ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P460

Intrasellar and parasellar tumors - concomitant symptoms and clinical syndromes

Maria Kurowska, Joanna Malicka, Jerzy S Tarach, Agnieszka Zwolak, Marta Dudzinska & Mariusz Kowalczyk

Department of Endocrinology, Lublin, Poland.

Introduction: Pituitary gland, sella turcica and parasellar region can be involved by wide variety of lesions. Diagnosis of this pathology demands a multidisciplinary effort, especially endocrinological, ophthalmologic and neurological procedures. Each of these entities has unique diagnostic and treatment considerations.

Aim: Review of clinical symptoms related to sellar–parasellar region tumors and documentation of heterogeneity of clinical syndromes accompanying their diagnosis in own material.

Material: 105 pts (63F; 42M) aged 18–83, observed in 2000–2007 in our department.

Method: Analysis of clinical picture, hormonal and visual studies.

Results: Intrasellar pituitary adenomas composed 85% (89 pts) of the whole group, including 73 macroadenomas (with 1 Nelsons’ syndrome and 3 corticothroph tumors) and 16 microadenomas (1 TSH-oma). Among intrasellar tumors of extrapituitary origin 2 chordomas and 1 meningioma have been found. Extrasellar tumors comprised 14.3% (15 pts) of cases, with 3 craniopharyngiomas, 2 meningiomas, 2 cysts, 1 germinoma and 3 extremely rare: involving the sella brown tumor, pituitary stalk granular cell tumor and located in sphenoid sinus somatotroph adenoma among them. In four remaining patients pituitary metastases of breast (2 pts), lung (1) and prostate (1) carcinomas have been recognized. In the group of hormonal active pituitary adenomas we found: acromegaly in 21 subjects, prolactinoma in 10, Cushing disease in 8 and secondary hyperthyroidism in 1 patient. Among pituitary adenomas 51.5% were hormonally inactive. Parasellar tumor invasion (cavernous sinus, suprasellar region, sphenoid sinus) was observed in 78.1%. At least one of the mass effects (headache, cranial nerves paralysis, epilepsy, deafness, visual defects, anosmia, hyperprolactinemia and diabetes insipidus) or pituitary anterior lobe insufficiency have been found in 40 pts. Clinically evident pituitary apoplexy has appeared in 9 subjects.

Conclusion: Abundant symptomatology and disturbed pituitary functions caused by sellar–parasellar tumors require broad knowledge of several allied medical domains.

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