Aim: To study features of neuroendocrine, hormonal and ophthalmic complications of giant pituitary adenomas depending on the volume and growth of the tumor (data from a prospective study).
Material and methods: Us for the period from 2020 to 2022. 151 patients with macro- and giant NFPA were prospectively examined. According to the size of pituitary adenomas, patients of prospective (151 patients) observation were divided into 2 groups: group 1 patients with macro NFPA 55 persons, group 2 patients with giant NFPA 96 persons. The patients were subjected to a complete examination: biochemical, hormonal, immunocytochemical, ophthalmic neuroimaging (MRI of the pituitary gland). Some of investigations have been repeated in various time. MRI showed that in half of the cases pituitary adenomas were observed with a total growth variant 104 cases (69.0%), as well as with endo- and suprasellar growth 25 (16.5%)
Results: The most common complaint in patients with pituitary adenomas were: headaches 122 patients (80.7%), bitemporal hemianopsia 128 (84.7%) secondary amenorrhea 51 patients out of 66 women (77.2%), decreased vision 95 (62.8%), etc. It was found that in the 2nd group of patients, panhypopituitarism was most common in 78 out of 96 patients (81.2%), postoperative panhypopituitarism occurred in 43 out of 96 patients (44.9%), while in group 1, panhypopituitarism was up to no operation was observed. Bitemporal hemianopsia was also observed with greater frequency in patients of group 2 93 cases (97%). In addition, secondary amenorrhea was also more common in patients of group 2 37 (38.5%). The most significant decrease in the average values of basal levels of tropic plasma hormones STH, LH, FSH, ACTH was recorded in patients of group 2. In addition, it was in these patients that the levels of cortisol and IGF-1 were also significantly reduced, while in patients of group 1, IGF-1 was on average within the normal range.
Conclusions: In general, patients had a decrease in the average values of tropic pituitary hormones, but most significantly and often in patients with giant pituitary adenomas. In patients with giant pituitary adenomas, first of all, there is a decrease in the level of growth hormone, FSH, LH (45%). The most pronounced neuroendocrine and ophthalmic disorders occurred in group 2 patients with giant pituitary adenomas.
13 May 2023 - 16 May 2023