Endocrine Abstracts (2009) 20 P215

Neuroendocrine disorders of patients with pituitary tumours

Said Ismailov, Kozim Makhkamov, Michael Powell, Ashley Grossman, Zamira Khalimova & Yulduz Urmanova

Institute of Endocrinology, Tashkent, Uzbekistan.

Aim: Aim of research is to study special features of pituitary adenoma (PA).

Materials and methods: Seventy-four operations on CST were performed. Outcomes of surgery in 66 patients with PA were analyzed. Age of patients at surgery was from 18 to 71 years. Mean age of patients – 44 years. Four patients (6%) had a corticotropinoma, 11 patients (17%) had somatotropinoma, 11 patients (17%) had prolactinoma and remaining 40 patients (60%) had non-functioning pituitary adenomas (NFPA). Analyzed patients with PA undergone transnazall selective hypophysisectomy surgery (TSH).

Results: In patients with NFPA manifestation of disease signs of cerebral hypertension (100%), visual disturbances (83.2%), secondary hypopituitarism (59%) and hyperprolactinemia (56.5%). Among operated patients with ACTH-secreting PA, all patients were females including 3 cases (75%) with obesity, 4 cases with hyrsutism (100%), 3 women with amenorrhea and 1 female (25%) with myopathy. Fifty-six cases (85%) neurological symptoms regressed right after TNS, in 8 cases (12%) focal signs regressed partially and worsening of presented neurological deficiency have seen in 2 cases (3%). Eleven patients with acromegaly after TSH have shown signs such as changes in facial appearance (100%), headaches (88.9%), increased sweating (68.7%), in men, decrease of libido and erectile dysfunction (91.2 and 58.7% respectively).

Conclusions: (1) During the analysis of clinical manifestation and hormonal activity of PA there characteristic features revealed in clinical and neurological course. (2) Among the histological types of pituitary tumors in prolactinomas and somatotropinomas there are acidophilic adenomas prevail in comparison with less rare chromophobe adenomas. (3) As somatotropinomas have invasive growth and recurs postoperatively there is need in radiotherapy. (4) NFPA characterized with consecutive manifestation; initially, brain and focal symptoms occur as the result of tumor focal effects and then endocrine symptoms appear which are result in secondary endocrine deficiency with obliterated flow.

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