Non-functional pituitary adenomas: management and therapeutic outcomes in the Tunisian population

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

doi:10.1530/endoabs.90.EP876

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Endocrine Abstracts (2023) 90 EP876 | DOI: 10.1530/endoabs.90.EP876

ECE2023 Eposter Presentations Pituitary and Neuroendocrinology (234 abstracts)

Non-functional pituitary adenomas: management and therapeutic outcomes 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 assess the management and therapeutic outcomes of non-functioning pituitary adenomas (NFPA) in the Tunisian population.

Patients and Methods: We conducted a retrospective descriptive study of 35 patients followed for NFPA between 2000 and 2022 at the endocrinology department of Hedi Chaker University Hospital.

Results: The mean age was 52.1±11.4 years, with a male predominance (61.3%). The majority of tumors were between 1 and 2 cm in size (46.7%). In half of the cases (53.1%), surgical treatment was performed. Pituitary apoplexy (35.3%), optic tract invasion (29.4%), and large tumor size (23.5%) were the main indications for surgery in our series. Tumour resection was often incomplete with remnants in 71.4%. The tumor residue size was >3cm in 63.6% of the surgeries. Second-line treatment was indicated for 54.5% of patients, including re-do surgery (18.8%), radiotherapy (18.8%), or medical treatment (18.8%). No second-line treatment was performed in 45.5% of cases despite the persistence of a tumor remnant. Post-operatively, an improvement in visual disorders (53.8%) was generally obtained at the cost of stabilization or worsening of pituitary insufficiency in 92.4%. The average follow-up time was less than 5 years for 60% of our patients.

Discussion: Complete remission is difficult to achieve in NFPA compared to secreting adenomas. The recurrence and progression rate of NFPA after initial surgery varies from 15-66%. This rate may be reduced to 2-28% after adjuvant radiotherapy. Long-term clinical and radiological monitoring is strongly recommended.

References: 1. Chanson, Philippe, et al. "Management of clinically non-functioning pituitary adenoma." Annales d’endocrinologie. Vol. 76. No. 3. Elsevier Masson, 2015. 2. Schorr, Melanie. "Nonfunctioning Pituitary Adenoma: Management." Pituitary Tumors. Springer, Cham, 2018. 21-29.