• Dawid Hordejuk, Yee-Ming M Cheung, Wei Wang, Timothy Smith, Edward Laws, Ursula B Kaiser, and Le Min.
• Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (D.H., Y.M.C., U.B.K., L.M.).
• Ann. Intern. Med. 2023 Mar 1; 176 (3): 298302298-302.

BackgroundThe estimated prevalence of pituitary lesions is 10% to 38.5% in radiologic studies. However, how frequently these incidental lesions should be monitored by serial pituitary magnetic resonance imaging (MRI) remains unclear.ObjectiveTo evaluate changes in pituitary microadenomas over time.DesignRetrospective, longitudinal cohort study.SettingMass General Brigham, Boston, Massachusetts.PatientsEvidence of pituitary microadenoma from MRI.MeasurementsDimensions of pituitary microadenomas.ResultsDuring the study period (from 2003 to 2021), 414 patients with pituitary microadenomas were identified. Of the 177 patients who had more than 1 MRI, 78 had no change in the size of the microadenoma over time, 49 had an increase in size, 34 had a decrease in size, and 16 had both an increase and decrease in size. By linear mixed model analysis, the estimated slope was 0.016 mm/y (95% CI, -0.037 to 0.069). In the subgroup analysis, pituitary adenomas with a baseline size of 4 mm or less tended to increase in size. The estimated slope was 0.09 mm/y (CI, 0.020 to 0.161). In contrast, in the subgroup with baseline tumor size greater than 4 mm, the size tended to decrease. The estimated slope was -0.063 mm/y (CI, -0.141 to 0.015).LimitationRetrospective cohort, some patients were lost to follow-up for unknown reasons, and data were limited to local large institutions.ConclusionDuring the study period, approximately two thirds of the microadenomas remained unchanged or decreased in size. The growth, if any, was slow. These findings suggest that less frequent pituitary MRI surveillance for patients with incidental pituitary microadenomas may be safe.Primary Funding SourceNone.

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