Typical and atypical pituitary adenomas: A single-center analysis of outcome and prognosis

Sabrina Chiloiro, Francesco Doglietto, Barbara Trapasso, Donato Iacovazzo, Antonella Giampietro, Francesco Di Nardo, Chiara De Waure, Libero Lauriola, Annunziato Mangiola, Carmelo Anile, Giulio Maira, Laura De Marinis, Antonio Bianchi

Research output: Contribution to journalArticlepeer-review


Background and Objective: In 2004, the World Health Organization defined atypical pituitary adenomas as those with a Ki-67 expression >3%, an excessive p53 expression and increased mitotic activity. As the usefulness of this classification is controversial, we reviewed typical and atypical pituitary adenomas to compare the clinical and prognostic features. Patients and Methods: We retrospectively reviewed 343 consecutive pituitary adenomas. Atypical pituitary adenomas represented 18.7% of cases. All patients were operated on at the Department of Neurosurgery of our institution and were followed up at the Hypothalamic-Pituitary Disease Unit of the same institution. The median follow-up time was 75 months (range 7-345). Results: Younger age at diagnosis as well as immunohistochemical positivity for adrenocorticotropic hormone and prolactin correlated with a higher risk of atypical pituitary adenomas, whereas typical and atypical pituitary adenomas did not differ with regard to gender, tumor size, recurrence risk and disease-free survival time (DFST). Among the 219 patients who underwent radical surgery, a Ki-67 expression ≥1.5% was associated with a higher risk of recurrence and a worse DFST, even after correction for age at diagnosis, gender, immunohistochemical classification, tumor size, invasiveness and Knosp classification [p = 0.01; hazard ratio (HR) 2.572; 95% confidence interval (CI) 1.251-5.285). Pituitary adenomas with a Ki-67 expression ≥1.5% showed a worse DFST as compared to pituitary adenomas with a Ki-67 expression

Original languageEnglish
Pages (from-to)143-150
Number of pages8
Issue number2
Publication statusPublished - May 28 2015


  • Aggressive behavior
  • Atypical pituitary adenoma
  • Disease-free survival time
  • Ki-67
  • Prognosis
  • Typical pituitary adenoma

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Endocrine and Autonomic Systems
  • Cellular and Molecular Neuroscience
  • Medicine(all)


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