ECEESPE2025 Poster Presentations Pituitary, Neuroendocrinology and Puberty (162 abstracts)
Age-related differences in the clinical features and management of pituitary apoplexy: insights from a spanish cohort study
Betina Biagetti 1 , Esteban Cordero 2 , Víctor Rodríguez Berrocal 3 , Cristina Álvarez Escolá 4 , Andreu Simó-Servat 5 , Rocio Villar Taibo 6 , Pedro Iglesias 7 , Carlos Pérez-López 8 , Pablo García Feijoo 8 , Marta Araujo Castro 9 , Fernando Guerrero 10 , Cristina Lamas 11 , María Dolores Moure 12 , Guillermo Serra Soler 13 , Ana Irigaray 14 , Rosa Camara-Gómez 15 , M Dolores Ollero 16 , Almudena Vicente 17 , Inmaculada Gonzalez-Molero 18 , María Noelia Sánchez Ramírez 19 , Julia Garcia Arabehety 1 , Alba Gutierrez Hurtado 20 , Vanessa Capristán Díaz 7 , Marta Gallach 11 , Eva Safont Perez 21 , Victoria González Rosa 22 , Soralla Civantos 23 , Edelmiro Luis Menendez Torre 20 , Elena Martinez-Saez 24 , Anna Aulinas Maso 25 , Juan Jose Diez 26 , Ignacio Bernabeu 27 & Manel Puig-Domingo 28
1Hospital Universitario Vall d’Hebron, Endocrinology, Barcelona, Spain; 2Hospital Universitario Vall d’Hebron, Neurosurgery, Barcelona, Spain; 3Hospital Universitario Ramón y Cajal, Neurosurgery, Barcelona, Spain; 4Hospital Universitario La Paz, Endocrinology, Madrid, Spain; 5Hospital Universitario Mutua de Terrasa, Endocrinology, Terrasa, Spain; 6Hospital Universitario de Santiago de Compostela, Endocrinology, Galicia, Spain; 7Hospital Universitario Puerta de Hierro., Madrid, Spain; 8Hospital Universitario La Paz, Madrid, Spain; 9Hospital Universitario Ramón y Cajal, Endocrinology, Madrid, Spain; 10Hospital Universitari de Bellvitge, Endocrinology, Barcelona, Spain; 11Complejo Hospitalario Universitario De Albacete, Albacete, Spain; 12Hospital Universitario de Cruces, Bilbao, Spain; 13Son Espases University Hospital, Palma de Mallorca, Endocrinology, Palma de Mallorca, Spain; 14Hospital Universitario de Navarra, Endocrinology, Navarra, Spain; 15Hospital la Fe de Valencia, Endocrinology, Valencia, Spain; 16Hospital Universitario de Navarra, Navarra, Spain; 17Hospital Universitario de Toledo, Toledo, Spain; 18Hospital Regional Universitario de Málaga, Malaga, Spain; 19Hospital Universitario Ramón y Cajal, Endocrinology, Barcelona, Spain; 20Hospital Universitario Central de Asturias, Asturias, Spain; 21Hospital de la Santa Creu i Sant Pau, Endocrinology, Barcelona, Spain; 22Hospital Universitario Insular de Gran Canaria, Endocrinology, Gran Canaria, Spain; 23Hospital Universitario Funelabrada, Fuenlabrada, Spain; 24Hospital Universitario Vall d’Hebron, Barcelona, Spain; 25Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; 26Hospital Universitario Puerta de Hierro., Fuenlabrada, Spain; 27Hospital Universitario de Santiago de Compostela, Galicia, Spain; 28Hospital Germans Trias i Pujol, Badalona, Spain
JOINT22
Background: Pituitary apoplexy (PA) is a potentially life-threatening rare clinical syndrome. The objective of this study was to analyze the clinical presentation, treatment approaches, and outcomes of PA in patients younger than 65 years compared to those aged 65 years and older at PA diagnosis.
Methods: Retrospective, multicenter study including 301 patients diagnosed with PA from 2010 to 2023 across 18 medical centers in Spain. Patients were categorized into two groups based on age (<65 years and ≥65 years). Baseline characteristics, clinical presentation, treatment approaches (surgical vs. conservative), and outcomes were analyzed.
Results: Out of the 301 patients, 185 (61.5%) were younger than 65 years and 116 (38.5%), were 65 years or older. Older patients had a higher prevalence of comorbidities, such as diabetes (11.4 vs. 34.5%; P < 0.01), hypertension (29.7 vs. 79.3%; P < 0.01), dyslipemia (32.4 vs. 62.9%; P < 0.01) and cardiovascular disease (4.3 vs. 27.6%; P < 0.01). No significant differences were observed in clinical presentation, including Pituitary Apoplexy Score and radiological findings except for higher frequency of cranial nerve palsy (46.2 vs. 64.9%; P = 0.02) and decreased consciousness (12.0 vs. 20.7%; P = 0.04), that was higher in older patients. Regarding treatment approach, surgery was underwent in 209 and conservative approach in 92 patients without differences between age groups (29.9 vs. 32.8%; P = 0.52). In the histological study, necrosis was more frequent in older patients (66.7 vs. 80.6%; P = 0.04). Regardless of the treatment approach there were no statistically significant differences in outcomes. However, in patients managed conservatively, the percentage of spontaneous tumor shrinkage, was more pronounced in older patients (39.1±38.7 vs. 58.7±28.1%; P = 0.03).
Conclusions: While older patients with PA had higher rates of comorbidities and specific neurological symptoms, the clinical presentation and treatment approaches were largely similar across age groups. Older patients showed greater spontaneous tumor shrinkage with conservative management. These findings suggest that advanced age alone should not guide PA management, as outcomes appear comparable regardless of treatment approach across age groups. Given the higher frequency of necrosis observed in older patients, computed tomography imaging could underestimate the presence of apoplexy in this group, thus, the magnetic resonance imaging should be prioritized during the diagnostic workup for pituitary apoplexy in elderly individuals.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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