Radiological features of non-functioning pituitary adenomas in the Tunisian population

Abdel Mouhaymen Missaoui; Nabila Rekik Majdoub; Siddiqa Soomauroo; Faten Haj Kacem Akid; Dhoha Ben Salah; Fatma Mnif; Nadia Charfi; Mouna Mnif; Mouna Elleuch; Mohamed Abid

doi:10.1530/endoabs.90.EP783

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Endocrine Abstracts (2023) 90 EP783 | DOI: 10.1530/endoabs.90.EP783

ECE2023 Eposter Presentations Pituitary and Neuroendocrinology (234 abstracts)

Radiological features of non-functioning pituitary adenomas in the Tunisian population

Abdel Mouhaymen Missaoui , Nabila Rekik Majdoub , Siddiqa Soomauroo , Faten Haj Kacem Akid , Dhoha Ben Salah , Fatma Mnif , Nadia Charfi , Mouna Mnif , Mouna Elleuch & Mohamed Abid

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Hedi Chaker University Hospital, Department of Endocrinology, Sfax, Tunisia.

Objective: To describe the radiological features of non-functioning pituitary adenomas (NFPA) at diagnosis.

Patients and methods: A retrospective descriptive study of 35 patients followed for NFPA between 2000 and 2022. A pituitary magnetic resonance imaging (MRI) scan was performed in all patients.

Results: The mean age was 52.1±11.4 years with a male predominance (61.3%). Pituitary tumor syndrome was the main reason for consultation (77.4%). Visual impairments were observed in 80.6% of cases. It was frequently a macroadenoma in 90%, and a microadenoma in 10%. The majority of tumors were between 1 and 2 cm in size (46.7%). In 10% of the cases, the NFPAs were larger than 4 cm in diameter. Radiological analysis revealed hemorrhagic lesions in 25% of cases, and rarely a necrotic aspect (19.2%). Optic structures were invaded in 41.4%. Sphenoidal sinus infiltration was observed in 32.1%. In two-thirds of the cases, the cavernous sinus was invaded, indicating a locally advanced tumor status. The NFPA showed an aspect encompassing the internal carotid artery partially (< 180°) in 53.3% and massively (> 180°) in 13.3% of cases.

Discussion: The most common radiological findings at the time of diagnosis of NFPA are those of a locally aggressive sellar tumor invading the noble visual and vascular structures. This locoregional aggressiveness poses a therapeutic challenge, particularly for surgical resection, which is often incomplete. The tumor residue is a major prognostic factor that requires clinical, ophthalmological, and radiological monitoring, sometimes with adjuvant treatment (radiotherapy, surgical revision).

References: 1. Chanson, Philippe, et al. “Management of clinically non-functioning pituitary adenoma.” Annales d’endocrinologie. Vol. 76. No. 3. Elsevier Masson, 2015.

2. Ntali, Georgia, and John A. Wass. “Epidemiology, clinical presentation and diagnosis of non-functioning pituitary adenomas.” Pituitary 21.2 (2018): 111–118.