Abstract
ACTH-secreting pituitary adenomas account for about two-thirds of cases of endogenous Cushing's syndrome and are considered the most common cause of endogenous hypercortisolemia. Silent corticotroph adenomas (SCAs) are pituitary tumors that stain positive for adrenocorticotropic hormone (ACTH) but do not produce biochemical levels of excess ACTH or cortisol. These tumors account for approximately 20% of all corticotroph adenomas and 5.5% of nonfunctioning pituitary adenomas. New immunohistochemical (IHC) techniques continue to be the gold standard in diagnosis, while having prognostic implications.
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