Which subtypes of pituitary adenoma must you be aware of as tending to be more clinically agressive?

Certain subtypes of pituitary adenoma have been shown to be more clinically aggressive in that they tend to be more invasive, have earlier recurrence, and are more resistant to treatment. The following adenoma subtypes are recognized as having a more aggressive clinical behavior:

- Acidophil stem cell adenoma

- Crooke cell adenoma

- Lactotroph adenoma when occurring in men

- Pit-1 positive plurihormonal adenoma

- Sparsely granulated somatotroph adenoma

- Silent corticotroph adenoma

Thanks to Dr. Bea Lopes of the University of Virginia for consulting on the compilation of this list!