Non functioning pituitary adenomas (NFPA) are considered as rare (about 20% of all tumors of pituitary area) but severe regarding to their complications.
In this retrospective study we have analyzed 60 subjects with NFPA in order to study clinical, hormonal, visual and radiological abnormalities.
Diagnosis of NFPA is made when there is a pituitary tumor demonstrated by CT-scan and or MRI with normal or discreetly elevated PRL (≤ 120 ng/ml) but without hypercortisolic or hypersomatotropic signs, negative immunohistochimy and no response to dopaminergic agonists (for those with elevated PRL).
Results: Our population is composed of 26 males and 34 females (sex ratio =1.30 vs 1.4 in literature). Mean age at diagnosis is 45.6±11 years (range 2174). These patients came to our unit for headaches and or visual disturbances and rarely for gonadal abnormalities.
There is a diagnosis retardation of 2±1 years (1 month to 19 years) regarding to first ophtalmological symptoms.
For clinical signs pituitary insufficiency is in the first position. There is no diabetes insipidus. Neurological and or psychiatric disorders are observed in 17% (10/60). Hormonal results show a total or partial (≥ 2) pituitary deficits in 75% (45/60), high prolactin in 29%. Visual abnormalities are seen in 75% with blindness in 20%. For radiological results we have 5 microadenomas (<10 mm) =8% and 55 macroadenomas (≥10 mm) =92%. Among macroprocessus 22% are giant (≥4 cm).
Conclusion: In this study NFPA are observed with equal frequency in men and women. 92% are macro or giant adenomas, so they have many complications as neurological or psychiatric troubles (17%), pituitary deficits (75%) and visual damages (75%). Our results agree with those reported in literature.
01 - 05 Apr 2006
European Society of Endocrinology