imaging at 6 months for macroIncidentalomas, 1 yr for a microIncidentaloma, and thereafter progressively less frequently if unchanged in size), visual field examinations for Incidentalomas that abut or compress the optic nerve and chiasm (6 months and yearly), and endocrine testing for macroIncidentalomas (6 months and yearly) after the initial evaluations. We recommend that patients with a Pituitary Incidentaloma be referred for surgery if they have a visual field deficit; signs of compression by the tumor leading to other visual abnormalities, such as ophthalmoplegia, or neurological compromise due to compression by the lesion; a lesion abutting the optic nerves or chiasm; Pituitary apoplexy with visual disturbance; or if the Incidentaloma is a hypersecreting tumor other than a prolactinoma.
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clinical review 65 evaluation and treatment of the patient with a Pituitary Incidentaloma
The Journal of Clinical Endocrinology and Metabolism, 1995Co-Authors: Mark E. MolitchAbstract:Incidental Pituitary adenomas are being found commonly with our improved neuroradiological imaging procedures. Screening for hormone oversecretion by these tumors appears to be warranted. For patients with macroadenomas, patients should also be screened for hypopituitarism. In the absence of visual field abnormalities or hypothalamic/stalk compression, it may be appropriate to observe such patients carefully with repeated CT or MRI scans. A limited amount of data suggests that significant tumor enlargement will occur in less than 15% of patients with microadenomas (7). However, all macroadenomas must start out as microadenomas, so periodic follow-up is indicated to assess this possibility. Macroadenomas, by their very existence at the time of detection, have already indicated a propensity for growth. Over the limited period of follow-up in the two series reported, significant growth occurred in almost one third of patients with macroadenomas (7, 8). Hemorrhage into such tumors is uncommon, but anticoagula...
Philippe Chanson - One of the best experts on this subject based on the ideXlab platform.
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management of nonfunctioning Pituitary Incidentaloma
Annales D Endocrinologie, 2015Co-Authors: Françoise Galland, Philippe Chanson, Jean-françois Bonneville, Marie-christine Vantyghem, Laure Cazabat, Anne Boulin, François Cotton, Emmanuel Jouanneau, G VidaltrecanAbstract:Abstract Prevalence of Pituitary Incidentaloma is variable: between 1.4% and 27% at autopsy, and between 3.7% and 37% on imaging. Pituitary microIncidentalomas (serendipitously discovered adenoma 1 cm in diameter) show increased size in 20–24% and 34–40% of cases at respectively 4 and 8 years’ follow-up. Radiologic differential diagnosis requires MRI centered on the Pituitary gland. Initial assessment of nonfunctioning (NF) microIncidentaloma is firstly clinical, the endocrinologist looking for signs of hypersecretion (signs of hyperprolactinemia, acromegaly or Cushing's syndrome), followed up by systematic prolactin and IGF-1 assay. Initial assessment of NF macroIncidentaloma is clinical, the endocrinologist looking for signs of hormonal hypersecretion or hypopituitarism, followed up by hormonal assay to screen for hypersecretion or hormonal deficiency and by ophthalmologic assessment (visual acuity and visual field) if and only if the lesion is near the optic chiasm (OC). NF microIncidentaloma of less than 5 mm requires no surveillance; those of ≥ 5 mm are not operated on but rather monitored on MRI at 6 months and then 2 years. MacroIncidentaloma remote from the OC is monitored on MRI at 1 year, with hormonal exploration (for anterior Pituitary deficiency), then every 2 years. When macroIncidentaloma located near the OC is managed by surveillance rather than surgery, MRI is recommended at 6 months, with hormonal and visual exploration, then annual MRI and hormonal and visual assessment every 6 months. Surgery is indicated in the following cases: evolutive NF microIncidentaloma, NF macroIncidentaloma associated with hypopituitarism or showing progression, Incidentaloma compressing the OC, possible malignancy, non-compliant patient, pregnancy desired in the short-term, or context at risk of apoplexy.
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Management of nonfunctioning Pituitary Incidentaloma
Annales d'Endocrinologie, 2015Co-Authors: Françoise Galland, Jean-françois Bonneville, Marie-christine Vantyghem, Laure Cazabat, Anne Boulin, François Cotton, Emmanuel Jouanneau, Gwénaelle Vidal-trécan, Philippe ChansonAbstract:Prevalence of Pituitary Incidentaloma is variable: between 1.4% and 27% at autopsy, and between 3.7% and 37% on imaging. Pituitary microIncidentalomas (serendipitously discovered adenoma \textless1cm in diameter) may increase in size, but only 5% exceed 10mm. Pituitary macroIncidentalomas (serendipitously discovered adenoma\textgreater1cm in diameter) show increased size in 20-24% and 34-40% of cases at respectively 4 and 8years' follow-up. Radiologic differential diagnosis requires MRI centered on the Pituitary gland. Initial assessment of nonfunctioning (NF) microIncidentaloma is firstly clinical, the endocrinologist looking for signs of hypersecretion (signs of hyperprolactinemia, acromegaly or Cushing's syndrome), followed up by systematic prolactin and IGF-1 assay. Initial assessment of NF macroIncidentaloma is clinical, the endocrinologist looking for signs of hormonal hypersecretion or hypopituitarism, followed up by hormonal assay to screen for hypersecretion or hormonal deficiency and by ophthalmologic assessment (visual acuity and visual field) if and only if the lesion is near the optic chiasm (OC). NF microIncidentaloma of less than 5mm requires no surveillance; those of≥5mm are not operated on but rather monitored on MRI at 6months and then 2years. MacroIncidentaloma remote from the OC is monitored on MRI at 1year, with hormonal exploration (for anterior Pituitary deficiency), then every 2years. When macroIncidentaloma located near the OC is managed by surveillance rather than surgery, MRI is recommended at 6months, with hormonal and visual exploration, then annual MRI and hormonal and visual assessment every 6months. Surgery is indicated in the following cases: evolutive NF microIncidentaloma, NF macroIncidentaloma associated with hypopituitarism or showing progression, Incidentaloma compressing the OC, possible malignancy, non-compliant patient, pregnancy desired in the short-term, or context at risk of apoplexy
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management of clinically non functioning Pituitary adenoma
Annales D Endocrinologie, 2015Co-Authors: Philippe Chanson, Françoise Galland, Gerald Raverot, Frederic Castinetti, C Cortetrudelli, Sylvie SalenaveAbstract:Clinically NFPA is currently the preferred term for designing all the Pituitary adenomas which are not hormonally active (in other words, not associated with clinical syndromes such as amenorrhea-galactorrhea in the context of prolactinomas, acromegaly, Cushing's disease or hyperthyroidism secondary to TSH-secreting adenomas). They account for 15-30% of Pituitary adenomas. Diagnosis is usually made either in the context of mass effect due to a macroadenoma or, increasingly, fortuitously during imaging performed for some unrelated purpose; the latter case is known as Pituitary Incidentaloma. Surgery is indisputably indicated in case of tumoral syndrome, but other aspects of NFPA (hormonal work-up, follow-up, and especially postoperative follow-up, management of remnant or recurrence, the special case of Incidentaloma, or apoplexy) remain controversial. The French Endocrinology Society (SFE) therefore set up an expert working group of endocrinologists, neurosurgeons, ophthalmologists, neuroradiologists, pathologists and biologists to draw up guidelines, at the 2012 SFE Congress in Toulouse, France. The present article presents the guidelines suggested by this group of French-speaking experts.
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normal Pituitary hypertrophy as a frequent cause of Pituitary Incidentaloma a follow up study
The Journal of Clinical Endocrinology and Metabolism, 2001Co-Authors: Philippe Chanson, Angela Bellucci, Dominique Doyon, Michele Kujas, Jacques Young, Gilbert SchaisonAbstract:Enlargement of the Pituitary gland is a frequent cause of Incidentaloma and of referrals to endocrinologists for hormonal evaluation and therapeutic advice. In neuroradiological series, 25–50% of healthy women who are 18–35 yr old have a convex superior Pituitary contour, but Pituitary height exceeds 9 mm in less than 0.5% of cases. This study was performed to provide thorough clinical and hormonal data and long-term endocrinological and imaging follow-up data on subjects with incidentally discovered Pituitary hypertrophy (height > 9 mm). Seven eugonadal nulliparous women, 15–27 yr old, referred between 1989 and 1998 with incidentally diagnosed Pituitary gland enlargement (height > 9 mm) and a suspected Pituitary tumor, were studied. At presentation and at yearly intervals, PRL plasma levels and corticotropic, somatotropic, and thyrotropic Pituitary function were measured; and Pituitary dimensions and signal on magnetic resonance imaging (MRI), before and after iv gadolinium-diethylene-triamine-pentaaceti...
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Normal Pituitary hypertrophy as a frequent cause of Pituitary Incidentaloma: a follow-up study.
The Journal of clinical endocrinology and metabolism, 2001Co-Authors: Philippe Chanson, Angela Bellucci, Dominique Doyon, Michele Kujas, Jacques Young, Gilbert SchaisonAbstract:Enlargement of the Pituitary gland is a frequent cause of Incidentaloma and of referrals to endocrinologists for hormonal evaluation and therapeutic advice. In neuroradiological series, 25-50% of healthy women who are 18-35 yr old have a convex superior Pituitary contour, but Pituitary height exceeds 9 mm in less than 0.5% of cases. This study was performed to provide thorough clinical and hormonal data and long-term endocrinological and imaging follow-up data on subjects with incidentally discovered Pituitary hypertrophy (height > 9 mm). Seven eugonadal nulliparous women, 15-27 yr old, referred between 1989 and 1998 with incidentally diagnosed Pituitary gland enlargement (height > 9 mm) and a suspected Pituitary tumor, were studied. At presentation and at yearly intervals, PRL plasma levels and corticotropic, somatotropic, and thyrotropic Pituitary function were measured; and Pituitary dimensions and signal on magnetic resonance imaging (MRI), before and after iv gadolinium-diethylene-triamine-pentaacetic acid injection, were assessed. PRL plasma levels were normal; and corticotropic, somatotropic, and thyrotropic Pituitary function was considered normal in all cases. In all the women, the upper boundary of the Pituitary was convex, on MRI, and touched the optic chiasm in four cases. The width and anteroposterior diameter of the gland were normal. The Pituitary itself seemed normal, with a homogeneous signal, on plain and dynamic studies with iv contrast injection. Despite normal initial hormone values, two women underwent surgery, by the transsphenoidal approach, in another center. During surgery, the Pituitary seemed normal in both cases, with no evidence of tumoral or inflammatory processes. Biopsy specimens showed the morphologic characteristics of a normal, nonhyperplastic Pituitary gland. All seven women were seen at yearly intervals for 2-8 yr (median, 4 yr). Clinical and hormonal status remained stable, as did the structure and size of Pituitary, on serial MRI. No tumor formation occurred, supporting the diagnosis of physiologic hypertrophy of the Pituitary gland. In conclusion, these observations suggest that careful examination of MRI results may help to distinguish physiologic Pituitary hypertrophy from Pituitary tumors and infiltrating lesions. The former diagnosis is confirmed by normal baseline Pituitary function in extensive hormonal tests. Correct identification of such patients is important to avoid unnecessary Pituitary surgery and costly MRI surveillance.
Jacques Young - One of the best experts on this subject based on the ideXlab platform.
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normal Pituitary hypertrophy as a frequent cause of Pituitary Incidentaloma a follow up study
The Journal of Clinical Endocrinology and Metabolism, 2001Co-Authors: Philippe Chanson, Angela Bellucci, Dominique Doyon, Michele Kujas, Jacques Young, Gilbert SchaisonAbstract:Enlargement of the Pituitary gland is a frequent cause of Incidentaloma and of referrals to endocrinologists for hormonal evaluation and therapeutic advice. In neuroradiological series, 25–50% of healthy women who are 18–35 yr old have a convex superior Pituitary contour, but Pituitary height exceeds 9 mm in less than 0.5% of cases. This study was performed to provide thorough clinical and hormonal data and long-term endocrinological and imaging follow-up data on subjects with incidentally discovered Pituitary hypertrophy (height > 9 mm). Seven eugonadal nulliparous women, 15–27 yr old, referred between 1989 and 1998 with incidentally diagnosed Pituitary gland enlargement (height > 9 mm) and a suspected Pituitary tumor, were studied. At presentation and at yearly intervals, PRL plasma levels and corticotropic, somatotropic, and thyrotropic Pituitary function were measured; and Pituitary dimensions and signal on magnetic resonance imaging (MRI), before and after iv gadolinium-diethylene-triamine-pentaaceti...
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Normal Pituitary hypertrophy as a frequent cause of Pituitary Incidentaloma: a follow-up study.
The Journal of clinical endocrinology and metabolism, 2001Co-Authors: Philippe Chanson, Angela Bellucci, Dominique Doyon, Michele Kujas, Jacques Young, Gilbert SchaisonAbstract:Enlargement of the Pituitary gland is a frequent cause of Incidentaloma and of referrals to endocrinologists for hormonal evaluation and therapeutic advice. In neuroradiological series, 25-50% of healthy women who are 18-35 yr old have a convex superior Pituitary contour, but Pituitary height exceeds 9 mm in less than 0.5% of cases. This study was performed to provide thorough clinical and hormonal data and long-term endocrinological and imaging follow-up data on subjects with incidentally discovered Pituitary hypertrophy (height > 9 mm). Seven eugonadal nulliparous women, 15-27 yr old, referred between 1989 and 1998 with incidentally diagnosed Pituitary gland enlargement (height > 9 mm) and a suspected Pituitary tumor, were studied. At presentation and at yearly intervals, PRL plasma levels and corticotropic, somatotropic, and thyrotropic Pituitary function were measured; and Pituitary dimensions and signal on magnetic resonance imaging (MRI), before and after iv gadolinium-diethylene-triamine-pentaacetic acid injection, were assessed. PRL plasma levels were normal; and corticotropic, somatotropic, and thyrotropic Pituitary function was considered normal in all cases. In all the women, the upper boundary of the Pituitary was convex, on MRI, and touched the optic chiasm in four cases. The width and anteroposterior diameter of the gland were normal. The Pituitary itself seemed normal, with a homogeneous signal, on plain and dynamic studies with iv contrast injection. Despite normal initial hormone values, two women underwent surgery, by the transsphenoidal approach, in another center. During surgery, the Pituitary seemed normal in both cases, with no evidence of tumoral or inflammatory processes. Biopsy specimens showed the morphologic characteristics of a normal, nonhyperplastic Pituitary gland. All seven women were seen at yearly intervals for 2-8 yr (median, 4 yr). Clinical and hormonal status remained stable, as did the structure and size of Pituitary, on serial MRI. No tumor formation occurred, supporting the diagnosis of physiologic hypertrophy of the Pituitary gland. In conclusion, these observations suggest that careful examination of MRI results may help to distinguish physiologic Pituitary hypertrophy from Pituitary tumors and infiltrating lesions. The former diagnosis is confirmed by normal baseline Pituitary function in extensive hormonal tests. Correct identification of such patients is important to avoid unnecessary Pituitary surgery and costly MRI surveillance.
Michele Kujas - One of the best experts on this subject based on the ideXlab platform.
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normal Pituitary hypertrophy as a frequent cause of Pituitary Incidentaloma a follow up study
The Journal of Clinical Endocrinology and Metabolism, 2001Co-Authors: Philippe Chanson, Angela Bellucci, Dominique Doyon, Michele Kujas, Jacques Young, Gilbert SchaisonAbstract:Enlargement of the Pituitary gland is a frequent cause of Incidentaloma and of referrals to endocrinologists for hormonal evaluation and therapeutic advice. In neuroradiological series, 25–50% of healthy women who are 18–35 yr old have a convex superior Pituitary contour, but Pituitary height exceeds 9 mm in less than 0.5% of cases. This study was performed to provide thorough clinical and hormonal data and long-term endocrinological and imaging follow-up data on subjects with incidentally discovered Pituitary hypertrophy (height > 9 mm). Seven eugonadal nulliparous women, 15–27 yr old, referred between 1989 and 1998 with incidentally diagnosed Pituitary gland enlargement (height > 9 mm) and a suspected Pituitary tumor, were studied. At presentation and at yearly intervals, PRL plasma levels and corticotropic, somatotropic, and thyrotropic Pituitary function were measured; and Pituitary dimensions and signal on magnetic resonance imaging (MRI), before and after iv gadolinium-diethylene-triamine-pentaaceti...
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Normal Pituitary hypertrophy as a frequent cause of Pituitary Incidentaloma: a follow-up study.
The Journal of clinical endocrinology and metabolism, 2001Co-Authors: Philippe Chanson, Angela Bellucci, Dominique Doyon, Michele Kujas, Jacques Young, Gilbert SchaisonAbstract:Enlargement of the Pituitary gland is a frequent cause of Incidentaloma and of referrals to endocrinologists for hormonal evaluation and therapeutic advice. In neuroradiological series, 25-50% of healthy women who are 18-35 yr old have a convex superior Pituitary contour, but Pituitary height exceeds 9 mm in less than 0.5% of cases. This study was performed to provide thorough clinical and hormonal data and long-term endocrinological and imaging follow-up data on subjects with incidentally discovered Pituitary hypertrophy (height > 9 mm). Seven eugonadal nulliparous women, 15-27 yr old, referred between 1989 and 1998 with incidentally diagnosed Pituitary gland enlargement (height > 9 mm) and a suspected Pituitary tumor, were studied. At presentation and at yearly intervals, PRL plasma levels and corticotropic, somatotropic, and thyrotropic Pituitary function were measured; and Pituitary dimensions and signal on magnetic resonance imaging (MRI), before and after iv gadolinium-diethylene-triamine-pentaacetic acid injection, were assessed. PRL plasma levels were normal; and corticotropic, somatotropic, and thyrotropic Pituitary function was considered normal in all cases. In all the women, the upper boundary of the Pituitary was convex, on MRI, and touched the optic chiasm in four cases. The width and anteroposterior diameter of the gland were normal. The Pituitary itself seemed normal, with a homogeneous signal, on plain and dynamic studies with iv contrast injection. Despite normal initial hormone values, two women underwent surgery, by the transsphenoidal approach, in another center. During surgery, the Pituitary seemed normal in both cases, with no evidence of tumoral or inflammatory processes. Biopsy specimens showed the morphologic characteristics of a normal, nonhyperplastic Pituitary gland. All seven women were seen at yearly intervals for 2-8 yr (median, 4 yr). Clinical and hormonal status remained stable, as did the structure and size of Pituitary, on serial MRI. No tumor formation occurred, supporting the diagnosis of physiologic hypertrophy of the Pituitary gland. In conclusion, these observations suggest that careful examination of MRI results may help to distinguish physiologic Pituitary hypertrophy from Pituitary tumors and infiltrating lesions. The former diagnosis is confirmed by normal baseline Pituitary function in extensive hormonal tests. Correct identification of such patients is important to avoid unnecessary Pituitary surgery and costly MRI surveillance.