Although non-functioning pituitary tumors are frequent, diagnostic and therapeutic concepts are not well standardized. We here present the first German multidisciplinary guideline on this topic. The single most important message is to manage the patients by a multidisciplinary team (consisting at least of an endocrinologist, a neurosurgeon, and a (neuro-) radiologist). The initial diagnostic work-up comprises a detailed characterization of both biochemical (focusing on hormonal excess or deficiency states) and morphological aspects (with magnetic resonance imaging of the sellar region). An ophthalmological examination is only needed in presence of symptoms or large tumors affecting the visual system. Asymptomatic, hormonally inactive tumors allow for a 'wait and scan' strategy. In contrast, surgical treatment by an experienced pituitary surgeon is standard of care in case of (impending) visual impairment. Therapeutic options for incompletely resected or recurrent tumors include re-operation, radiotherapy, and observation; the individual treatment plan should be developed multidisciplinary. Irrespective of the therapeutic approach applied, patients require long-term follow-up. Patient with larger pituitary tumors or former surgery/radiotherapy should be regularly counseled regarding potential symptoms of hormonal deficiency states.

中文翻译：

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德国首个临床无功能垂体瘤诊断和治疗指南

尽管无功能的垂体瘤很常见，但诊断和治疗概念还没有很好地标准化。我们在此介绍有关该主题的第一个德国多学科指南。唯一最重要的信息是由多学科团队（至少由内分泌学家、神经外科医生和（神经）放射科医生组成）管理患者。最初的诊断检查包括详细的生化特征（关注荷尔蒙过量或缺乏状态）和形态学方面（鞍区的磁共振成像）。仅在存在影响视觉系统的症状或大肿瘤时才需要进行眼科检查。无症状、荷尔蒙不活跃的肿瘤允许采取“等待和扫描”策略。相比之下，在（即将发生的）视力障碍的情况下，由经验丰富的垂体外科医生进行手术治疗是标准护理。未完全切除或复发肿瘤的治疗选择包括再次手术、放疗和观察；个体治疗计划应该是多学科的。无论采用何种治疗方法，患者都需要长期随访。应定期向垂体瘤较大或曾接受过手术/放射治疗的患者咨询激素缺乏状态的潜在症状。患者需要长期随访。应定期向垂体瘤较大或曾接受过手术/放射治疗的患者咨询激素缺乏状态的潜在症状。患者需要长期随访。应定期向垂体瘤较大或曾接受过手术/放射治疗的患者咨询激素缺乏状态的潜在症状。