The presentation of sellar and parasellar tumours in Uzbekistan
Said Ismailov, Ashley Grossman, Michael Powell, Abdukhakim Khadjibaev, Yulduz Urmanova & Mukhlisa Shakirova
Aim: To analyse the epidemiology and presentation of pituitary tumours in Uzbekistan.
Materials and methods: Over a period of 1.5 years, we studied 53 consecutive patients with tumours in the sellar and suprasellar region (mean age 41.5 years) in terms of neurological and ophthalmological status, MRI imaging and detailed neuroendocrine functional assessment. A detailed examination of the sellar area by means of computer and magnetic resonance tomography was performed in all patients.
Results: Microadenomas (<10 mm) were found in 9 patients, mesoadenomas (1115 mm) in 19 and moderate macroadenomas (1520 mm) in 7. Eighteen (33% of the cohort) presented with large macroadenomas (>2 cm). Thirty-nine patients (73.5%) had non-functioning pituitary adenomas, five had prolactinomas, three had corticotroph tumours, two had craniopharyngioma, while there was one each of a germinoma, a menngioma, and astrocytoma. Neurological complaints included headache in 32 patients (60%), a decrease of memory in 28 (52.5%), diplopia in one and unilateral ptosis in one. Abnormalities of the visual field or of visual acuity were seen in all 53 patients (100%). Panhypopituitarism was noted in two persons (3.7%), GH deficiency in 39 (73.5%), GHD and LH, FSH deficiency in 12 patients (22.6%), primary infertility in 5 (10%), impotence in one (1.8%), and secondary amenorrhoea in 13 (25%). Hypopituitarsin, that is, reduction in the levels of pituitary tropic hormones, such as, STH, LH and FSH was found in 26.4% (14 patients), large pituitary tumors with supra-, para- and infrasellar growth being registered in the patients.
Conclusions: The distribution of sellar and parasellar lesions in Uzbekistan and their pathology is similar to that reported in other parts of the world, but tumours tend to be larger and visual problems predominate.