Endocrine Abstracts

JOINT479

Background: Pituitary adenomas are the most common pituitary lesions. The prevalence of incidental pituitary adenomas ranges from 10% to 22%. In contrast, the prevalence of undiagnosed macroadenomas is very low, primarily due to their mass effects on nearby structures or their hormonal activity. Other, less common lesions are pituitary carcinoma, craniopharyngioma or Rathke’s cleft cyst.

The objective: of this retrospective observational study was to evaluate the prevalence of pituitary tumors, as well as their demographic characteristics, treatment approaches, and clinical outcomes.

Methods and Results: In a single centre of the University Hospital, altogether 196 patients were diagnosed with pituitary tumors based on their laboratory and imaging results between 2009 and 2024 (106 women, 90 men, age 22–92 years). Of these, 125 patients were diagnosed with macroadenoma (63.8% vs. 68.7% in literature), 41 with microadenoma (20.9% vs. 10% in literature), 4 (2%) with picoadenoma, 5 (2.6%) craniopharyngiomas, 17 (8.6% vs. 13.1% in literature) Rathke’s cleft cysts, and 4 (2%) other lesions, respectively. Surgical resection was performed in 103 patients (52.6%), and 11 (10.7%) of them required surgical revision. Additionally, 38 patients (19.4%) underwent radiation therapy. Histological analysis of resected macroadenomas revealed the following subtypes: 32 (38.6% vs. 22.8% in literature) nonfunctioning adenomas, 21 (25.3% vs. 21.8% in literature) gonadotroph adenomas, 18 (21.7% vs. 9.6% in literature) somatotroph adenomas, 5 (6% vs. 28.3% in literature) prolactinomas, 4 (4.8% vs. 9.4% in literature) corticotroph adenomas, and 3 patients (3.6%) with somatomammotroph adenomas. Based on hormonal secretion, 83 (66.4%) were non-functioning adenomas, growth hormone production was detected in 23 (18.4%), PRL secretion in 16 (12.8%), and ACTH secretion was demonstrated in 2 (1.6%) patients. One patient (0.8%) was diagnosed with concurrent PRL and GH secretion. Among microadenomas, 22 (53.6%) were non-functioning, 12 (29.2%) produced PRL, 5 (12.2%) GH, and 2 (4.8%) had ACTH, respectively. Overall, hypopituitarism developed in 77 patients (39.3% vs. 37–85% in literature). Gonadotropin deficiency was found in 26 (13.3% vs. 36–96% in literature), TSH deficiency in 55 (28.1% vs. 8–81% in literature), GH deficiency in 7 (5.6% vs. 61–100% in literature), and diabetes insipidus in 18 patients (9.2%). Hydrocortisone supplementation was required in 66 patients (33.7% vs. 17–62% in literature).

Conclusion: Among pituitary tumours, the most common are nonfunctioning adenomas. The prevalence of hypopituitarism was relatively high in our patients. Early diagnosis improves the clinical outcome of patients and may prevent irreversible pituitary destruction.