Silent corticotroph adenomas

Purpose Silent corticotroph adenomas (SCAs) comprise 20 % of all corticotroph adenomas and 3-19 % of nonfunctioning adenomas (NFAs). As they do not manifest clinical or biochemical hypercortisolism, they are diagnosed after pathologic examination of resected tumor tissue demonstrates positive ACTH expression. While preoperative features are similar to those of NFAs, SCAs may have more cavernous sinus invasion. Further, patients with SCAs tend to have more frequent and earlier recurrences than those with NFAs, often necessitating multiple surgeries and other modalities of treatment. This article reviews the incidence, pathogenesis, and clinical behavior of SCAs. Methods A systematic literature review was performed using PubMed for information regarding SCAs. Results Up to date findings regarding epidemiology, pathogenesis, pathology, clinical presentation, postoperative course, and management of patients with SCAs are presented. Conclusion This review highlights the necessity of rigorous monitoring for recurrences and hypopituitarism in patients with SCAs.