Endocrine Abstracts

It is known from the literature that primary empty sella syndrome (PES) and secondary empty sella syndrome (SES) are distinguished. Empty sella syndrome is a radiographic finding characterized of a herniation of suprasellar cistern into the sella turcica. SES is a result of influence of surgery or radial therapy on hypothalamic-pituitary area. The aim of our study was a comparison the clinical features of primary and secondary empty sella syndrome.

Fifty four patients (47 females, 7 males, range 15–71 years) at an average age 43.4±11.2 years with PES were studied. The results were compared with earlier published data from 12 patients (females, range 23–42 years) at an average age 34±6.4 years with SES consequence the treatment by proton beam irradiation among 100 patients with Cushing’s disease with mean follow up 7±2.5 years.

Both the patients with PES and those with SES equally frequently had a headache (87% vs 83%) and visual disorders (87% vs 91.7%). Among endocrine abnormalities a hyperprolactinemia (24% vs 25%), hypothyrosis (22% vs 33%), type 2 diabetes (20.4% vs 16.7%) were found in PES group and SES group respectively. The patients with SES, compared to those with PES had a higher frequency of hypocorticoidism (25% vs 5.6%), disorders of menstrual cycle (41.7% vs 19%). In the group with PES compared to the group with SES more frequently were seen obesity (72% vs 41.7%), cranial diabetes insipidus (11% vs 0%), hypopituitarism (3.7% vs 0%).

In conclusion, we suppose that the common clinical features: headache, visual disorders, hyperprolactinemia observed in patients with PES and SES because of the presence of intracranial hypertension which was revealed in the most of the cases. The symptoms predominated in SES were due to earlier preceded hypercorticoidism and partially to radial therapy.