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Endocrine Abstracts (2022) 81 EP651 | DOI: 10.1530/endoabs.81.EP651

ECE2022 Eposter Presentations Pituitary and Neuroendocrinology (211 abstracts)

Unusual evolution of a non-functionning pituitary adenoma

Yosra Hasni1, 2, Marwa El Arem1, Hamza Elfekih1,2, wiem saafi1, Abdelhafidh Slimane3, Amel Maaroufi1, 2, Maha Kacem1, 2, Molka Chadli Chaieb1, 2 & Koussay Ach1,2


1Farhat-Hached University Hospital, Endocrinology-Diabetology Department, Sousse, Tunisia; 2Faculty of Medicine Ibn El Jazzar, University of Sousse, Sousse, Tunisia; 3National Institute of Neurology, Department of Neurosurgery, Tunis, Tunisia


Introduction: Pituitary neuroendocrine tumors (PitNET) represent 15.5% of primary brain tumors and they can be clinically functioning or non-functioning. Although they are mostly benign, PitNET may be invasive in 30-45% of cases and aggressive in at least 15%. Here, we report the case of a patient who presented a multiple and rapid recurrence of a non-functional pituitary macroadenoma.

Observation: A 42-year-old man was admitted initially for headaches, monocular blindness and Knosp grade 3A macrodenoma on MRI. Biochemial analysis didn’t reveal hormones deficiencies nor hypersecretions. He underwent a transphenoidal resection with a visual improvement. Histologic diagnosis was a null cell adenoma with Ki67 index = 4% and a positive p53. Based on the new classification of PitNET, it was proliferative and invasive tumor, classsified garde 2b. Six months later, he deveolpped a tumor regrowth with visual impairment (diplopia), for which he underwent a partiel resection and an adjuvant radiotherapy was planned. Before starting the radiotherapy, he was readmitted 6 months later for a complete ptosis of the right eye and an increase in size of his non-functionning pituitary macroadenoma.

Discussion: This case showed that invasive and proliferative non-functionning pituitary adenomas can have an unpredictable rapid recurence and an agressive behaviour than usual. Null cell adenoma are known to be more aggressive than the other types of tumors with a mean time to recurrence of 15.9 months. In our case, the time to recurrence was 6 months only between the first and second surgeries. Selecting the high risk of recurrence tumors is essential to avoid their impacts and to improve the quality of life of patients.

Volume 81

European Congress of Endocrinology 2022

Milan, Italy
21 May 2022 - 24 May 2022

European Society of Endocrinology 

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