Aim of the research: To study special features of pituitary adenoma (PA) clinical manifestation depending on hormonal characteristic and histological structure, and reveal correlation between clinical manifestation and tumor pathology.
Materials and methods: 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.
According to K. Thapar classification (1977), 4 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). PA was diagnosed in according with clinical signs, hormonal tests, neuroendocrine status and histological analysis. All patients were undergone surgical treatment by transsphenoidal access Center of Endocrinology of MoH RU in neurosurgery department during 20142015 years.
Results: According to histology, 47 adenomas (71%) were chromophobe, 15 adenomas (23%) were acidophilic and 2 adenomas (3%) were basophilic, and 2 adenomas (3%) were defined as compound.
Comparison between histological structure and clinical manifestation revealed that chromophobe prolactinomas showed progressive course, big size of the tumor with the tendency to extrasellar growth and barely respond to conservative treatment. Acidophilic prolactinomas performed gradual onset with the endocrine dysfunction, body mass changes, dysmenorrhea, galactorrhea, intracranial hypertension and erectile dysfunction in men.
Histology in 4 patients revealed basophilic structure of PA and clinical manifestation have seen in short period.
Clinical manifestation of NFPA presented in all patients with the focal symptoms, including dislocation and hypertension syndromes, visual and oculomotor disturbances. Besides, there apoplexy symptoms have seen which degree depended on the course of disorder.
Conclusions: In according with literature reviews and own study results early clinical symptoms of PA should be evaluated opportunely and indications for surgery should be defined taking into account clinical forms which decreases the complications development risk.