Endocrine Abstracts

JOINT3928

Objective: The association between growth hormone (GH)- secreting pituitary adenomas and primary empty sella (ES) has been reported mostly in case reports and is thought to be rare. In this study aimed to evaluate the coexistence of primary ES in newly diagnosed acromegaly and to investigate the effect of the presence of ES on the clinical and laboratory parameters of acromegaly.

Methods: Fifty-two patients with GH-producing pituitary adenomas who were followed up in our clinic between February 2017 and June 2024 and whose pituitary magnetic resonance imaging (MRI) was available at the time of diagnosis were analyzed retrospectively. Pituitary magnetic resonance imaging (MRI), computed tomography (CT) imaging, and pituitary function tests were evaluated. ES was defined as the pituitary gland and adenoma occupying less than 50% of the sella turcica on midsagittal magnetic resonance (MR) imaging. Demographic data, pituitary adenoma size, hormonal profile and postoperative pathologies of the patients were examined.

Results: Of 52 patients with acromegaly due to GH-producing pituitary adenomas, 27 (51.9%) were female and 25 (48.1%) were male (age range 21-73 years). Empty sella was detected in 8 (15.4%) patients and 2 had complete and 6 had partial empty sella. No ectopic adenoma cases were found in acromegaly patients with empty sella. No significant difference was found in preoperative pituitary hormone levels in patients with and without ES. Postoperative GH and insulin-like growth factor 1 (IGF-1) levels decreased in all patients.

Conclusion: This study showed that newly diagnosed acromegaly and primary ES coexisted in 15.4%. Acromegaly and ES coexisted more frequently than expected. The pathophysiology of this coexistence may be due to soft and hard tissue changes and serebrospinal fluid pressure changes that develop with the paracrine effect of GH during abundant GH production. The association between GH-producing adenomas and ES is not rare, but the underlying mechanism is not yet clear and requires further study.