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

Endocrine Abstracts (2019) 63 P258 | DOI: 10.1530/endoabs.63.P258

Anterior pituitary insufficiency in clinically non-functioning pituitary microadenoma

Karina Arcano1, Vanesa Triviño2, Paula García-Sancho3, Juan José Diez4, Fernando Cordido2, Carles Villabona3 & Pedro Iglesias4

1Hospital Universitario Rey Juan Carlos, Madrid, Spain; 2Hospital Universitario A Coruña, A Coruña, Spain; 3Hospital Universitario De Bellvitge, Barcelona, Spain; 4Hospital Universitario Puerta De Hierro, Madrid, Spain.

Background: Systematic exploration for anterior pituitary deficiency in patients harboring pituitary microadenomas is not well defined. So far, little is known on the involvement of pituitary function in clinically non-functioning pituitary microadenomas (CNFPM).

Objective: To evaluate the prevalence of anterior pituitary insufficiency, defined as at least one hormonal deficiency, in patients diagnosed of CNFPM.

Patients and methods: A multicenter retrospective study in patients diagnosed of CNFPM was performed. In every patient, clinical parameters (age at a diagnosis, sex, and main complaint at presentation) and endocrine dysfunction (the presence of hypopituitarism, number of axes involved, and hyperprolactinemia) were recorded.

Results: Of a total of 162 patients with CNFP adenomas, 31 patients (19.1%; mean age 43.6±15.65 yr (range, 14–83); 21 women (67.7%)) with microadenomas (median size 5 mm (IQR, 4–7 mm) were evaluated. In most patients (n=23, 74.2%), the finding of the pituitary microadenoma was incidental. In the remaining, the main complain at presentation was galactorrhea (n=3), erectile dysfunction (n=2), infertility (n=1), amenorrhea (n=1) and menstrual disorders (n=1). Anterior pituitary insufficiency was seen only in 2 patients (6.5%), both of them with only one hormonal deficiency. The first one was a 51-year-old woman who complained of facial pain. Pituitary MRI showed a 5 mm pituitary microadenoma and hormonal evaluation was compatible with ACTH deficiency (low/normal ACTH (13 pg/ml) with low cortisol (3.8 μg/dl)). The second one was a 28-year-old man studied for infertility. Investigations showed hypogonadotropic hypogonadism (low FSH (0.2 mU/ml), low LH (0.4 mU/ml) and low total testosterone (20 ng/dl)). Pituitary MRI showed a 4 mm pituitary adenoma. In both patients serum PRL concentrations were into the normal range.

Conclusion: In our series, the percentage of pituitary hormone deficiencies associated with CNFPM was very low (6.5%). Although the relationship between CNFPM and pituitary hormone deficiency might be coincidental, it would seem appropriate and prudent to rule out pituitary hormonal insufficiency in these patients.

Article tools

My recent searches

No recent searches.