Endocrine Abstracts

Introduction: Non functioning pituitary adenomas (NFPA) frequency varies from 15 to 30% among all pituitary adenomas. Some authors think they are more aggressive and at risk of pituitary apoplexy. Our aim is to analyze their characters and their complications.

Subjects and methods: It is a retrospective study that takes in account 37 subjects having a NFPA and recruited from 2005 to 2012. Among this group only 13 have been operated on and had immunochemical study. They were all questioned and had clinical and ophthalmological examination. Hormonal assessment and cerebral MRI were also done. We checked for posterior pituitary insufficiency too.

Results: We observed 26 men and 11 women (sex ratio=0.42), mean age=50.13 years. Among them 15% were gonadotrop. They consulted for visual troubles in 44%, severe neurological problems in 33%, endocrine problems in 11% and the NFPA was incidentally discovered in 19.4%. They are giant (height ≥4 cm) in 21.7% and invading the cavernous sinuses in 45%. Other invasions are: anterior (orbital and/or nasal)=8%, temporal (6.45%), frontal (6.45%), post (2.7%). Among endocrine complications gonadotrop deficit is observed in 51% and a multiple deficit in 36%. Diabetes insipidus=2.6%. Thyreo- and corticotrop axis are the most preserved. Optic atrophy±nerves palsy=42%, convulsion, apoplexy, hydrocephalus and unconsciousness are observed in 10.8%.

Conclusion: NFPA prevail in male, there are giant in 21% and invasive in 45% which explains numerous complications such as multiple pituitary deficits, severe ophthalmological and life threatening neurological troubles which are observed in a high rate compared to other pituitary adenomas.