Endocrine Abstracts (2012) 29 P1139

Pituitary incidentaloma: clinical presentation and endocrine evaluation in a Spanish population

M. Alhambra Expósito, M. Gálvez Moreno, C. Tenorio Jiménez, P. Moreno Moreno & P. Benito López

Reina Sofia University Hospital, Córdoba, Spain.

Introduction: The incidence of previously unrecognized lesions within the pituitary has been studied by MRI. The data suggest that up to 10% of people have clinically unsuspected pituitary tumors, the majority being<10 mm. Currently, little information is available about the prevalence of incidentally-discovered sellar masses.

Objective: To perform a clinical audit on pituitary incidentalomas in order to establish an appropriate clinical approach to them.

Patients and Methods: Twenty three patients were referred to our endocrine department between January 1990 and July 2011 for evaluation of incidentally-discovered pituitary lesions. All patients underwent a complete history, physical examination, laboratory evaluation for hormone hypersecretion and hypopituitarism and a formal visual field examination. Clinical presentation, type of imaging used and endocrine status are evaluated retrospectively.

Results: Twenty three patients (16 female) with a mean age of 41.3±19.2 years were included. 91.3% of them were diagnosed through brain magnetic resonance imaging (MRI) and 8.7% through Computed Tomography (CT). The reasons for head CT and/or MRI are shown in Table 1. 16 patients were diagnosed with non-functioning pituitary adenomas (69.5%), two with microprolactinomas (8.6%), two with hypophysitis (8.6%), one with Cushing’s Disease (4.3%) and one with craneopharingyoma (4.3%). Of 16 patients diagnosed with non-functioning pituitary adenoma (mean size 7.9±6.3 mm, range 2–23 mm), 13 patients had a microadenoma without pituitary dysfunction. Of the three macroadenomas, 2 had hypogonadotrophic hypogonadism.

Conclusions: Despite the high prevalence of pituitary incidentalomas, the literature reporting on the natural history of this entity is scarce. In our study we found an important prevalence of endocrine abnormalities whose adequate diagnosis is essential.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Table 1 Reasons which led to MRI and/or CT.
Total (n=23)
Headache 6 (26.1%)
Stroke 3 (13.0%)
Obesity 2 (8.7%)
Amenorrhoea 2 (8.7%)
Infertility 2 (8.7%)
Head injury 1 (4.35%)
Basal cell cancer 1 (4.35%)
Other brain diseases 3 (13.0%)
Unknown 3 (13.0%)

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