EYES2019 7th ESE Young Endocrinologists and Scientists (EYES) Meeting Oral Presentations (67 abstracts)
Non-functioning pituitary adenomas experience of a reference center
Clara Cunha 1 , Cátia Ferrinho 1 , Eugénia Silva 1 , Lídia Dias 2 , Conceição Marques 2 , Martinha Chorão 3 , Catarina Saraiva 1 & João Sequeira Duarte 1
1Department of Endocrinology and Diabetes, Hospital Egas Moniz, Lisbon, Portugal; 2Department of Neurosurgery, Hospital Egas Moniz, Lisbon, Portugal; 3Department of Pathological Anatomy, Hospital Egas Moniz, Lisbon, Portugal.
Objective: Describe clinical, laboratorial, imaging features, therapeutic management and the outcomes of patients with clinically non-functioning pituitary adenomas (NFPAs) presenting at our department.
Methods: Retrospective review of electronic medical records of all patients with NFPAs evaluated at our department between 2010 and 2019.
Results: We evaluated 160 patients, 51.3% female, with a median age of 56.6 years (18–89). Regarding comorbidities, 61.3% had hypertension, 21.3% were diabetic and 51.3% had dyslipidemia. At diagnosis 38.1% had visual field defects (n=61), 31.3% had headache (n=50), 5% apoplexy (n=8) and 25.6% was an incidentaloma (n=41). Pituitary function assessment showed that 50.6% had hypopituitarism, specifically hypogonadism in 33.1% (n=53), secondary adrenal insufficiency in 32.5% (n=52) and hypothyroidism in 24.4% (n=39). The NFPA were mainly macroadenomas (84.3%) with suprasellar extension (53.8%), 7.5% had left cavernous sinus invasion, 10.6% right cavernous sinus invasion, 3.1% bilateral cavernous sinus invasion and 6.9% sphenoidal sinus invasion. Median diameter of the adenoma was 17.5 mm (2.4-45.0). Surgery was performed as primary therapy in 71.9% patients (n=115) and radiotherapy in 0.6% (n=1). Complete removal of the NFPA was achieved with one surgery in 52.2% of patients (n=60). Immunohistochemical analyses showed 57 gonadotrophs, 13 silent corticotroph, 10 plurihormonal adenomas, 5 null-cell and 1 silent thyrotroph. Immunochemistry resulted negative in 46.3% of the tested pituitary tissues due to insufficient/ necrotic samples.
Discussion: Our data support the elevated prevalence of mass effect and hypopituitarism in patients with NFPAs. Recurrence due to invasion or incomplete resection of the tumor is quite common.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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