A 65-year-old man has a pituitary lesion with no hormone excess. What is the most likely clinical consequence of this finding?

In the scenario presented, where a 65-year-old man has a pituitary lesion that does not result in hormone excess, the most likely clinical consequence is indeed the absence of significant symptoms or complications associated with hormone overproduction or pituitary dysfunction.

Typically, pituitary lesions can secrete hormones, leading to conditions such as acromegaly, Cushing's disease, or prolactinoma when there is excess hormone production. However, in the absence of hormone excess, the lesion may remain asymptomatic, especially if it is small.

Bitemporal hemianopia, which results from compression of the optic chiasm due to a mass effect from an expanding pituitary tumor, is generally associated with larger lesions that exert pressure on surrounding structures. Similarly, pituitary apoplexy involves sudden hemorrhage or infarction of the pituitary gland, which is not a consequence of a non-functioning lesion, but rather occurs in instances of significant growth or hormonal activity.

Anterior hypopituitarism could occur if the lesion were to encroach on the pituitary stalk or if it were large enough to affect the surrounding pituitary tissue, but without any overt symptoms or hormone excess, this is less likely to be an immediate consequence.

Thus,