Skip to main content
Springer Nature Link
Log in

Predictors of silent corticotroph adenoma recurrence; a large retrospective single center study and systematic literature review

  • Published:
Pituitary Aims and scope Submit manuscript

Abstract

Purpose

Silent corticotroph adenomas (SCAs) are clinically silent and non-secreting, but exhibit positive adrenocorticotropic hormone (ACTH) immunostaining. We characterized a single center cohort of SCA patients, compared the SCAs to silent gonadotroph adenomas (SGAs), identified predictors of recurrence, and reviewed and compared the cohort to previously published SCAs cases.

Methods

Retrospective review of SCA and SGA surgically resected patients over 10 years and 6 years, respectively. Definitions; SCA—no clinical or biochemical evidence of Cushing’s syndrome and ACTH positive immunostaining, and SGA—steroidogenic factor (SF-1) positive immunostaining. A systematic literature search was undertaken using Pubmed and Scopus.

Results

Review revealed 814 pituitary surgeries, 39 (4.8%) were SCAs. Mean follow-up was 6.4 years (range 0.5–23.8 years). Pre-operative magnetic resonance imaging demonstrated sphenoid and/or cavernous sinus invasion in 44%, 33% were > 50% cystic, and 28% had high ACTH levels pre-operatively. Compared to SGAs (n = 70), SCAs were of similar size and invasiveness (2.5 vs. 2.9 cm, p = 0.2; 44 vs. 41%, p = 0.8, respectively), but recurrence rate was higher (36 vs. 10%, p = 0.001) and more patients received radiation therapy (18 vs. 3%, p = 0.006). Less cystic tumors (0 vs. 50%, p < 0.001) and higher pre-operative ACTH levels (54 vs. 28 pg/ml, p = 0.04) were predictors of recurrence for SCAs.

Conclusion

This review is unique; a strict definition of SCA was used, and single center SCAs were compared with SGAs and with SCAs literature reviewed cases. We show that SCAs are aggressive and identify predictors of recurrence. Accurate initial diagnosis, close imaging and biochemical follow up are warranted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Canada)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Horvath E, Kovacs K, Killinger DW, Smyth HS, Platts ME, Singer W (1980) Silent corticotropic adenomas of the human pituitary gland: a histologic, immunocytologic, and ultrastructural study. Am J Pathol 98(3):617–638

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Kovacs K, Horvath E, Bayley TA, Hassaram ST, Ezrin C (1978) Silent corticotroph cell adenoma with lysosomal accumulation and crinophagy. A distinct clinicopathologic entity. Am J Med 64(3):492–499

    Article  CAS  PubMed  Google Scholar 

  3. Saeger W, Ludecke DK, Buchfelder M, Fahlbusch R, Quabbe HJ, Petersenn S (2007) Pathohistological classification of pituitary tumors: 10 years of experience with the German Pituitary Tumor Registry. Eur J Endocrinol 156(2):203–216

    Article  CAS  PubMed  Google Scholar 

  4. Cooper O (2015) Silent corticotroph adenomas. Pituitary 18(2):225–231

    Article  PubMed  PubMed Central  Google Scholar 

  5. Scheithauer BW, Jaap AJ, Horvath E, Kovacs K, Lloyd RV, Meyer FB, Laws ER Jr, Young WF Jr (2000) Clinically silent corticotroph tumors of the pituitary gland. Neurosurgery 47(3):723–729

    CAS  PubMed  Google Scholar 

  6. Webb KM, Laurent JJ, Okonkwo DO, Lopes MB, Vance ML, Laws ER (2003) Clinical characteristics of silent corticotrophic adenomas and creation of an internet-accessible database to facilitate their multi-institutional study. Neurosurgery 53(5):1076–1085

    Article  PubMed  Google Scholar 

  7. Cho HY, Cho SW, Kim SW, Shin CS, Park KS, Kim SY (2010) Silent corticotroph adenomas have unique recurrence characteristics compared with other nonfunctioning pituitary adenomas. Clin Endocrinol 72(5):648–653

    Article  Google Scholar 

  8. Bradley KJ, Wass JA, Turner HE (2003) Non-functioning pituitary adenomas with positive immunoreactivity for ACTH behave more aggressively than ACTH immunonegative tumours but do not recur more frequently. Clin Endocrinol 58(1):59–64

    Article  CAS  Google Scholar 

  9. Baldeweg SE, Pollock JR, Powell M, Ahlquist J (2005) A spectrum of behaviour in silent corticotroph pituitary adenomas. Br J Neurosurg 19(1):38–42

    Article  CAS  PubMed  Google Scholar 

  10. Abe M, Sawabe Y, Mochizuki Y, Sunaga S, Izumiyama H, Matsumoto K, Kushima M, Taniyama M, Ban Y, Sano T (2001) Corticotroph cell adenoma without typical manifestations of Cushing’s disease presenting with cavernous sinus syndrome following pituitary apoplexy. Endocr J 48(4):503–507

    Article  CAS  PubMed  Google Scholar 

  11. Alahmadi H, Lee D, Wilson JR, Hayhurst C, Mete O, Gentili F, Asa SL, Zadeh G (2012) Clinical features of silent corticotroph adenomas. Acta Neurochir 154(8):1493–1498

    Article  Google Scholar 

  12. Al-Sarraj S, King A, Harris P, Lantos P (2002) Atypical pituitary adenoma (silent corticotroph pituitary adenoma). Neuropathol Appl Neurobiol 28(2):157–158

    Article  Google Scholar 

  13. Ambrosi B, Colombo P, Bochicchio D, Bassetti M, Masini B, Faglia G (1992) The silent corticotropinoma: is clinical diagnosis possible? J Endocrinol Invest 15(6):443–452

    Article  CAS  PubMed  Google Scholar 

  14. Benaiges D, Puig J, Lafuente J, Gimeno J, Prados M, Sagarra E, Flores-Le-Roux J (2012) Biochemical behaviour of an incidentally diagnosed silent corticotroph adenoma. Neuro Endocrinol Lett 33(3):290–293

    PubMed  Google Scholar 

  15. Bordo G, Duong H, McLaughlin N, Cornell R, Findling J, Kelly D (2012) Case report: silent corticotroph adenoma progressing to cushing’s disease then to pituitary carcinoma with dramatic treatment response. J Neurol Surg Part B 73:02

    Google Scholar 

  16. Braithwaite SS, Clasen RA, D’Angelo CM (1997) Silent corticotroph adenoma: case report and literature review. Endocr Pract 3(5):297–301

    Article  CAS  PubMed  Google Scholar 

  17. Brown RL, Wollman R, Weiss RE (2007) Transformation of a pituitary macroadenoma into to a corticotropin-secreting carcinoma over 16 years. Endocr Pract 13(5):463–471

    Article  PubMed  Google Scholar 

  18. Cazabat L, Dupuy M, Boulin A, Bernier M, Baussart B, Foubert L, Raffin-Sanson ML, Caron P, Bertherat J, Gaillard S (2014) Silent, but not unseen: multimicrocystic aspect on T2-weighted MRI in silent corticotroph adenomas. Clin Endocrinol 81(4):566–572

    Article  CAS  Google Scholar 

  19. Chen SC, Chung WY (2015) Progression rate of silent corticotroph adenomas after stereotactic radiosurgery. In regard to Xu et al. Int J Radiat Oncol Biol Phys 91(5):1113–1114

    Article  PubMed  Google Scholar 

  20. Coire CI, Horvath E, Kovacs K, Smyth HS, Sasano H, Iino K, Feig DS (1998) A composite silent corticotroph pituitary adenoma with interspersed adrenocortical cells: case report. Neurosurgery 42(3):650–654

    Article  CAS  PubMed  Google Scholar 

  21. Cooper ME, Murray RM, Kalnins R, Woodward J, Jerums G (1987) The development of Cushing’s syndrome from a previously silent pituitary tumour. Aust N Z J Med 17(2):249–251

    Article  CAS  PubMed  Google Scholar 

  22. Cooper O, Ben-Shlomo A, Bonert V, Bannykh S, Mirocha J, Melmed S (2010) Silent corticogonadotroph adenomas: clinical and cellular characteristics and long-term outcomes. Horm Cancer 1(2):80–92

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Fang H, Tian R, Wu H, Xu J, Fan H, Zhou J, Zhong L (2015) Cushing disease after treatment of nonfunctional pituitary adenoma: a case report and literature review. Medicine 94(51):e2134

    Article  Google Scholar 

  24. Farrell WE, Coll AP, Clayton RN, Harris PE (2003) Corticotroph carcinoma presenting as a silent corticotroph adenoma. Pituitary 6(1):41–47

    Article  CAS  PubMed  Google Scholar 

  25. Felix I, Asa SL, Kovacs K, Horvath E (1991) Changes in hormone production of a recurrent silent corticotroph adenoma of the pituitary: a histologic, immunohistochemical, ultrastructural, and tissue culture study. Hum Pathol 22(7):719–721

    Article  CAS  PubMed  Google Scholar 

  26. Gheri RG, Boddi W, Ammannati F, Olivotto J, Nozzoli C, Franchi A, Bordi L, Luisi ML, Mennonna P (1997) Two-step development of a pituitary adenoma: from hyperprolactinemic syndrome to Cushing’s disease. J Endocrinol Invest 20(4):240–244

    Article  CAS  PubMed  Google Scholar 

  27. Ghervan C (2014) Silent corticotroph adenoma transformed in secreting adenoma with severe Cushing’s disease after two pituitary surgeries. Acta Endocrinol 10(2):283–292

    Google Scholar 

  28. Gibson S, Ray DW, Crosby SR, Dornan TL, Jennings AM, Bevan JS, Davis JR, White A (1996) Impaired processing of proopiomelanocortin in corticotroph macroadenomas. J Clin Endocrinol Metab 81(2):497–502

    CAS  PubMed  Google Scholar 

  29. Gogel EL, Salber PR, Tyrrell JB, Rosenblum ML, Findling JW (1983) Cushing’s disease in a patient with a ‘nonfunctioning’ pituitary tumor: spontaneous development and remission. Arch Intern Med 143(5):1040–1042

    Article  CAS  PubMed  Google Scholar 

  30. Guttenberg KB, Mayson SE, Sawan C, Kharlip J, Lee JY, Martinez-Lage M, Loevner LA, Ewanichak J, Grady MS, Snyder PJ (2016) Prevalence of clinically silent corticotroph macroadenomas. Clin Endocrinol 85(6):874–880

    Article  CAS  Google Scholar 

  31. He L, Forbes JA, Carr K, Highfield Nickols H, Utz A, Moots P, Weaver K (2016) Response of silent corticotroph pituitary carcinoma to chemotherapy: case report. J Neurosurg Sci 60(2):272–280

    PubMed  Google Scholar 

  32. Ikeda H, Yoshimoto T, Kovacs K, Horvath E (1995) Cushing’s disease due to female gonadotroph adenoma of the pituitary. Clin Endocrinol 43(3):383–386

    Article  CAS  Google Scholar 

  33. Ioachimescu AG, Eiland L, Chhabra VS, Mastrogianakis GM, Schniederjan MJ, Brat D, Pileggi AV, Oyesiku NM (2012) Silent corticotroph adenomas: Emory University cohort and comparison with ACTH-negative nonfunctioning pituitary adenomas. Neurosurgery 71(2):296–303

    Article  PubMed  Google Scholar 

  34. Jahangiri A, Wagner JR, Pekmezci M, Hiniker A, Chang EF, Kunwar S, Blevins L, Aghi MK (2013) A comprehensive long-term retrospective analysis of silent corticotrophic adenomas vs hormone-negative adenomas. Neurosurgery 73(1):8–17

    Article  PubMed  Google Scholar 

  35. Kojima Y, Suzuki S, Yamamura K, Ohhashi G, Yamamoto I (2002) Comparison of ACTH secretion in Cushing’s adenoma and clinically silent corticotroph adenoma by cell immunoblot assay. Endocr J 49(3):285–292

    Article  CAS  PubMed  Google Scholar 

  36. Iino K, Oki Y, Matsushita F, Yamashita M, Hayashi C, Miura K, Nishizawa S, Nakamura H (2007) Immunohistochemical properties of silent corticotroph adenoma and Cushing’s disease. Pituitary 10(1):35–45

    Article  CAS  PubMed  Google Scholar 

  37. Lipatenkova A, Dzeranova L, Pigarova E, Ektova A (2014) Clinical case: silent corticotroph pituitary macroadenoma transforming into Cushing disease. Endocr Abstr. doi:10.1530/endoabs.35.P915

    Google Scholar 

  38. Lopez JA, Kleinschmidt-Demasters BK, Sze C-I, Woodmansee WW, Lillehei KO (2004) Silent corticotroph adenomas: Further clinical and pathological observations. Hum Pathol 35(9):1137–1147

    Article  PubMed  Google Scholar 

  39. Matsuno A, Okazaki R, Oki Y, Nagashima T (2004) Secretion of high-molecular-weight adrenocorticotropic hormone from a pituitary adenoma in a patient without Cushing stigmata: case report. J Neurosurg 101(5):874–877

    Article  PubMed  Google Scholar 

  40. Mindermann T, Kovacs K, Wilson CB (1994) Changes in the immunophenotype of recurrent pituitary adenomas. Neurosurgery 35(1):39–44

    Article  CAS  PubMed  Google Scholar 

  41. Moshkin O, Syro LV, Scheithauer BW, Ortiz LD, Fadul CE, Uribe H, Gonzalez R, Cusimano M, Horvath E, Rotondo F, Kovacs K (2011) Aggressive silent corticotroph adenoma progressing to pituitary carcinoma: the role of temozolomide therapy. Hormones 10(2):162–167

    Article  Google Scholar 

  42. Ohta S, Nishizawa S, Oki Y, Yokoyama T, Namba H (2002) Significance of absent prohormone convertase 1/3 in inducing clinically silent corticotroph pituitary adenoma of subtype I–immunohistochemical study. Pituitary 5(4):221–223

    Article  CAS  PubMed  Google Scholar 

  43. Pawlikowski M, Kunert-Radek J, Radek M (2008) “Silent" corticotropinoma. Neuro Endocrinol Lett 29(3):347–350

    PubMed  Google Scholar 

  44. Psaras T, Honegger J, Buslei R, Saeger W, Klein D, Capper D, Meyermann R, Mittelbronn M (2007) Atypical type II silent corticotrophic adenoma developing into Cushing’s disease upon second recurrence. Exp Clin Endocrinol Diabetes 115(9):610–615

    Article  CAS  PubMed  Google Scholar 

  45. Raverot G, Wierinckx A, Jouanneau E, Auger C, Borson-Chazot F, Lachuer J, Pugeat M, Trouillas J (2010) Clinical, hormonal and molecular characterization of pituitary ACTH adenomas without (silent corticotroph adenomas) and with Cushing’s disease. Eur J Endocrinol 163(1):35–43

    Article  CAS  PubMed  Google Scholar 

  46. Reincke M, Allolio B, Saeger W, Kaulen D, Winkelmann W (1987) A pituitary adenoma secreting high molecular weight adrenocorticotropin without evidence of Cushing’s disease. J Clin Endocrinol Metab 65(6):1296–1300

    Article  CAS  PubMed  Google Scholar 

  47. Righi A, Faustini-Fustini M, Morandi L, Monti V, Asioli S, Mazzatenta D, Bacci A, Foschini MP (2017) The changing faces of corticotroph cell adenomas: the role of prohormone convertase 1/3. Endocr 56(2):286–297

    Article  CAS  Google Scholar 

  48. Sakaguchi H, Koshiyama H, Sano T, Inoue D, Hashimoto N, Aoki N, Nakao K (1997) A case of nonfunctioning pituitary adenoma resembling so-called silent corticotroph adenoma. Endocr J 44(2):329–333

    Article  CAS  PubMed  Google Scholar 

  49. Sano T, Kovacs K, Asa SL, Yamada S, Sanno N, Yokoyama S, Takami H (2002) Pituitary adenoma with “honeycomb Golgi” appearance showing a phenotypic change at recurrence from clinically nonfunctioning to typical Cushing disease. Endocr Pathol 13(2):125–130

    Article  PubMed  Google Scholar 

  50. Scheithauer BW, Gaffey TA, Lloyd RV, Sebo TJ, Kovacs KT, Horvath E, Yapıcıer Ö, Young WF, Meyer FB, Kuroki T, Riehle DL, Laws ER (2006) Pathobiology of pituitary adenomas and carcinomas. Neurosurgery 59(2):341–353

    Article  PubMed  Google Scholar 

  51. Serri O, Robert F, Pelletier G, Beauregard H, Hardy J (1987) Hyperprolactinemia associated with clinically silent adenomas: endocrinologic and pathologic studies; a report of two cases. Fertil Steril 47(5):792–796

    Article  CAS  PubMed  Google Scholar 

  52. Tan EU, Ho MS, Rajasoorya CR (2000) Metamorphosis of a non-functioning pituitary adenoma to Cushing’s disease. Pituitary 3(2):117–122

    Article  CAS  PubMed  Google Scholar 

  53. Tateno T, Izumiyama H, Doi M, Akashi T, Ohno K, Hirata Y (2007) Defective expression of prohormone convertase 1/3 in silent corticotroph adenoma. Endocr J 54(5):777–782

    Article  CAS  PubMed  Google Scholar 

  54. Tateno T, Kato M, Tani Y, Oyama K, Yamada S, Hirata Y (2009) Differential expression of somatostatin and dopamine receptor subtype genes in adrenocorticotropin (ACTH)-secreting pituitary tumors and silent corticotroph adenomas. Endocr J 56(4):579–584

    Article  CAS  PubMed  Google Scholar 

  55. Ueyama T, Tamaki N, Kondoh T, Kurata H (1998) Large and invasive silent corticotroph-cell adenoma with elevated serum ACTH: a case report. Surg Neurol 50(1):30–31

    Article  CAS  PubMed  Google Scholar 

  56. Walsh MT, Couldwell WT (2010) Symptomatic cystic degeneration of a clinically silent corticotroph tumor of the pituitary gland. Skull Base 20(5):367–370

    Article  PubMed  PubMed Central  Google Scholar 

  57. Yamada S, Ohyama K, Taguchi M, Takeshita A, Morita K, Takano K, Sano T (2007) A study of the correlation between morphological findings and biological activities in clinically nonfunctioning pituitary adenomas. Neurosurgery 61(3):580–584

    Article  PubMed  Google Scholar 

  58. Yamakita N, Murai T, Kawamura S, Teramachi H, Matsuhisa T, Hirata T, Ikeda T, Morita H, Mune T, Yasuda K (1999) High molecular weight corticotropin measured with immunoradiometric assay in a patient with asymptomatic pituitary corticotropinoma. Endocr J 46(4):563–571

    Article  CAS  PubMed  Google Scholar 

  59. Yokoyama S, Kawahara Y, Sano T, Nakayama M, Kitajima S, Kuratsu J (2001) A case of non-functioning pituitary adenoma with Cushing’s syndrome upon recurrence. Neuropathology 21(4):288–293

    Article  CAS  PubMed  Google Scholar 

  60. Zoli M, Faustini-Fustini M, Mazzatenta D, Marucci G, De Carlo E, Bacci A, Pasquini E, Lanzino G, Frank G (2015) ACTH adenomas transforming their clinical expression: report of 5 cases. Neurosurg Focus 38(2):E15

    Article  Google Scholar 

  61. Barr K, Pillinger DA, Miller CR, Wan Y, Sharpless JL (2016) ACTH staining does not predict retx in silent acth adenomas. Poster presentation, Endocrine Society Meeting SUN-487

  62. Bonner RA, Mukai K, Oppenheimer JH (1979) Two unusual variants of Nelson’s syndrome. J Clin Endocrinol Metab 49(1):23–29

    Article  CAS  PubMed  Google Scholar 

  63. Petrossians P, Ronci N, Valdes Socin H, Kalife A, Stevenaert A, Bloch B, Tabarin A, Beckers A (2001) ACTH silent adenoma shrinking under cabergoline. Eur J Endocrinol 144(1):51–57

    Article  CAS  PubMed  Google Scholar 

  64. Sahli R, Christ ER, Seiler R, Kappeler A, Vajtai I (2006) Clinicopathologic correlations of silent corticotroph adenomas of the pituitary: report of four cases and literature review. Pathol Res Pract 202(6):457–464

    Article  PubMed  Google Scholar 

  65. Salgado LR, Machado MC, Cukiert A, Liberman B, Kanamura CT, Alves VA (2006) Cushing’s disease arising from a clinically nonfunctioning pituitary adenoma. Endocr Pathol 17(2):191–199

    Article  PubMed  Google Scholar 

  66. Asano S, Ooka H, Okazaki R, Ishikawa T, Ochiai H, Nakashima M, Ide F, Hasegawa I, Miyawaki S, Nakaguchi H, Murakami M, Ogino Y, Takano K, Matsuno A (2007) Long-term remission of cyclic Cushing’s disease that was diagnosed and treated surgically in non-active phase. Endocr J 54(3):407–412

    Article  PubMed  Google Scholar 

  67. Popovic V, Micic D, Nesovic M, Howlett T, Doniach I, Kendereski A, Djordjevic P, Manojlovic D, Micic J, Besser M (1990) Cushing’s disease cycling over ten years. Exp Clin Endocrinol 96(2):143–148

    CAS  PubMed  Google Scholar 

  68. Ceccato F, Lombardi G, Manara R, Emanuelli E, Denaro L, Milanese L, Gardiman MP, Bertorelle R, Scanarini M, D’Avella D, Occhi G, Boscaro M, Zagonel V, Scaroni C (2015) Temozolomide and pasireotide treatment for aggressive pituitary adenoma: expertise at a tertiary care center. J Neurooncol 122(1):189–196

    Article  CAS  PubMed  Google Scholar 

  69. Nishioka H, Hirano A, Asa SL (1992) Silent corticotroph adenoma with multiple cysts: Pars intermedia tumor? Endocr Pathol 3(1):47–51

    Article  Google Scholar 

  70. Kasuki L, Ventura N, Wildemberg L, Cardão Chimelli L, Gadelha M (2017) Accuracy of microcystic aspect on T2-weighted magnetic resonance imaging for the diagnosis of silent corticotropinomas. Presented at the 99th Endocrine Society Meeting, Orlando, April 2017 SAT 469

  71. Kovacs K, Lloyd R, Horvath E, Asa SL, Stefaneanu L, Killinger DW, Smyth HS (1989) Silent somatotroph adenomas of the human pituitary. A morphologic study of three cases including immunocytochemistry, electron microscopy, in vitro examination, and in situ hybridization. Am J Pathol 134(2):345–353

    CAS  PubMed  PubMed Central  Google Scholar 

  72. Cooper O, Melmed S (2012) Subclinical hyperfunctioning pituitary adenomas: the silent tumors. Best Pract Res Clin Endocrinol Metab 26(4):447–460

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Sano T, Mader R, Asa SL, Qian ZR, Hino A, Yamada S (2003) “Honeycomb Golgi” in pituitary adenomas: not a marker of gonadotroph adenomas. Endocr Pathol 14(4):363–368

    Article  PubMed  Google Scholar 

  74. Jin L, Riss D, Ruebel K, Kajita S, Scheithauer BW, Horvath E, Kovacs K, Lloyd RV (2005) Galectin-3 expression in functioning and silent ACTH-producing adenomas. Endocr Pathol 16(2):107–114

    Article  CAS  PubMed  Google Scholar 

  75. Thodou E, Argyrakos T, Kontogeorgos G (2007) Galectin-3 as a marker distinguishing functioning from silent corticotroph adenomas. Hormones 6(3):227–232

    Google Scholar 

  76. Mete O, Hayhurst C, Alahmadi H, Monsalves E, Gucer H, Gentili F, Ezzat S, Asa SL, Zadeh G (2013) The role of mediators of cell invasiveness, motility, and migration in the pathogenesis of silent corticotroph adenomas. Endocr Pathol 24(4):191–198

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Author information

Authors and Affiliations

  1. Department of Medicine, Oregon Health & Science University, Portland, OR, USA

    Fabienne Langlois, Dawn Shao Ting Lim & Maria Fleseriu

  2. Department of Medicine Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada

    Fabienne Langlois

  3. Department of Neurological Surgery, Oregon Health & Science University, Mail Code CH8N, 3303 SW Bond Avenue, Portland, OR, 97239, USA

    Chris G. Yedinak, Isabelle Cetas, Shirley McCartney, Justin Cetas, Aclan Dogan & Maria Fleseriu

  4. Northwest Pituitary Center, Oregon Health & Science University, Portland, OR, USA

    Chris G. Yedinak, Shirley McCartney, Justin Cetas, Aclan Dogan & Maria Fleseriu

  5. Department of Endocrinology, Singapore General Hospital, Singapore, Singapore

    Dawn Shao Ting Lim

Authors
  1. Fabienne Langlois
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dawn Shao Ting Lim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chris G. Yedinak
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Isabelle Cetas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shirley McCartney
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Justin Cetas
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Aclan Dogan
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Maria Fleseriu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maria Fleseriu.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

The study was approved under an IRB approved data repository with waiver of consent.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Langlois, F., Lim, D.S.T., Yedinak, C.G. et al. Predictors of silent corticotroph adenoma recurrence; a large retrospective single center study and systematic literature review. Pituitary 21, 32–40 (2018). https://doi.org/10.1007/s11102-017-0844-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11102-017-0844-4

Keywords

Search

Navigation