Endocrine Abstracts

Introduction: Pituitary adenomas in general are deemed to be more aggressive in males. Our aim is to analyze somatotrop adenomas (SA) characteristics and neurological complications. In the second time we will compare male and female cases.

Subjects and methods: In this retro-and prospective study, 112 pure and mixed SA diagnosed between 1980 and 2012 were analyzed. They all had hormonal assessment (GH before and after OGTT±IGF1, PRL, cortisol, ACTH, testosterone/E₂, FSH, LH, TSH, FT₄), ophthalmological examination and cerebral CT scan, or MRI or both.

Results: Sex-ratio=1, mean age 39.11 years (14–60). Paediatric forms=8.03%. Mean tumour volume=117.1 mm³. Giant forms (height ≥40 mm)=10%. Mean GH=62.3 ng/ml. IGF1 was increased in all tested cases. Cavernous system invasion was observed in 42.15%. Gonadotrop deficit=44.8%, corticotrop=22.22% and thyreotrop=21.59%. Global pituitary insufficiency=4.58%. Posterior pituitary deficit=0%. Optic atrophy=2.9%. We did not observe any severe neurological complications such as hydrocephalus, convulsions, frontal syndrome, meningitis, memory troubles and unconsciousness, but we had some apoplexy.

Sexual comparison showed men were diagnosed later (39.89 years vs 30.33, P=0.01). We did not find any difference in tumour volume and GH rate before and after OGTT, but women had more invasive tumours (P=0.03). Thyreotrop and gonadotrop deficits were more frequent in women (respective P=0.016, 0.000075).

Conclusion: In this study where the sex-ration is equal to one, female cases appeared more aggressive although male cases were diagnosed later. To explain this difference the role of estrogens should be discussed.