Endocrine Abstracts (2017) 49 EP907 | DOI: 10.1530/endoabs.49.EP907

Diagnosis, treatment and follow-up of non-functioning pituitary adenomas

Ana Barrera-Martín1, Paloma Moreno-Moreno1, María-Rosa Alhambra-Expósito1, Aura-Dulcinea Herrera-Martínez1, Ángel Rebollo-Román1, Pedro-Blas García-Jurado2 & María-Ángeles Galvez-Moreno1

1Endocrinology Service. Hospital Universitario Reina Sofia, Córdoba, Spain; 2Radiology Service. Hospital Universitario Reina Sofia, Córdoba, Spain.

Introduction: Non-functioning pituitary adenomas (NFPAs) represent the most common pituitary tumour. They usually appear in the middle age of life, without differences between genders. Mass growth produces the first symptoms so the diagnosis is usually late. Surgery is the first-line treatment with variable success (19-83%). The objective of this study is to evaluate the symptoms, diagnosis, treatment and final state of patients with NFPAs.

Methods: Observational retrospective study of patients with NFPAs evaluated between January 2002 and December 2015 at “Hospital Universitario Reina Sofía” in Córdoba. Results were analysed with SPSS 18.0.

Results: 34 patients, 50% women. Mean age: 56.2±11.9 years old. Mean follow-up: 5.2±3.9 years (range: 1-14 years). Symptomatology: 38.2% campimetric alterations, 35.3% headache and 11.8% symptoms derived from hormonal deficits. 29.4% incidental diagnosis in magnetic resonance imaging. Mean diameter of tumour: 30.2±11.4 mm. 64.7% extrasellar growth, 55.9% chiasmal compression, 23.5% grade I of Knosp classification. Initial treatment: 91.2% transsphenoidal surgery (8.8% cabergoline). 64.7% post-surgery complications. Anatomopathological diagnosis: pituitary adenoma, except 1 patient with tissue necrosis; 11.8% patients had p53 positive; mean Ki-67: 2±2.4%. Only 5 patients were cured after the first surgery (2 patients had recurrence) and 29 had radiological persistence of disease. Adjuvant treatment: cabergoline (10 patients), radiotherapy (11 patients), radiosurgery (2 patients), second surgery (10 patients) and third surgery (2 patients). Finally, 26.5% of patients are cured and 73.5% have persistent disease. Hormonal deficits: 44.1% pre-surgery and 79.4% post-surgery. Campimetry improved in all patients.

Conclusions: i) There are not differences in the prevalence of NFPAs by gender in our series. ii) The diagnosis was motivated by the symptomatology (predominantly visual); less frequent incidental diagnosis. iii) Most patients underwent transsphenoidal surgery, being the success of this first surgery in our series less than the published rates.

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