Endocrine Abstracts

Background and aims: Pituitary adenomas (PA) are small, generally benign tumors found in the pituitary gland. PA in men are rare However, they are characterized by the frequency of invasive and aggressive tumours, which makes their management difficult. The aim of this study is to clarify radiological characteristics of pituitary adenomas in men. Materials and methods: Retrospective descriptive study of 80 adult men with PA, hospitalized in the endocrinology department from 1998 to 2020. It included 35 non-functioning adenomas (NFPA), 27 prolactin adenomas, 15 somatotropic adenomas and 3 corticotropic adenomas.

Results: The mean tumour size was 31.6 mm ±17.2 [5–90 mm] with macroadenomas predominating; 55 cases (68.7%). Prolactinomas had the largest dimensions with a mean height of 46 mm [9–90 mm] compared to 27.8±12 mm [9–56 mm] for NFPA, 27.6 mm ±8.9 [9–56 mm] for somatotropic adenomas and 14.3 mm [5–37 mm] for corticotropic adenomas. Fifteen patients (18.7%) had a giant adenoma of which 13 patients had a prolactinoma. Macroadenomas were predominant in NFPA (88.5%), somatotropic adenomas (73.3%) and corticotropic adenomas (66.6%). Prolactin adenomas and NFPA were predominantly T2 hypersignal (71.1% and 74% respectively). Somatotropic adenomas, on the other hand, were predominantly T2-hyposignal (60%). Suprasellar extension was the most frequent, whatever the type of adenoma (59 cases, 73.7%), i.e. 82.8% of NFPAs, 85.2% of prolactinomas, 33.3% of somatotropic adenomas and 66.6% of corticotropic adenomas. Compression of the optic chiasma was found in 35% of cases and hydrocephalus in 15% of patients. The pituitary stem was compressed in 21.2% of cases. Lateral extension to the cavernous sinuses was found in 42.5% of cases, i.e. 66.6% of corticotropic adenomas, 45.7% of NFPA, 48.1% of prolactinomas and 20% of GH adenomas. Invasion of the sphenoidal sinus was noted in 16.2% of cases, all were giant adenomas. Posterior extension to the brainstem and prepontine cisterns was noted in 3 cases. The post-pituitary gland was pushed back in 2 cases. Finally, extension to the nasal cavity and orbit was noted in 3 cases. Radiological pituitary apoplexy was found in 38.7% of PA. A cystic component was present in 20% of NFPA and 30.7% of giant prolactinomas. Only one PA was abcessed. This was a NFPA.

Conclusion: PA are characterised by the frequency of macroadenomas and by a greater potential for progression. They are more prone to pituitary apoplexy, which causes higher morbidity and mortality.